Sasano Tetsuo, Hirao Kenzo
Heart Rhythm Center, Tokyo Medical and Dental University.
Nihon Rinsho. 2013 Jan;71(1):67-71.
Rhythm control therapy improves the quality of life in properly selected patients with atrial fibrillation (AF). Sodium channel blockers are recommended as a first-line therapy for lone paroxysmal AF. Pilsicainide, a pure sodium channel blocker is the most frequently used drug in Japan. In addition to amiodarone, several reports performed in Japan described defibrillating effect of bepridil. These two drugs are considered as first choice for rhythm control treatment to lone persistent AF. Since sodium channel blockers increase mortality in patients with reduced cardiac function, amiodarone or bepridil are recommended for rhythm control in AF accompanied with structural heart disease. However, sufficient treatment for underlying heart disease is required prior to administration of antiarrhythmic drugs.
节律控制疗法可改善经适当选择的心房颤动（AF）患者的生活质量。钠通道阻滞剂被推荐作为孤立性阵发性AF的一线治疗药物。吡西卡尼，一种纯钠通道阻滞剂，是日本最常用的药物。除胺碘酮外，日本的多项报告描述了苄普地尔的除颤作用。这两种药物被认为是孤立性持续性AF节律控制治疗的首选。由于钠通道阻滞剂会增加心功能不全患者的死亡率，因此对于伴有结构性心脏病的AF，推荐使用胺碘酮或苄普地尔进行节律控制。然而，在给予抗心律失常药物之前，需要对基础心脏病进行充分治疗。
