比索洛尔透皮贴剂对心脏直视手术后阵发性心房颤动的疗效

[Efficacy of Transdermal Patch of Bisoprolol for Paroxysmal Atrial Fibrillation after Open Heart Surgery].

作者信息

Yamamoto Kenji, Yamada Tomoyuki, Hamuro Mamoru, Kawatou Masahide, Enomoto Sakae

机构信息

Department of Cardiovascular Surgery, Okamura Memorial Hospital, Shizuoka, Japan.

出版信息

Kyobu Geka. 2017 Nov;70(12):971-977.

PMID:29104194

Abstract

2014 American Association for Thoracic Surgery (AATS) guidelines recommend beta blocker for prevention and management of perioperative atrial fibrillation and flutter for thoracic surgical procedures. In recent years, transdermal patch of bisoprolol (TDPB) has become available in Japan. We examined the efficacy of TDPB for paroxysmal atrial fibrillation (PAF) after open heart surgery. Among 289 patients who had undergone open heart surgery in our hospital from December 2013 to April 2016, 48(16.6%)patients, for whom TDPB was used for PAF, were analyzed retrospectively. The summary of our PAF protocol:HR >80;a sheet of TDPB (4 mg) is pasted, HR≤60;TDPB is removed, HR >140 persisted;another sheet of TDPB is added. Eighteen of the 48 (37.5%) patients recovered sinus rhythm within 24 hours. Six patients( 12.5%), because of persistent tachycardia, shifted to continuous infusion of landiolol. Ten underwent electrical defibrillation during hospitalization. In 3 patients, TDPB was removed due to advanced bradycardia. TDPB could be used safely and feasibly for PAF after open heart surgery.

摘要

2014年美国胸外科医师协会（AATS）指南推荐使用β受体阻滞剂预防和管理胸外科手术围手术期的心房颤动和心房扑动。近年来，比索洛尔透皮贴剂（TDPB）在日本已上市。我们研究了TDPB对心脏直视手术后阵发性心房颤动（PAF）的疗效。在2013年12月至2016年4月期间在我院接受心脏直视手术的289例患者中，对48例（16.6%）使用TDPB治疗PAF的患者进行了回顾性分析。我们的PAF治疗方案总结如下：心率>80；粘贴一片TDPB（4mg），心率≤60；移除TDPB，心率>140持续存在；添加另一片TDPB。48例患者中有18例（37.5%）在24小时内恢复窦性心律。6例患者（12.5%）因持续性心动过速转为持续静脉输注兰地洛尔。10例患者在住院期间接受了电除颤。3例患者因严重心动过缓移除了TDPB。TDPB可安全、可行地用于心脏直视手术后的PAF。