Capucci A, Gubelli S, Carini G, Frabetti L, Magnani B
Istituto di Malattie dell'Apparato Cardiovascolare, Università degli Studi di Bologna.
G Ital Cardiol. 1987 Nov;17(11):975-82.
The efficacy of intravenous propafenone (P) infused at 2 mg/kg in 3 min as a loading dose followed by 0.007 mg/kg/min along 24 hours, in converting atrial fibrillation (AF) was evaluated under continuous electrocardiographic and blood pressure control in 22 patients. In case of inefficacy after a wash out of 24 hours, amiodarone (A) 5 mg/kg in 3 min followed by 1.8 gr/24 hours was infused. AF had to be constant (at least one 24/hour Holter recording) and of recent onset. All the patients were NYHA class 1 or 2. Ten patients reverted to sinus rhythm after P usually within 60 min; two of the non responders reverted after A and ten did not revert at all. RR intervals were significantly shorter in the responders compared to the others: mean value 537 +/- 64 vs 771 +/- 200 msec (p less than 0.001). During P the QRS duration increased 12.9% (p less than 0.005) and QTc of a lesser extent 7.8%; during A QRS did not modify significantly and QTc prolonged 9.5% (p less than 0.002). Propafenone i.v. infusion appears to be a rapid effective method of converting recent onset AF to sinus rhythm in patients with high ventricular rate. Amiodarone i.v. does not significantly help in converting to sinus rhythm the patients non responder to P.
在持续心电图和血压监测下，对22例患者评估了静脉注射普罗帕酮（P）的疗效。负荷剂量为在3分钟内静脉注射2mg/kg，随后以0.007mg/kg/min的速度持续输注24小时，观察其对房颤（AF）的转复效果。若24小时洗脱期后无效，则静脉注射胺碘酮（A），负荷剂量为5mg/kg，3分钟内注射完毕，随后以1.8g/24小时的速度持续输注。房颤必须持续存在（至少有一次24小时动态心电图记录）且为近期发作。所有患者的心功能分级均为纽约心脏病协会（NYHA）1级或2级。10例患者在使用P后通常在60分钟内恢复窦性心律；2例对P无反应的患者在使用A后恢复窦性心律，另外10例患者则根本未恢复。与未恢复者相比，恢复者的RR间期明显缩短：平均值分别为537±64毫秒和771±200毫秒（p<0.001）。使用P期间，QRS时限增加了12.9%（p<0.005），QTc增加幅度较小，为7.8%；使用A期间，QRS时限无明显改变，QTc延长了9.5%（p<0.002）。静脉输注普罗帕酮似乎是将近期发作的房颤且心室率较高的患者快速有效地转复为窦性心律的方法。静脉注射胺碘酮对P治疗无效的患者转复为窦性心律并无明显帮助。
