Weiner P, Bassan M M, Jarchovsky J, Iusim S, Plavnick L
Am Heart J. 1983 Feb;105(2):223-7. doi: 10.1016/0002-8703(83)90517-3.
Forty-seven episodes of acute atrial fibrillation (AF) in 45 patients were examined prospectively to determine the course of the disorder treated with rapid digitalization. Patients received 1.5 mg of digoxin intravenously over 12 hours. In 40 of the 47 attacks, reversion to sinus rhythm occurred with no additional therapy at 1 to 96 hours (median 4 hours) after beginning digoxin. In thirty-two patients, conversion occurred within 8 hours; only one patient showed important ventricular slowing before conversion. Thus, if digoxin facilitates conversion, it does not do so by slowing the ventricular response. Of the 11 patients still in AF at 16 hours, conversion subsequently occurred in only four who were receiving digoxin alone. We conclude that the prognosis for quick reversion to sinus rhythm in patients with acute AF treated with rapid digitalization alone is excellent. If reversion does not occur by 16 to 24 hours, additional measures to restore sinus rhythm are indicated.
对45例患者的47次急性心房颤动（AF）发作进行了前瞻性研究，以确定采用快速洋地黄化治疗该疾病的病程。患者在12小时内静脉注射1.5毫克地高辛。在47次发作中的40次中，在开始使用地高辛后的1至96小时（中位数4小时）内，未进行额外治疗即恢复为窦性心律。在32例患者中，8小时内实现了转复；只有1例患者在转复前出现明显的心室率减慢。因此，如果地高辛有助于转复，其作用并非通过减慢心室反应来实现。在16小时时仍处于房颤状态的11例患者中，只有4例仅接受地高辛治疗随后实现了转复。我们得出结论，仅采用快速洋地黄化治疗的急性房颤患者快速恢复窦性心律的预后良好。如果在16至24小时内未实现转复，则需要采取其他措施来恢复窦性心律。
