Barranco F, Sanchez M, Rodriguez J, Guerrero M
Department of Intensive Medicine, Valme Universitary Hospital, Sevilla, Spain.
Intensive Care Med. 1994;20(1):42-4. doi: 10.1007/BF02425054.
Evaluation of efficacy of intravenous flecainide to revert supraventricular arrhythmias to sinus rhythm in patients with respiratory insufficiency.
Comparative randomized prospective trial.
ICU in a University Hospital.
30 patients with acute respiratory insufficiency or acute exacerbation of chronic respiratory insufficiency and supraventricular arrhythmias. Intravenous flecainide was administered to 15 patients (Group A) (2 mg/kg for 10 min and continuous perfusion of 1.5 mg/kg for 1 h). Intravenous verapamil was administered to 15 patients (Group B) (0.15 mg/kg for 5 min and continuous perfusion of 0.005 mg/kg/min for 1 h).
The categories of patients' arrhythmias were: Group A-atrial fibrillation (AF) in 5 cases, atrial flutter (AFl) in 2, multifocal atrial tachycardia (MAT) in 4 and other supraventricular tachycardia (SVT) in 4. Group B-AF in 6 cases, AFL in 2, MAT in 2 and SVT in 5 cases. Flecainide reverted arrhythmias to sinus rhythm in 12 out of 15 cases (80%); of these 12, 11 reverted with the initial bolus. Verapamil reverted 5 out of 12 cases (33.3%, p < 0.01). No significant secondary adverse effects were detected.
Intravenous flecainide is an effective antiarrhythmic drug to treat acute supraventricular arrhythmias in patients with respiratory insufficiency.
评估静脉注射氟卡尼使呼吸功能不全患者的室上性心律失常恢复为窦性心律的疗效。
比较随机前瞻性试验。
大学医院的重症监护病房。
30例急性呼吸功能不全或慢性呼吸功能不全急性加重且伴有室上性心律失常的患者。15例患者（A组）静脉注射氟卡尼（2mg/kg，持续10分钟，然后以1.5mg/kg持续灌注1小时）。15例患者（B组）静脉注射维拉帕米（0.15mg/kg，持续5分钟，然后以0.005mg/kg/分钟持续灌注1小时）。
患者心律失常的类型为：A组-心房颤动（AF）5例，心房扑动（AFl）2例，多源性房性心动过速（MAT）4例，其他室上性心动过速（SVT）4例。B组-AF 6例，AFL 2例，MAT 2例，SVT 5例。氟卡尼使15例中的12例（80%）心律失常恢复为窦性心律；在这12例中，11例在首次推注后恢复。维拉帕米使12例中的5例（33.3%，p<0.01）恢复。未检测到明显的继发不良反应。
静脉注射氟卡尼是治疗呼吸功能不全患者急性室上性心律失常的有效抗心律失常药物。
