Koenig A, Theolade R, Chauvin M, Brechenmacher C
Service de Cardiologie, Centre Médico-Chirurgical et Obstétrical, Schiltigheim.
Presse Med. 1993 Nov 20;22(36):1827-32.
Among the drugs recommended to prevent recurrences of atrial fibrillation after external electric shock, antiarrhythmic agents of classes Ia (quinidine, disopyramide), Ic (cibenzoline, flecainide, propafenone) and III (sotalol) seem to have the same effectiveness in maintaining the sinus rhythm in about 50 percent of the cases after 6 months and one year. Amiodarone, seldom used as first-line treatment, appears to be the most effective drug. The percentage of side-effects requiring discontinuation of treatment is the same for all drugs (about 10 percent). All these drugs have potential proarrhythmic effects. In case of recurrence electric shocks can be repeated in some special cases. The therapeutic strategy according to the clinical context (atrial fibrillation of vagal nerve or catecholergic origin, normal or altered left ventricular function) is discussed.
在推荐用于预防体外电击后房颤复发的药物中，Ia类（奎尼丁、双异丙吡胺）、Ic类（西苯唑啉、氟卡尼、普罗帕酮）和III类（索他洛尔）抗心律失常药物在6个月和1年后约50%的病例中维持窦性心律的效果似乎相同。胺碘酮很少用作一线治疗，但似乎是最有效的药物。所有药物因副作用而需要停药的百分比相同（约10%）。所有这些药物都有潜在的促心律失常作用。在复发的情况下，某些特殊病例可重复电击。文中还讨论了根据临床情况（迷走神经或儿茶酚胺源性房颤、左心室功能正常或改变）制定的治疗策略。
