Elam K, Bolar-Softich K L
Emergency Department, St. Joseph Medical Center, Tacoma, WA 98415, USA.
Am J Emerg Med. 1997 Jul;15(4):418-9. doi: 10.1016/s0735-6757(97)90141-8.
A recently conducted observational study of the prehospital treatment of uncontrolled atrial fibrillation brought to light therapeutic inconsistencies by emergency providers in dealing with this dysrhythmia. A review of the literature suggests that digoxin lacks efficacy in controlling ventricular rate in atrial fibrillation and that the slow onset of digoxin makes its use in the emergency setting questionable. Because of their demonstrated ability to rapidly slow ventricular rate, the calcium channel blocker, diltiazem, or the beta-adrenergic blocker, esmolol, should be the preferred agents for treating rapid atrial fibrillation in the emergency department or the paramedic ambulance.
最近一项关于院前未控制的心房颤动治疗的观察性研究揭示了急救人员在处理这种心律失常时存在治疗不一致的情况。文献综述表明，地高辛在控制心房颤动的心室率方面缺乏疗效，且地高辛起效缓慢，这使得其在紧急情况下的使用存在疑问。由于钙通道阻滞剂地尔硫䓬或β-肾上腺素能阻滞剂艾司洛尔具有快速减慢心室率的能力，它们应是急诊科或护理人员救护车中治疗快速心房颤动的首选药物。
