Dell'Orfano J T, Luck J C, Wolbrette D L, Patel H, Naccarelli G V
Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA.
Am Fam Physician. 1998 Aug;58(2):471-80.
Atrial fibrillation is the most common arrhythmia in patients visiting a primary care practice. Although many patients with atrial fibrillation experience relief of symptoms with control of the heart rate, some patients require restoration of sinus rhythm. External direct current (DC) cardioversion is the most effective means of converting atrial fibrillation to sinus rhythm. Pharmacologic cardioversion, although less effective, offers an alternative to DC cardioversion. Several advances have been made in antiarrhythmic medications, including the development of ibutilide, a class III antiarrhythmic drug indicated for acute cardioversion of atrial fibrillation. Other methods of pharmacologic and nonpharmacologic cardioversion remain under development. Until the results of several large-scale randomized clinical trials are available, the decision to choose cardioversion or maintenance of sinus rhythm must be individualized, based on relief of symptoms and reduction of the morbidity and mortality associated with atrial fibrillation.
心房颤动是初级保健机构就诊患者中最常见的心律失常。虽然许多心房颤动患者通过控制心率症状得到缓解，但有些患者需要恢复窦性心律。体外直流电（DC）心脏复律是将心房颤动转为窦性心律最有效的方法。药物复律虽然效果较差，但可作为DC心脏复律的替代方法。抗心律失常药物已取得多项进展，包括开发了伊布利特，一种用于心房颤动急性复律的III类抗心律失常药物。其他药物和非药物复律方法仍在研发中。在获得几项大规模随机临床试验结果之前，选择复律或维持窦性心律的决定必须个体化，基于症状缓解以及降低与心房颤动相关的发病率和死亡率。
