天津医药

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伊布利特及胺碘酮转复房颤时对Tpeak-end/QT的影响

杨琦1,姚青海1,吴尚勤2,孙姗3,程爱娟4,李鹏，2   

  1. 1. 天津市胸科医院
    2. 天津市胸科医院内7科
    3. 胸科医院心内科
    4. 胸科医院心血管病研究所
  • 收稿日期:2013-05-10 修回日期:2013-08-09 出版日期:2014-01-15 发布日期:2014-01-15
  • 通讯作者: 杨琦

Compare the effects of Tpeak-end/QT using ibulitide with amiodarone to terminate atrial fibrillation

  • Received:2013-05-10 Revised:2013-08-09 Published:2014-01-15 Online:2014-01-15

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摘要： 目的 探讨伊布利特在转复房颤过程中对患者跨壁复极异质性及室性心律失常的影响。方法 房颤发病在48 h~7 d的患者87例分入伊布利特组和胺碘酮组， 比较2组房颤转复成功率； 分析2组患者用药前、 用药4 h内QT间期以及Tpeak-end/QT间期比值的变化。结果 伊布利特组房颤转复成功率明高于胺碘酮组 （61.7% vs40.7%， P＜0.05）； 伊布利特组QT间期在用药后较用药前显著延长、 Tpeak-end/QT间期比值增大 （P＜0.05）， 分别在用药后2 h、 1 h恢复用药前水平 （P＞0.05）。胺碘酮组QT间期显著延长 （P＜0.01）， 持续至用药后4 h， 但Tpeak-end/QT间期比值在用药前后无明显变化 （P＞0.05）。结论 伊布利特房颤转复成功率高于胺碘酮； 但伊布利特在用药后跨壁复极异质性有所增加， 即室性心律失常的风险增加， 并可在1 h内恢复正常。

关键词: 伊布利特, 胺碘酮, 心房颤动, 心室跨壁复极离散度, 室性心律失常

Abstract: [Abstract] Objective To study the alteration of transmural heterogeneity of repolarization and its relationship to ventricular arrhythmia in the process of cardioversion of atrial fibrillation with ibutilide.Method .87 persistent atrial fibrillation cases with less than three months duration were enrolled randomizedly in group ibulitide and amiodarone to compare the success rate of cardioversion,analyze the alteration of the QT interval and Tpeak-end/QT before treatment and within 4 hours. Result The success rate of cardioversion of the group Ibutilide was significantly higher than the amiodarone group (61.7% vs 40.7%, P <0.05). QT interval of ibutilide group was significantly prolonged after treatment than before treatment, Tpeak-end/QT increased (P <0.01, P <0.05),and restored the level before treatment in 2 hours after treatment, and 1 hour, respectively (P> 0.05).QT interval of the amiodarone group was significantly prolonged (P <0.01), and continued to 4h after treatment, but Tpeak-end/QT did not change significantly before and after treatment (P> 0.05). Conclusion The success rate of atrial fibrillation cardioversion using ibutilide was significantly higher than amiodarone.But,after administration,ibutilide increased transmural heterogeneity of repolarization,and restored within 1 hour. Namely,it increased the risk of ventricular arrhythmias within 1 hour.

Key words: ibutilide, amiodarone, atrial fibrillation, transmural dispersion of repolarization, ventricular arrhythmia