缬沙坦对病窦综合征双腔起搏术后阵发性心房颤动的影响

摘要

Objective To evaluate the effect of valsartan on preventing paroxysmal atrial fibrillation(PAF) following dual-pacemaker implantation in patients with sick sinus syndrome (SSS). Methods Eighty-one patients with SSS who was suffering from PAF after pacemaker implantation were randomized to the treatment group(n =41)and the control group(n = 40). On the basis of the treatment of original diseases,the treatment group were administrated with Valsartan,80mg served every night,the control group were not give any Angiotensin II receptor blocker. After 1 year follow-up,the PAF times,AF burden and left atrial diameter (LAD)were observed. Results At 1 year follow-up after pacemaker,the PAF times,AF burden and LAD in the treatment group were not only significantly lower than those in the control group(4.2 ± 1.9 beat per day vs 9.5 ±3.4 beat per day,0.395 ±0.285 h/d vs 0.860 ±0. 316 h/d,35.9 ±2.7 mm vs 40.7 ±3. 8 mm,all P <0. 05) ,but also lower than those before treatment(P<0.01). However,there were no significant changes in the control group. Conclusions Valsartan can effectively inhibit the occurrence of PAF after dual-chamber pacemaker implantation in patients with SSS.%目的 评价缬沙坦对病窦综合征(SSS)双腔起搏后阵发性心房颤动(AF)的作用.方法 双腔起搏器植入术的患者,术后随访时选出有阵发性AF者81例,将其随机分为治疗组(n=41)和对照组(n=40).在治疗基础疾病的基础上,治疗组给予缬沙坦80 mg,每晚顿服,对照组不予血管紧张素Ⅱ受体阻滞剂类药物治疗.随访1年,观察AF发作次数、AF负荷及左房内径.结果 治疗组起搏术后1年AF发作次数、AF负荷、左房内径明显低于对照组(4.2±1.9次/天vs9.5±3.4次/天,0.395±0.285 h/d vs 0.860±0.316 h/d,35.9±2.7 mm vs 40.7±3.8mm,P均＜0.05),亦低于用药前(P＜0.01),而对照组上述指标无变化.结论 缬沙坦可有效抑制SSS双腔起搏后阵发性AF的发生.