Objective: To investigate the efficacy and safety of intravenous ibutilide for conversion of atrial fibrillation( AF) and flutter(AFL) to sinus rhythm. Methods: Ninety-nine consecutive patients aged 18-75 y with AF/AFL were included. The duration of arrhythmia was <90d(lh-90d) and ventricular rate was > 60 beats/min. Patients were assigned randomly into two groups; 49 patients in ibutilide group received ibutilide 1 mg,then repeated if AF/AFL was not converted after 10 min; 50 patients in propafenone group received propafenone 70 mg,then repeated if AF/AFL persisted after 10 min. Two drugs were diluted by 50 ml of 5% glucose and injected intravenously within 10 min. Results: Ventricular rates were decreased in both groups. AF/AFL were converted in 34 of 49 patients(69. 4% ) in ibutilide group and in 22 of 50 patients(44. 0% ) in propafenone group( P <0. 05 ). The converting time of ibutilide was significantly shorter than that of propafenone[ (16. 79 ± 12. 31) min vs (36. 92 ± 11. 38) min,P<0.01 ]. The most serious adverse effect of ibutilide was non-sustained monomorphic ventricular tachycardia(3/49, 6. 12%). Transient hypotension and heart pause were the main adverse events in patients who received propafenone, acute left heart failure occurred in one patient of propafenone group. Conclusions:Intravenous ibutilide is a safe and effective agent for cardioversion of recent-onset AF/ AFL. Furthermore, strict processing under electrocardio-monitoring is important.%目的:探讨静脉应用国产依布利特转复心房颤动(房颤)/心房扑动(房扑)的有效性和安全性.方法:筛选18 ～75岁,持续时间≤90d(1 h～90d),心室率≥60次/min的阵发性或持续性房颤/房扑患者共99例,随机分为依布利特组和普罗帕酮组各49和50例.依布利特组首剂1mg静注,如无效10 min后再给予1 mg.普罗帕酮组首剂70 mg静注,如无效10 min后再给予70mg.结果:两组均能有效降低房颤/房扑的心室率.转复率:依布利特组69.39％(34/49),普罗帕酮组44.00％(22/50),两组差异有统计学意义(P＜0.05);转复时间:依布利特组显著短于普罗帕酮组(16.79±12.31) min对(36.92±11.38) min,P＜0.01.不良反应:依布利特组最严重的不良反应为非持续性单形性室速,发生率6.12％(3/49),普罗帕酮组多为一过性低血压及长间歇,一例出现急性左心衰.结论:依布利特转复房颤/房扑的疗效高于普罗帕酮,转复时间短于普罗帕酮,不良反应发生率低,但须在严格监控下进行.
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