【摘要】 本文报道45例心房颤动,68次电复律中应用双异丙吡胺(DP)的经验,45例中41例为风湿性瓣膜病,术前2～3天开始口服DP准备,0.1每日3次,复律前2小时加服一次,复律成功后用同量维持1～2周,以后改用奎尼丁继续维持,结果67例次(98.5％)复律成功,DP服用过程中,3例有短暂头昏,1例出现口干,面红,没有见到电击后短期内出现“奎尼丁晕厥”样反应者,8例有不同程度QTC延长。1例在服DP11天后死于心室颤动。不能排除药物诱发的可能;但该患者主动脉瓣病变严重,由于疾病本身的可能亦较大,作者认为DP在提高心房颤动电复律的成功率方面效果较好,副反应亦较少,可以作为奎尼丁一个较好的替代药物,但仍不能忽视出现“奎尼丁晕厥”样反应的可能。更多还原

【Abstract】 Diisopyramide (DP) was used in 45 cases of chronic atrial fibrillation for 68 times of direct current electroversion. Among these 45 cases. 41 were pat ientswith chronic rheumatic valvular disease. 0.1gm DP was given three times daily for 2 to 3 days followed by a single additional dose 2 hours just before cardioversion. Same dose was continued for maintenance of sinus rhythm after successful defibrillation. 1 to 2 weeks later DP was replaced by quinidine for further maintenance. The immediate success rate of cardioversion was 98.5%(67 in 68 times). During the DP treatment only 3 cases experienced transient dizziness. No quinidine syncope-like reaction occurred within short period after electric shock. However, there were 8 cases showing variable degree of QTc prolongation. One patient died of ventricular fibrillation after 11 days of DP administration. The death may have been due to the severe aortic valve disease of the patient, but the possibillity of DP-induced ventriculararrhythmias are still to be ruled out. We concluded that DP bad fewer side effects and appeared to be effective in increasing the success rate of cardioversion of chronic atrial fibrillation. It can be used us a better substitute for quinidine, hat the possibility of quinidine-syncope like reaction has to be emphasized更多还原