CAJ | 학술논문

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%vs 40.7%，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1h内恢复正常。
목적：탐토이포리특재전복방전과정중대환자과벽복겁이질성급실성심률실상적영향。방법방전발병재48 h~7 d적환자87례분입이포리특조화알전동조，비교2조방전전복성공솔；분석2조환자용약전、용약4 h내QT간기이급Tpeak-end/QT간기비치적변화。결과이포리특조방전전복성공솔명고우알전동조（61.7%vs 40.7%，P＜0.05）；이포리특조QT간기재용약후교용약전현저연장、Tpeak-end/QT간기비치증대（P＜0.05），분별재용약후2 h、1 h회복용약전수평（P＞0.05）。알전동조QT간기현저연장（P＜0.01），지속지용약후4 h，단Tpeak-end/QT간기비치재용약전후무명현변화（P＞0.05）。결론이포리특방전전복성공솔고우알전동；단이포리특재용약후과벽복겁이질성유소증가，즉실성심률실상적풍험증가，병가재1h내회복정상。
Objective To investigate the effects of ibutilide and amiodarone on the ventricular transmural heteroge-neity of repolarization and ventricular arrhythmia for the treatment of atrial fibrillation. Methods Eighty-seven patients with paroxymal atrial fibrillation at 48 h~7 d were enrolled and randomized to two groups, ibutilide and amiodarone treat-ment groups. The successful rate of cardioversion to sinus rhythm was compared between two groups. The electrocardiograph-ic QT interval and Tpeak-end/QT ratio were also analyzed before and after treatment in two groups. Results The successful rate of cardioversion was significantly higher in ibutilide group than that of amiodarone group (61.7%vs 40.7%, P<0.05). The QT intervals and Tpeak-end/QT ratio were both significantly increased in ibutilide group (P<0.05), which were re-turned to the levels before treatment in 2 hours and 1 hour, respectively (P<0.05). The QT intervals were significantly in-creased in the amiodarone group (P<0.01), which were continued until 4 h after treatment. There were no significant differ-ences in the Tpeak-end/QT ratios before and after treatment (P>0.05). Conclusion The successful rate of cardioversion to sinus rhythm for atrial fibrillation by ibutilide was significantly higher compared with that of amiodarone. Ibutilide slightly in-creased the transmural heterogeneity of repolarization within the first hour, which may increase the risk of ventricular arrhyth-mia.