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Kokyu to Junkan Volume 44, Issue 2 （February 1996）

呼吸と循環 44巻2号（1996年2月発行）

Japanese English

研究

発作性心房細動に対する抗不整脈剤停止ならびに予防効果についての臨床的検討 Termination and Prevention of Paroxysmal Atrial Fibrillation by Antiarrhythmic Drugs 小松隆 ¹ , 蓬田邦彦 ¹ , 千葉実行 ¹ , 佐藤潔 ¹ , 三国谷淳 ² , 加藤武 ² , 角田悟 ² , 小野寺庚午 ² , 高橋健 ³ , 中山寛 ³ Takashi Komatsu ¹ , Kunihiko Yomogida ¹ , Noriyuki Chiba ¹ , Kiyoshi Sato ¹ , Atsushi Mikuniya ² , Takeshi Kato ² , Satoru Tsunoda ² , Kougo Onodera ² , Ken Takahashi ³ , Hiroshi Nakayama ³ ¹岩手県立磐井病院第二内科 ²弘前大学医学部第二内科 ³岩手県共立医科器械株式会社 ¹The Second Department of Internal Medicine, Iwai Hospital ²The Second Department of Internal Medicine, Hirosaki University School of Medicine ³Department of Engineering for Medical System, Kyoritu Corporation キーワード：発作性心房細動 , 停止効果 , 予防効果 , paroxysmal atrial fibrillation , pharmacological termination , pharmacological prevention Keyword: 発作性心房細動 , 停止効果 , 予防効果 , paroxysmal atrial fibrillation , pharmacological termination , pharmacological prevention pp.181-186

発行日 1996年2月15日 Published Date 1996/2/15

DOI https://doi.org/10.11477/mf.1404901200

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Abstract 文献概要
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　発作性心房細動（Paf）56例を対象に各抗不整脈剤の静注による停止効果ならびに長期経口投与による予防効果について検討した．静注後30分以内に25／46例（54.4％）にPaf停止効果を認めた．有効率は基礎心疾患を有する群（OHD群）と有しない群（NOHD群）との間に有意差を認めなかったが，有効群の病悩期間は無効群のそれに比し有意に短く（p＜0.01），病悩期間1カ月未満群の有効率は1カ月以上のそれに比し有意に高値であった（p＜O．05）．内服開始後38／56例（67.8％）にPaf予防効果を認め，有効率はOHD群とNOHD群との間に有意差を認めなかった．経過観察中の再発群は34／56例（60.7％）に認め，再発率はOHD群とNOHD群との間に有意差を認めなかった．停止効果が確認された経口剤による再発率は7／25例（28.0％）であった．慢性心房細動への移行は9／56例（16.1％）に認めた．Pafに対する各抗不整脈剤の有効性が示唆されたが，その管理には再発有無を監視しつつより早期に有効薬剤を選択することが重要と思われた．

The pharmacological effects of termination and pre-vention of paroxysmal atrial fibrillation (Paf) were studied in 56 patients. The successful ratio of the pharmacological cardioversion with intravenous antiar-rhythmic therapy was 54.4% in a total of 46 patients within 30 minutes after administration, but it was not significantly different between the organic heart disease (OHD) group and the non-organic heart disease (NOHD) group. The duration from onset of Paf in the suceessful group was significantly shorter than that in the failed group (p＜0.01), and the successful ratio of the group whose duration was under 1 month from onset was significantly higher than that in which the duration was over 1 month from onset (p＜0.05). The success rate of pharmacological prevention with oral antiarr-hythmic therapy was 67.8% in a total of 56 patients, but it was not significantly different in the OHD-group and the NOHD-group. The rate of recurrence during oral administration was 60.7%, but it was not significantly different in the OHD-group and the NOHD-group. The recurrence rate in the group receiving oral administra-tion which theminated Paf with intravenous antiarr-hythmic therapy was 28.0% in a total of 25 patients. The rate of development into a state of permanent atrial fibrillation was, finally, 16.1% in a total of 56 patients. These results suggested that antiarrhythmic agents were useful for the management of Paf, and that it was important to select adequate agents for Paf as early as possible, and to use careful observation to detect recurrence.