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Kokyu to Junkan Volume 49, Issue 10 （October 2001）

呼吸と循環 49巻10号（2001年10月発行）

Japanese English

研究

発作性心房細動例における抗不整脈薬の停止・長期予防効果と加齢の影響—高齢者（65歳以上）ならびに非高齢者（65歳未満）との比較 Analysis of Clinical Profiles of Elder Patients with Paroxysmal Atrial Fibrillation and Efficacy of Antiarrhythmic Drugs: Comparison with younger patients 小松隆 ¹ , 中村紳 ¹ , 木村正雄 ¹ , 富田泰史 ¹ , 大和田真玄 ¹ , 蓬田邦彦 ¹ , 奥村謙 ² Takashi Komatsu ¹ , Shin Nakamura ¹ , Masao Kimura ¹ , Yasushi Tomita ¹ , Shingen Oowada ¹ , Kunihiko Yomogida ¹ , Ken Okumura ² ¹岩手県立磐井病院循環器科 ²弘前大学医学部第二内科 ¹The Division of Cardiology, Department of Internal Medicine, Iwate Prefectural Iwai Hospital ²The Second Department of Internal Medicine, Hirosaki University School of Medicine キーワード：発作性心房細動 , 高齢者 , 停止効果 , 予防効果 , 抗不整脈薬 , paroxysmal atrial fibrillation , elder , antiarrhythmic drugs , termination , prevention Keyword: 発作性心房細動 , 高齢者 , 停止効果 , 予防効果 , 抗不整脈薬 , paroxysmal atrial fibrillation , elder , antiarrhythmic drugs , termination , prevention pp.1015-1020

発行日 2001年10月15日 Published Date 2001/10/15

DOI https://doi.org/10.11477/mf.1404902367

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Abstract 文献概要
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　発作性心房細動235例（男性172例，女性63例，平均年齢67±10歳）を対象に，高齢者（65歳以上，A群；137例）における臨床像ならびに抗不整脈薬の停止・長期予防効果を非高齢者（65歳未満，B群；98例）と比較した．男女比はA群92：45，B群80：18，高血圧はA群66例（48.2％），B群29例（29.6％），血栓塞栓症合併はA群32例（23.4％），B群10例（10.2％）であり，B群に比しA群で有意に高率であった．抗不整脈療法の停止効果は，A群47/98例（48.0％），B群44/73例（60.3％）であり，観察期間3ヵ月，6ヵ月，12ヵ月，24ヵ月，36ヵ月，48ヵ月目時点の抗不整脈療法による洞調律維持率は，A群97.8％，97.8％，94.9％，91.9％，90.5％，87.6％，B群98.0％，94.9％，92.9％，91.8％，90.8％，90.8％であり，各指標に有意差を認めなかった．一方，抗不整脈薬による副作用出現率はA群13例（9.4％），B群2例（2.0％）であり，B群に比しA群で有意に高率であった（p＜0.05）．

　To assess clinical profiles of high-aged patients with paroxysmal atrial fibrillation (Paf) and termination and long-term prevention effects of aggressive antiarrhythmic drugs, 235 patients (172 men, 63 women, mean age 67±10 years) were enrolled in a retrospective study (mean follow-up period 38.6±29.5 months). Successful termination with drugs was defined as defibrillation after intravenous injection of antiarrhythmic drugs within 30 minutes, and successful prevention of the arrhythmic recurrence was defined as the maintenance of sinus rhythm after aggressive antiarrhythmic treatment. The ratios of female (32.8% vs 18.4%), hypertension (48.2% vs 29.6%) and thromboembolism (23.4% vs 10.2%) in elder patients (65≧years, N=137) weresignificantly higher than those in younger patients (65＜years, N=98) (p＜0.05). There was no difference between elder and younger patients in the rates of termination of the arrhythmia (48% vs 60%) and prevention of the arrhythmia (88% vs 91%) at 48 months.

　On the other hand, the incidence of side effects of antiarrhythmic treatment in elder patients (9A%) was significantly higher than that in younger patients (2.0%) (p＜0.05).

　These results suggest that antiarrhythmic drugs are equally effective in both elder and younger patients although adverse effects may develop more frequently among elder patients.