[AF-FORUM] 53E 阵发性房颤?迷走神经介导 Dr. Nattel

[AF Symposium]

我同意对于冠心病患者Ic类药要慎重。除非再血管化 
治疗很确切，否则该类药的应用一点要小心（比如氟 
桂利嗪不超过100mg每天，心律平不超过450mg每天）， 
并确证QRS延长小于10%.

Disopyramide 可以尝试。当然鉴于患者所处的位置以及 
是否可提供该种治疗的可行性，导管消融可以是优先 
的几个选择之一。


Stanley Nattel, MD

Paul-David Chair in Cardiovascular Electrophysiology
Professor of Medicine
University of Montreal

Director, Electrophysiology Research Program
Montreal Heart Institute Research Center
5000 Belanger St. E.
Montreal, Quebec
Canada H1T 1C8

T: 514-376-3330 ext 3990
F: 514-376-1355
e-mail:
stanleynattel在aol.com
stanley.nattel在icm-mhi.org

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Re: [AF-FORUM] 53E PAF ? Vagally mediated. Dr. Nattel

I agree that the CAD is a concern with respect to class IC agents.

Unless the success of the revascularization is very clear, one would
have
to be very careful with such drugs, using a small dose (eg no more
than 100
mg flecainide or 450 mg of propafenone daily) and making sure that
any QRS
prolongation is under 10%.

Disopyramide may still be worth a try, and of course (depending on
feasability relative to patient location and procedural availability)
ablation should be near the top of the list of therapeutic options.

Stanley Nattel, MD

Paul-David Chair in Cardiovascular Electrophysiology
Professor of Medicine
University of Montreal

Director, Electrophysiology Research Program
Montreal Heart Institute Research Center
5000 Belanger St. E.
Montreal, Quebec
Canada H1T 1C8

T: 514-376-3330 ext 3990
F: 514-376-1355
e-mail:
stanleynattel在aol.com
stanley.nattel在icm-mhi.org

--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee