[AF-FORUM] 20E 房颤术后病人出现心室率缓慢 Prabhakar C 医生

[AF Symposium]

尊敬的女士/先生，
我碰到一名48岁的老年女性，她因风心、二尖瓣狭窄 
做过二尖瓣置换术。现在这位患者出现严重的主动脉 
狭窄合并二尖瓣返流（人工瓣膜功能失调）。因此， 
患者又进行了主动脉瓣和二尖瓣置换术。手术前，患 
者是快室率房颤。在瓣膜手术的过程中，患者同时进 
行了迷宫手术。术后第一天患者心律是窦性的，但是 
在术后第二天又转变为房颤，但心室率较慢(45-55次/ 
分)，而且还发作过一次晕厥。现在是术后第六天 
了，患者心率仍然是50-60次/分左右，伴有多源室早。 
现在应该采取什么样的治疗策略？术前患者服用美托 
洛尔和地高辛，术后患者不服用控制心率的药物了。
Sergio Dubner 医生
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Dr. Sergio Dubner
科委会主席

Dr. Edgardo Schapachnik
组委会主席

赵勤华译 王玲洁校
上海交通大学医学院附属瑞金医院心脏科

原文：
20E Post operative AF with slow ventricular rate. Dr. Prabhakar C
Dear sir/madam
     I have this patient a 48year old female who had undergone mitral
valve replacement for Rheumatic mitral stenosis. Now patient
presented with severe AS with mitral regurgitation (Prosthetic valve
dysfunction).Ptient underwent Aortic and Mitr4al valve replacement.
Preoperatively patient was AF with fast ventricular rate. Patient
underwent a maZe procedure during the valve sugery. First post of day
patient was in sinus rythm however on second post op day patient
reverted to AF but with slow ventricular rate (45-55) and had one
episode of syncope.Now day six post patient continues to have Hr 0f
about 50-60 with multiple ventricular ectopics. What should be the
strategy to manage her. Pre operatively patient was on metoprolol and
digitalis and no rate control medications post op
Dr Prabhakar C
--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee