[AF-FORUM] 56E:阵发性房颤预防性药物选择 Dr. Nattel

[AF Symposium]

就我个人而言，Ic类药物似乎是不错的初始用药选 
择，尤其是在冠脉正常的情况下。



或许你想增加一些药物来预防心室过快应答，钙通道 
阻滞剂由于对房颤患者有扩张血管的危险，并不推 
崇，而β受体阻滞剂要好些。

索他洛尔可供选择，它能让你少用一个药物，而不必 
同时使用Ic类和减慢心率药物两种药物，但对于左室 
肥厚的患者需要密切监测QT。

39梯度法？可能会发展，如果患者需要大动脉置换， 
建议同时进行Maze程序。

                                                     Stanley Nattel, MD

                                                      心血管电生 
理主任

                                                           医学教授

                                                        蒙特利尔 
大学



                                                         Dr. Sergio  
Dubner

科委会主席

Dr. Edgardo Schapachnik

组委会主席

   潘佳君译

56E Prophylactic drug regimen for PAF. Dr. Nattel





Class IC seems like a reasonable starting choice to me, especially in

View of the normal coronaries.

You may want to add something to prevent an excessively rapid

Ventricular response. A calcium channel blocker might not be  
advisable because of the risk of vasodilation in AF. Dig or a beta- 
blocker would probably be better.

Sotalol is an alternative that would let you get away with 1 drug

Instead of 2 (IC + rate-slower), but you would have to monitor the QT  
response carefully in view of the LVH.

The gradient of 39 may well progress and if the patient needs aortic  
Valve replacement it would probably be a good idea to do a Maze  
procedure

at the same time.



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



--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee