醛固酮受体拮抗剂防治起搏器术后房颤的临床研究

doi:10.3969/j.issn.1006-6233.2020.04.028

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Abstract Objective: To evaluate the preventive effects of spironolactone (SPI, one of the aldosterone receptor antagonists) on atrial fibrillation of patients after pacemaker implantation and impacts on left atrial diameter and cardiac function. Methods: From January 2018 to April 2019, a total of 84 patients with dual chamber pacemaker implantation were selected. Atrial fibrillation was excluded before entering the group. The patients were randomly divided into two groups: the spironolactone group (42 cases) and the control group (42 cases). The spironolactone group was treated with oral spironolactone (20mg / D) on the basis of routine treatment, and the control group was treated with routine treatment after pacemaker operation. The patients in the two groups were superceded at 1, 3, 6 and 12 months before and after operation Echocardiography (recording left atrial diameter and left ventricular ejection fraction) and serum aldosterone level were measured. Pacemakers were programmed 1, 3, 6 and 12 months after operation and the recurrence of AF was recorded. Results: After 12-month follow-up visit, there are 7 cases (16.7%) of recurrence of atrial fibrillation in spironolactone group and 15 cases (35.8%) in control group. Therefore, there are no significant difference (p=0.081). Within 12 months after operation, left atrial diameter in spironolactone group is smaller than that of control group (31.3±2.3mm vs. 33.8±2.1mm). Obviously, the difference has statistical significance (P<0.05). However, during each period, there is no significant difference with regard to left ventricular ejection fraction among two groups (P>0.05). The level of plasma aldosterone of spironolactone group is smaller than that of control group in the 3rd and 6th month after operation with significant difference (P<0.05), but the level is increasing after 6 months until there is no significant difference in 12th month (P>0.05). Conclusion: Left atrial expansion can be delayed by taking spironolactone. The mechanism is to suppress the function of aldosterone. Long-term application may reduce and delay recurrence of atrial fibrillation after pacemaker implantation.

Key words： Aldosterone receptor antagonists Pacemaker Atrial fibrillation

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	WU Youhua
	LI Nan
	XU Baohua

Cite this article:

WU Youhua,LI Nan,XU Baohua. Clinical Study of Aldosterone Receptor Antagonists in the Prevention and Treatment of Atrial Fibrillation after Pacemaker Operation[J]. HeBei Med, 2020, 26(4): 649-653.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2020.04.028 OR http://www.hbyxzzs.cn/EN/Y2020/V26/I4/649

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