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READING TIME 【读英文＆学心电】 -Day251- 
Atrial fibrillation 心房纤颤 During atrial fibrillation, most atrial impulses reach the ventricles via the accessory AV pathway. Thus AV nodal blocking drugs such as digoxin and verapamil are of little use during atrial fibrillation in WPW syndrome. Indeed, both digoxin and verapamil can increase the frequency of conduction in the accessory pathway and therefore lead to a faster ventricular rate. These drugs must not be used in those patients who are capable of a rapid ventricular response in case a dangerously fast ventricular rate develops. In patients in whom atrial fibrillation has never occurred, and thus a fast response has not been excluded, the drugs should be avoided. 心房颤动时，大多数心房的冲动通过房室旁路传导途径到达心室。因此，地高辛、维拉帕米等房室结阻断药物在WPW综合征心房颤动治疗中作用不大。事实上，地高辛和维拉帕米都能增加旁路的传导频率，从而导致心室率加快。这些药物不能用于那些心室率快的病人，以防出现危险的快速心室率。对于从未发生过房颤的患者，不能排除快速心室率反应，应避免使用该药物。 Intravenous sotalol, flecainide, disopyramide or amiodarone, drugs that slow conduction in the accessory pathway, should be used. These drugs will slow the ventricular response to atrial fibrillation and will often restore sinus rhythm. A simple alternative method of terminating atrial fibrillation is cardioversion, but this is not appropriate if the arrhythmia is frequently recurrent. 应静脉注射索他洛尔、氟卡胺、异丙吡胺或胺碘酮等减慢旁路传导的药物。这些药物会减缓心室对房颤的反应，并经常会恢复窦性心律。终止房颤的一种简单的替代方法是复律，但如果心律失常经常复发，这种方法就不合适。 For prevention of atrial fibrillation, the drugs listed above that slow conduction in the accessory pathway given orally are often effective, but catheter ablation is the treatment of choice. 对于心房颤动的预防，上述药物在旁路传导中是有效的，但导管消融是根治的方法。   -未完待续- 校审|尹德春-哈尔滨医科大学附属第一医院 参考文献 |
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