伊伐布雷定对慢性心力衰竭患者 QT 间期和 心率的影响.

Objective To explore the effect of ivabradine on QT interval and sinus rhythm in patients with chronic heart failure (HF). Methods A total of 179 patients with chronic HF were selected as the research subjects. They underwent 12-lead synchronous ambulatory electrocardiography (AECG) examination, and reexamination of AECG 30-45 days after oral administration of ivabradine. The changes of QT interval and heart rate before and after medication were compared. Results A total of 143 patients complete clinical follow-up and are enrolled in this study. After oral administration of ivabradine, the maximum QT interval [(467. 9 ± 62. 6)ms vs. (473. 6±63.4) ms], the maximum QTc [(489. 3±56. 0) ms vs. (496. 6±55. 4) ms], the average QT interval [(390. 5±41.1) ms vs. (398. 6±43.7) ms], the average QTc [(417. 2±31. 4) ms vs. (414. 4±36. 9) ms], and the minimum QTc [(377. 5± 36. 0) ms vs. (361.3±37. 0) ms] of all the 143 patients are significantly different from those before medication (P<0. 01). The minimum QT interval [(348. 3 ± 42. 8) ms vs. (349. 6±38. 9) ms] does not vary significantly before and after medication (P > 0. 05). The differences of the minimum heart rate [(50. 3±8. 6) times per minute vs. (47. 7±7. 8) times per minute], the average heart rate [(69. 9±11. 7) times per minute vs. (64. 9±10.6) times per minute], and the maximum heart rate [(116. 6±23.1) times per minute vs. (109. 0±20.1) times per minute] are all statistically significant before and after medication (P<0. 01). During the follow-up period, there is no incidence of ventricular arrhythmia or sudden death. Conclusion Ivabradine could significantly shorten the maximum QT interval / QTc and the average QT interval, and slow down heart rate. Its clinical application is safe and effective. [ABSTRACT FROM AUTHOR]