Effect of Low Molecular Weight Heparin Combined with Warfarin on the Early Cardioversion of Atrial Fi-brillation / 中国药房

ABSTRACT

OBJECTIVE:To observe the effect of low molecular weight heparin combined with warfarin on early cardioversion of atrial fibrillation. METHODS:Totally 58 patients with atrial fibrillation were randomly divided into observation group (32 cas-es)and control group(26 cases). All patients were given conventional treatment;meanwhile,control group was orally treated with warfarin with initial dose of 2.5 mg,once a day,and when international normalized ratio (INR) was maintained at 2.5-3 weeks, amiodarone was orally given for cardioversion;observation group was subcutaneously injected warfarin (the same dose as control group)+ Low molecular weight heparin for injection 5 000 U for continuous 3-5 d,q12 h,it was stopped when INR was 2.5 and cardioversion was started at the same time. If the heart rate was fast,a loading dose of 150 mg amiodarone was given to maintain 6 h with rate of 1 mg/min and more than 24 h with rate of 0.5 mg/min. If hemodynamics is stable,amiodarone was orally given for cardioversion,it was not achieved after 4 weeks of amiodarone or QTc>0.50,it was replaced by controlling heart rate and warfa-rin. All patients were continuously given warfarin for 4 weeks after cardioversion to maintain INR in about 2.5. After one month of using amiodarone,the cardioversion rate,recurrence rate,cardioversion time,total amount of amiodarone and incidence of ad-verse reactions were evaluated. RESULTS:The cardioversion rate,recurrence rate,cardioversion time and total amount of amioda-rone in observation group were significantly better than control group,the differences were statistically significant(P0.05). CONCLUSIONS:Low molecular weight heparin combined with warfarin can improve the success rate of early cardioversion of atrial fibrillation,without bleeding and embolic complications and with good safety.