Objective To evaluate the curative effect of coenzyme complex and potassium magnesium aspartate on the restoration of rhythm and anti-arrhythmia in postoperative valve replacement patients for rheumatic heart disease.Methods Eight two patients with rheumatic heart disease were randomized into 2 groups,with no statistical significance in the patients' parameters.Treatment group A (n =41 )received i.v.coenzyme complex and potassium magnesium aspartate 30 ml during operation.Group B ( n =41 ) were only given potassium magnesium aspartate 30 ml.Other conventional therapies were the same for the two groups.At the same time,rate of spontaneous restoration of rhythm and severe arrhythmia incidences and low cardiac output syndrome were also recorded.Results The rate of spontaneous restoration of rhythm in the treatment group were higher than that in the control group ( 97.56％ vs 80.49％,x2 =6.12,P =0.01 ).There were significant differences in the severe ventricular tachycardia,ventricle fibrillation and auricular flutter events between the 2 groups ( 19.51％ vs 41.46％,x2 =4.67,P =0.03 ).The rate of low cardiac output in the treatment group were lower than that in the control group( 14.63％ vs 36.58％.x2 =5.18,P =0.02).To evaluate the effect of combination therapy on the spontaneous restoration of rhythm,Logistic regression analysis showed that OR( odds ratio) value was 9.69 and 95％ CI( confidence interval) was 1.15 - 81.55 ( P =0.03 ).Other variables affecting the spontaneous restoration of rhythm included the time of aortic obstruction( OR =9.28,95％ CI 1.21 - 78.18,P =0.02) and cardiac function before operation ( OR =4.95,95％ CI 1.27 - 17.88,P =0.02),operating time (OR=3.99,95％CI 1.18- 11.62,P =0.04),age(OR=2.77,95％CI1.11 -9.74,P=0.04).Conclusion Combined administration of coenzyme complex and potassium and magnesium aspartate in the operation of valve replacement in patients with rheumatic heart disease is able to promote the spontaneous heart rhythm restoration and reduce the chance of severe ventricular tachycardia and low cardiac output events.

Objective To evaluate the influence of preoperation medical treatment on recurrence of atrial fibrillation(AF) in valve replacement postoperative patients of rheumatic heart disease during in-hospital and other risk factors. Methods One-hundred and eight patients with rheumatic heart disease and AF that underwent valve replacement postoperative patients were randomly divided into 2 groups: the treatment group (n =54)and the control group (n = 54 ). The treatment group were treated with ranipril, felodipine and simvastatin for 1 month and other conventional preoperational treatments before operation . The control group were only treated conventional preoperational therapy. Occurrence of AF postoperation were observed during inhospital. Results The occurrence of atrial fibrillation of the two group was no difference( 35.85% vs 41.51%,P = 0.55) immediately after rebeat. There was significant difference in the occurrence of atrial fibrillation of the 2 groups within 24 h post-operation ( 47.17% vs 69.81%, P = 0.02 ) . Logistic regression showed that intervention before operation had significant effect on the occurrence of AF( OR =0.39,95% CI: 0.17 -0.86,P =0.018) ,as well as the diameter of left atrium (LAD) ( OR= 4.28,95% CI:1.12 - 18.23, P = 0.018 ),pulmonary artery pressure(PAP) ( OR = 3.28,95% CI: 1.14 - 12.25, P = 0.01 ), duration of atrial fibrillation (AFD) (OR = 4.19,95% CI: 1.15 -14.22,P = 0.011). ROC curve showed that the best cut-off of LAD was 46.5 mm to predict AF,with sensitivity of 73% and specify of 85% ;the best cut-off of PAP was 48.5 mm Hg,with sensitivity of 75.6% and specify of 80.3% ;the best cut-off of AFD was 7. 5 months,with sensitivity of 76.1% and specify of 88.3%. Conclusion The recurrence of AF can be effectively reduced during hospitalization by the preoperational triple treatments for patients with rheumatic heart disease successfully underwent valve replacement operation , which is also beneficial for maintenance of sinus rhythm after operation.