OBJECTIVE:To observe clinical efficacy and safety of adenosine cyclophosphate combined with diltiazem in the treatment of chronic pulmonary heart disease heart failure complicated with atrial fibrillation and atrial flutter. METHODS:100 cas-es of chronic pulmonary heart disease heart failure complicated with rapid atrial fibrillation and atrial flutter were randomly divided into observation group and control group,with 50 cases in each group. The control group was given conventional treatment,and the observation group was additionally given diltiazem orally,30 mg/time,once a day,and adenosine cyclophosphate 180 mg add-ed into 5% Glucose injection 200 ml intravenously,once a day,for 10 days,on the basis of conventional treatment. The heart rate,the pressure of pulmonary artery and left ventricular ejection fraction(LVEF)before and after treatment,and clinical efficacy were observed in two groups. RESULTS:After treatment,clinical symptoms of 43 cases of observation group and 31 cases of con-trol group improved significantly,and heart rate were satisfactory,with statistical significance(P<0.05). The decrease of pulmo-nary arterial pressure and LVEF in observation group were improved significantly,compared to control group,with statistical signif-icance (P<0.05). The bradycardia,hypotension,the exacerbation of asthma and heart failure and other side effects hadn’t been found in 2 groups. CONCLUSIONS:Adenosine cyclophosphate combined with diltiazem in the treatment of chronic pulmonary heart disease heart failure complicated with atrial fibrillation and atrial flutter can significantly improve cardiac function,control heart rate and promote the improvement of disease condition with good safety.

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(P<0.05). There was no significant difference in the incidence of adverse reactions between 2 groups (P>0.05). 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.