用洋地黄治疗房颤已有70余年历史。60年代末,Bender等人发现异搏定能有效地减慢房颤时的心率。近20年来,在房颤的处理中,异搏定似有与洋地黄平分秋色的趋势。本文介绍这方面的进展。一、地高辛和异搏定对房室结作用的机制洋地黄使房室结传导性减低、有效不应期延长,这主要是通过其拟迷走神经胆硷能及抗肾上腺能作用,对房室结的直接作用并不明显。据此可推测洋地黄对房颤患者在运动、紧张等状态下的心率并不能有效控制。因为在这些状态下迷走神经张力减低、交感 With digitalis treatment of atrial fibrillation has more than 70 years of history. In the late 1960s, Bender et al. Found that Verapamil effectively slows heart rate during atrial fibrillation. Over the past 20 years, in the treatment of atrial fibrillation, verapamil seems to have equal shares with digitalis. This article describes the progress in this area. First, digoxin and verapamil on the mechanism of atrioventricular node action Digitalis reduce the conductivity of the AV node, effective refractory period is prolonged, mainly through its quasi-vagal nerve cholinergic and anti-adrenergic effect on the room The direct effect of ventricular node is not obvious. Based on this, it can be inferred that the heart rate of digitalis in patients with atrial fibrillation under exercise, tension and other conditions can not be effectively controlled. Because in these conditions reduce vagal tone, sympathetic