心房撲動對於藥物治療經常出現反抗性，而後患者通常必需接受侵襲性的心臟電氣轉換術(DC-cardioversion)或導管電燒術(Catheter Ablation)。在現在的治療藥物之外，若能尋得其他有效而侵入性治療辨法，將是臨床上很重要的課題。本病案主角許先生，六十四歲。88年8月25日晚餐後發作嚴重心悸胸悶，由急診住院，診斷為陣發性心房撲動(Paroxysmal atrial flutter)。住院二日內，以多種抗心率不整藥物配合控制病情。然而反應不佳，而且出現血流動力學惡化的症狀，故建議患者接受導管電燒術，病人要求會診中醫。9月1日會診時，病人主訴胸悶心悸氣喘明顯。面色蒼白，語音低弱，前額微有冷汗，畏冷，手腳末端不溫。無法下床走動。夜間頻尿，尿清稀量多。舌質淡白舌苔薄白潤。脈來濡散偶一代。中醫辨證屬心腎陽虛，水氣凌心，西醫觀點屬心輸出量不足(Low cardiac output)。治療時急以回陽救逆法應對，處方以參附湯合真武湯加減。患者在口服中藥十五分鍾後立覺精神好轉，氣喘胸悶心悸諸症迅速獲得緩解，已能自行起床步行。服藥三貼後患者自覺各種症狀均已解除，心電圖監視恢復正常竇性率，故不再考慮導管電燒術治療。患者於88年9月4日出院。

Atrial flutter is often resistant to anti-arrhythmic drug, then Dirrect-current Car-dioversion and Catheter Ablation were considered, but with a 0.36% mortality rate and 4.8% incidence of early life-threatening complications. The case is a 64 years old male. Episodic palpitation and chest tightness happened after dinner on Aug. 25 1999. Then he was sent to the emergency room and admitted under the diagnosis of Paroxysmal atrial flutter. But the arrhythmia recurred and symptoms of hemodynamic compromised developed even after the administration of Inderal, Amiodarone, Digoxin and Ativan. So, Catheter Ablation was suggested, but the patient asked to consult the department of Chinese Medicine for alternative treatment. When we examined the patient, he showed pale-looking and weakness. The chief complains were chest tightness, dyspnea and palpitation. In addition, cold sweating, frequent nocturia, cold extremities and generalized weakness had been aggravated in these days. The tongue was pale and tender with a thin and moist fur. The pulse is soggy, scattered and irregularly interrupted. Those signs and symptoms indicated the diagnosis of-[Yang deficiency of the heart and kidney with the retention of fluid over the heart]. The treatment should focus on the rule of [Restore Yang from collapse], Decoction of Ginseng and Praeparata combined Zhenwu Decoction were prescribed. Fifteen minutes after medication, the patient felt spirited again and was able to walk. Dyspnea, palpitation and chest tightness were subsided effectively. Three days after, symptoms resolved smoothly and the electrocardiographic examination revealed normal sinus rhythm, so Catheter Ablation was cancelled and the patient was allowed to discharged.