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|本期目录/Table of Contents|

胺碘酮治疗心衰并发房颤的有效性和安全性研究(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
1999年第4期
页码:
238-240
栏目:
论著
出版日期:
1999-07-01

文章信息/Info

Title:
Efficacy and safety of amiodarone for patients with heart failure and atrial fibrillation
作者:
袁展群　魏 群
江西省人民医院心内科,南昌 330006
Author(s):
Yuan Zhanqun; Wei Qun
Department of Cardiology, Jiangxi Provincial people′s Hospital,Nanchang　330006
关键词:
心力衰竭　心房颤动　胺碘酮
Keywords:
heart failure;  atrial fibrillation;  amiodarone
分类号:
-
DOI:
-
文献标识码:
-
摘要:
评价胺碘酮对心衰并发房颤患者心室率的影响,转复窦性心律的可能性,以及治疗的安全性。采用随机、单盲、安慰剂对照方法, 运用24 h动态心电图监测心率。结果:①胺碘酮对心衰并发房颤患者的转复律为23.53% , 高于对照组(3.33% ), P<0.01。②治疗2周后试验组12导联心电图所得平均心室率、Holter监测下24 h最大心室率、平均心室率明显下降(P <0.01),最小心室率无影响(P>0.05)。③两组间左室射血分数(LVEF)无差异(P>0.05),均无尖端扭转性室性心动过速发生, 试验组QTc延长, 但改为维持量后QTc恢复正常。结论: 胺碘酮能使一部分心衰并发房颤患者复律, 并且无论复律与否, 均能减慢心室率, 而不影响心功能的改善, 严重副反应较少发生。
Abstract:
To evaluate the effect of amiodarone on heart rate, possibility of conversion and safety of treatment for the patients with heart failure and atrial fibrillation (AF),a randomized, singleblind and p lacebo2controlled study was performed and heart rate w as measured by Holter.The results were as follows:①Eight of 33 patients on amidarone(23.53%) and one of 32 patients on placebo(3.33%)convented to sinus rhythm (P<0.01)。②After two weeks of treatment the mean ventricular rate (VR) ,maximal VR over 24 hours were reduced from 86±5.3, 142±5.8 at baseline to 73±4.7, 114±4.3 beats per minute respectively (P<0.01),the mean VR obtained from 12 lead ECG showed the same results. These beneficial changes were sustained at the 3 month evaluation。③ Heart function has been improved for all patients, but no differences were observed for LVEF between the two groups (P>0.05). No refractory ventricular tachycardia was found. QTc was prolonged in the amidarone group, but returned to normal value during the follow-up when amidarone was to be taken with a daily dose of 200 mg. The above result suggest that AF can be converted to sinus rhythm by amidarone for some patients with heart failure and atrial fibrillation. Amidarone can reduce VR in those with either persistent AF or with sinus rhythm and has no significant effect on the improvement of heart function, serious side effect is rare.

参考文献/References

［1］Chun SH, Sager PT, Stevenson WG, et al. long-term efficacy of amiodarone for themaintenance of normal sinus rhythm in patients with refractory atrial fibrillation or flutter. Am J Cardiol, 1995; 76(1) : 47.

［2］Middlekauff HR,Wiener I, Saxon LA , et al. low-dose amiodarone for atrial fibrillation: time for a prospective study? Ann Intern Med , 1992; 116 (21) : 1017.

［3］Middlekauff HR, Stevenson WG, Stevenson LW. Prognostic significance of atrial fibrillation in advanced heart failure: a study of 390 patients. Circulation, 1991; 84 (1) : 40.

［4］Prakash C,Deedwania MD,Bramah N , et al. Spontaneous conversion and maintenance of sinus rhythm by amiodarone in patients with heart failure and atrial fibrilation:Observation from the veterans affairs congestive heart failure survival trial of antiarrhythmic therapy (CHF-STAT). Circulation, 1998; 98 (23) : 2574.

［5］Singh SN , Fletcher RD, Fisher SG, et al. For the survial trial of antiarrhythmic therapy in congestive heart failure. Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythinia. N Engl J Med , 1995; 333 (1) : 77.

备注/Memo

备注/Memo:
(收稿1999-06-14　修回1999-09-27)
更新日期/Last Update: 1999-07-01