胺碘酮治疗心力衰竭并心房颤动的有效性及安全性

Efficacy and safety of amiodarone for patients with heart failure and atrial fibrillation

目的:评价胺碘酮对心力衰竭合并心房颤动患者心室率影响,转复窦性心律的可能性.以及治疗的安全性。方法:采用随机、单盲、安慰剂对照方法,运用24 h动态心电图监测胺碘酮治疗组(33例),对照组(31例)的心律、心率。结果:(1)胺碘酮治疗组的心房颤动转复率为33.33%,高于对照组(3.29%).P<0.01;(2)治疗三个月后治疗组平均心室率明显下降(P<0.05);(3)两组间左室射血分数(LVEF)无差异(P>0.05),治疗组QTc延长, 但改为维持量后QTc恢复正常,均无严重副作用。结论:胺碘酮能显著减慢心率并使一部分心力衰竭合并心房颤动患者复律。

Objective:To evaluate the effect of amiodarone on heart rate, possibility of conversion and safety of therapy for the patients with heart failure and atrial fibrillation (AF). Methods:A randomized, single-blind and placebo-controlled study was performed in amiadarone group (33 cases), control group (31 cases) and heart rate was measured by Holter. Results:(1) The AF converted to sinus rhythm in 11 of 33 patients by amiodarone treatment (33. 33%) and one of 31 patients by placebo treatment (3. 29%) (P<0. 01);(2) After 3 month amiadarone therapy the mean ventricular rate decreased from (86±5. 3) beats/min to (72. 0±4. 5) beats/min (P<0. 05); (3) LVEF between the two groups was no significant difference (P>0. 05) ,no severe side-effect was found in all patients. QTc was prolonged in the amiodarone group, when amiodarone was taken with a daily dose of 200 mg, it was returned to normal, Conclusion:Amiodarone can reduce ventricular rate,converted AF to sinus rhythm for some patients with heart failure and atrial fibrillation.