静脉用胺碘酮治疗顽固性室速14例疗效观察

A study on the clinical effect of intravenous amiodarone in the treatment of refractory ventricular tachycardia

对14例经用1～3种常规抗心律失常药无效的顽固性室性心动过速(室速)患者,静脉应用胺碘酮,首剂150mg,继之以0.4～1.5mg/min维持1～6d(平均3.2d);同时口服胺碘酮600mg/d,必要时间隔15min重复静脉注射(静注)75～150mg,24h总量平均为1855mg.12例取得满意疗效,未见严重毒副反应.提示静脉用胺碘酮对顽固性室速治疗,安全有效.

Fourteen patients with refractory ventricular tachycardia could not be controlled by 1 to 3 antiarrhymic agents. Six had old myocardial infarction, three had acute myocardial infarction, two had dilated cardiomyopathy, one had hypertrophic cardiomypathy, one had arrhythmogenic right ventricular dysplasia and one had not other cardiac disease. They were treated with intravenous amiodarone. The dose of amiodarone was 150mg over 10 minutes intravenously followed by 0. 4mg to 1. 5mg per minute for 1 to 6 days (mean 3. 2 days). At the same time, the patients started on 600mg of oral amiodarone daily. If ventricular arrhythmia was uncontrolled, the bolus of 75mg or 150mg could be repeated 15 minutes later. The mean dose was 1 855mg/24h. In 12 of 14 patients the arrhythmia was controlled. No patient had significante adverse effects during the period of intravenous amiodarone. The result suggests that intravenous amiodarone can be used safely and effectively in patients with refractory ventricular tachycardia.