胺碘酮用于心房颤动心律转复后维持窦性心律的远期疗效观察

Long term efficacy of amiodarone for maintenance of sinus rhythm after cardioversion of atrial fibrillation

评价胺碘酮对８１例慢性心房颤动患者转复后长期维持窦性心律的有效性和安全性。胺碘酮负荷量６００ｍｇ／ｄ１～２周、４００ｍｇ／ｄ１～２周，继以维持量２１５±５０ｍｇ／ｄ，服药１～２周后行电转复。９例（９／７６，１１．８４％）在胺碘酮负荷量期间转为窦性心律，７２例电转复为窦性心律，平均随访１４．５个月（０．５～９２个月）．胺碘酮维持窦性心律半年有效率７１．６％（５８／８１），１年有效率６３．０％（５１／８１），副反应发生率１１．１％（９／８１）．未见严重毒副反应，逻辑回归分析显示心功能分级为维持窦性心律的负性因素，胺碘酮为慢性心房颤动转复后维持窦性心律的有效药物，用量以较小为宜。

The efficacy and safety of amiodarone was assessed in 81 patients for maintenance of sinus rhythm after cardioversion of persistent atrial fibrillation. The initial dose was 600 mg/d for 1 to 2 weeks,followed by 400 mg/d for 1 to 2 weeks,Synchronized direct-current cardioversion was carried out after 1 to 2 weeks of the loading period.A maintenance dose was mean 215±50 mg/d.Nine patients(11.8%)were reverted to sinus rhythm on the loading period.Seventy-two patients were reverted to sinus rhythm with synchronized direct-current cardioversion,During an average follow-up of 14.52 months,fifty-eight patients(71.6%) maintained sinus rhythm for at least six months,fifty-one patients(63.0%)maintained sinus rhythm for at least 1 year.Side effects occurred in 9 patients(11.1%).No patient had significant side effects.The logistic regressive analysis suggested that the classification of heart function appeared to have a significant predictive value in identifying efficacy.The relative low dose of amiodarone can be used safely and effectively for maintenance of sinus rhythm after cardioversion of atrial fibrillation.