小剂量胺碘酮治疗扩张性心肌病伴发心律失常

Effect of amiodarone on severe ventricular arrhythmias in patients with idiopathic dilated cardiomyopathy

目的探讨小剂量胺碘酮治疗扩张性心肌病伴发阵发性室性心动过速和预防心脏性猝死的疗效。方法扩张性心肌病患者65例,分为小剂量胺碘酮治疗组(n=33)及对照组(n=32),基础治疗用利尿药、强心苷、血管紧张素转化酶抑制药及硝酸酯,随访12个月,用超声心动图测定心功能指数,动态心电图监测阵发性室性心动过速和猝死率,进行两组病例比较。结果治疗12个月后,两组心功能指数均较治疗前改善,小剂量胺碘酮治疗组患者阵发性室性心动过速较对照组明显减少,两组猝死率没有明显区别。结论小剂量胺碘酮对于改善心功能和治疗扩张性心肌病患者恶性室性心律失常有效,可减少新发室性心律失常。

Objectives To investigate the effects of amiodarone on non-sustained ventrieular taehyeardia（VT） and sudden cardiac death in patients with idiopathic dilated eardiomyopathy （DCM）. Methods Sixty-five patients with DCM treated with diuretics,digitalis and angiotensin-eonverting enzyme inhibitors were assigned to receive minidose amiodarone （n=33） or not （n=32）, Mean follow-up was 12 months. The eehoeardiographie indices of cardiac ftmtion,the incidence of non-sustained VT on Holler monitoring electrocardiograms, and sudden cardiac death rate were compared between the 2 groups. Results Comparable improvement in cardiac ftmetion on eehoeardiographie was found in the 2 treatment groups. The patient group treated with minidose amiedarone showed a significant reduction in the prevalence of VT and reduced the development of new episodes of VT compared to the group without minidose amiedarone. The sudden cardiac death rate did not differ between two groups. Conclusions Amiedarone is effective and safe in treatment of DCM with arrhythmia and reduet the development of new episodes of VT.