静脉胺碘酮治疗老年充血性心力衰竭并恶性室性心律失常

The effect of amiodarone on malignant ventricular arrhythmia in the elderly with congestive heart failure

目的观察静脉与口服联合应用胺碘酮治疗老年充血性心力衰竭并恶性室性心律失常的疗效及安全性。方法对42例老年充血性心力衰竭并发室性心动过速（VT）和/或心室颤动（VF）患者,首剂给予胺碘酮150-300 mg,10 m in注入,继之以0.5-1 mg/m in维持泵入。静脉维持用药24-48 h后给予口服胺碘酮600 mg/d,并逐渐减至200 mg/d维持。结果维持静脉点滴平均（4.0±1.5）d,总有效率85.7%。静脉用药期间,未见QT间期明显延长,无因胺碘酮导致或加重心功能不全。结论静脉用大剂量胺碘酮治疗老年心力衰竭并发的恶性室性心律失常是安全有效的。静脉与口服联合给药起效快,可达到早期抢救生命的目的,又可稳定血药浓度,防止心律失常的复发。

Objective To observe the effectiveness and safety of amiodarone been administrated intravenously and orally. Methods Forty - two elderly patients suffering from ventricular tachycardia/fibrillation （ VT/VF ） accompany with congestive heart failure were started with 150 -300 mg intravenous loading regimen over 10 minutes, followed by a intravenous maintenance dose of 0.5 -1 mg/min. 24 -48 hours later, oral amiodarone with 600 mg per day were given, and then reduced the dosage of drug to a oral maintenance dose of 200 mg per day step by step. Results The average days of intravenous maintenance was （4.0 ± 1.5 ）d, and the total efficiency was 85.7 %. We didnt see any distinctly prolonged QT intervals or aggravated heart function because of the use of the drug during the time. Conclusion It is a safe and effective method to use amiodarone in large dose to treat malignant ventricular arrhythmia in the elderly with congestive heart failure. Onset of action comes earlier and the serum amiodarone concentration is stable following intravenous and oral amiodarone therapy in combination,which could save lives more quickly and prevent the recurrence of arrhythmia.