胺碘酮在房颤伴长RR间期合并室性心律失常患者中应用的安全性

Safety of Amiodarone in patients with atrial fibrillation complicated with long RR Intervals and ventricular arrhythmias

目的观察胺碘酮治疗心脏瓣膜替换术后心房颤动（房颤）伴RR间期显著延长（〉2．5s）合并室性心律失常患者的安全性。方法2011年6月—2013年6月，对12例瓣膜替换术后房颤、心功能Ⅱ～Ⅲ级、24h动态心电图监测发现：（1）RR间期〉1．5s。（2）合并室性心律失常（多源室性期前收缩、成对室性期前收缩及短阵室速）的患者，根据动态结果给小剂量胺碘酮治疗（600mg／dx7，400mg／dX7，100—200leftg／d持续维持），经15—24（16±3）个月随诊。结果（1）最长RR间期每例均未超过服药前。（2）成对室性期前收缩和短阵室速消失；多源室性期前收缩明显减少，与服药前比较，每例均减少达80％以上。（3）随诊监查12例患者心功能均有改善，未发现胺碘酮不良反应。结论小剂量胺碘酮治疗房颤（夜间）伴RR间期显著延长（〉2．5S）合并的室性心律失常安全有效。

Objective To observe the safety of Amiodarone in patients with atrial fibrillation （Af） complicated with long RR inter- vals （ 〉 2.5 s） and ventricuIar arrhythmias after heart valve replacement. Methods A total of 12 patients, who had undergone heart valve replacement with NYHA II - Ill and 24 h Hoher monitoring from June 2011 to June 2013, were enrolled. Postoperative Af plus RR intervals 〉 1.5 s and ventrieular arrhythmias [ premature ventrieular contraction （PVC） with multiple sources, paired PVC and nonsustained ventricular tachyeardia J were found. A low dose of Amiodarone （600 mg/d x 7, 400 mg x 7, 100 -200 mg/d continuous maintenance） was administrated to the patients according to their Hoher results, and all the patients were followed up for 15 - 24 （ average 16 ± 3） months. Results （ 1 ） In each patient, the longest RR interval was not prolonged. （2） Paired PVCs and nonsustained ventrieular taehyeardia disappeared; PVCs with multiple sources significantly reduced. Compared with be- fore, each patient were reduced by more than 80%. （3） Cardiac function improved in all the 12 patients without Amiodarone side effects. Conclusion Low-dose Amiodarone is safe and effective on the patients with Af complicated with long RR intervals （ 〉 2.5s） and ventricular arrhythmias.