胺碘酮对心房颤动心室反应昼夜节律的影响

The effects of amiodarone on diurnal distribution of ventricular response in patients with atrial fibrillation

目的 探讨胺碘酮对慢性持续性房颤患者心室反应昼夜节律的影响。方法 选择 6 8例 41～77岁的房颤患者接受小剂量胺碘酮治疗 ,胺碘酮剂量从 2 0 0 mg.d- 1 开始 ,一周后改为 10 0 mg.d- 1 继续治疗二周 ,用药前后行动态心电图检查 ,观察患者心室反应节律的昼夜分布特征。结果 发现房颤患者心室反应有其一定的昼夜节律 ,在凌晨 4时至 5时达谷值 ,于上午 10时至 11时达峰值。应用胺碘酮后 ,2 4小时总心室率 ,最快心率及 2 4小时平均心率均有所下降 ,但其心室反应的昼夜特征无改变。结论 胺碘酮可有效控制房颤患者的心室率 ,而对其心室反应的昼夜节律无显著影响。

Objective Effects of this study was aimed to investigate the amiodarone on diurnal distribution of ventricular response in patients with atrial fibrillation(AF).Method Totally 68 patients,age 41～72 years old with AF were given low dose amiodarone orally.The initial dose was 200mg.d -1 ,After one week;the dosage was diminished to 100mg.d -1 ,the treatment duration was three weeks,Hotler monitoring was used to assess the characteristic of diurnal distribution of ventricular respones before and after treatment.Results The diurnal disfribution of ventricular response in patients with AF showed a regular circadian variation,The trough of heart rate were from 4Am to 5Am and peak at 10Am to 11Am.The amiodarone decreased the total heart rate.maximum heart rate and 24 hour average heart rate of AF.but did not change the characteristic of circadian variation of ventricular response.Conclusion The amiodarone is effective and safe to slow down ventricular response of AF.There was no relationship between low dose amiodarone and circadian variation of ventricular response.