1例左心耳封堵术后应用胺碘酮致间质性肺炎分析

A case of interstitial pneumonia caused by amiodarone after left atrial appendage occlusion surgery

心房颤动(Atrial Fibrillation, AF)患者发生血栓栓塞的风险较高,主要治疗方法包括抗凝、复律、控制心室率等。近年来,左心耳封堵术(left atrial appendage closure, LAAC)的开展大大减小了房颤患者发生血栓栓塞的风险,且术后无须长期服用抗凝药物,但目前对于左心耳封堵术后的患者是否应继续服用抗心律失常药物尚无统一定论。胺碘酮是房颤患者最常用的抗心律失常药物之一,但因其较多的不良反应限制了在临床中的应用。本文报道1例左心耳封堵术后应用胺碘酮所致的间质性肺炎,分享临床诊断及治疗的经验,并结合病例复习相关文献,旨在为此类患者服用胺碘酮后出现不良反应的预防、早期诊断及治疗提供参考。

Patients with Atrial Fibrillation(AF)take a higher risk of thromboembolism.The main treatments include anticoagulation,cardioversion,and ventricular rate control.In recent years,the development of left atrial appendage closure(LAAC)has greatly reduced the risk of thromboembolism in patients with atrial fibrillation,and there is no need for long-term postoperative anticoagulant drugs.However,there is no consensus as to whether patients undergoing left atrial appendage closure should continue to take antiarrhythmic drugs.Amiodarone is one of the most commonly used antiarrhythmic drugs in patients with atrial fibrillation,but its clinical application is limited due to its many adverse reactions.This paper reports a case of interstitial pneumonia caused by amiodarone after left atrial appendage closure,shares the experience of clinical diagnosis and treatment,and reviews relevant literature in combination with the case,aiming at provide reference for the prevention,early diagnosis and treatment of adverse reactions after taking amiodarone in such patients.