口服胺碘酮转复心房颤动与QTc关系的探讨

EFFECTS OF AMIODARONE ON QTc IN PATIENTS WITH ATRIAL FIBRILLATION

目的 观察口服胺碘酮转复心房颤动QTc的变化。方法 4 0例心房颤动复律成功者均采用口服胺碘酮片 ,第 1周 6 0 0mg/d、第 2周 4 0 0mg/d、第 3周 2 0 0mg/d ,测量并比较用药前后心室率、QRS时间和QTc。结果 (1)与复律前相比 ,用胺碘酮转复心房颤动后心室率减慢 (P <0 .0 0 1) ,QRS时间不变 (P >0 .0 5 ) ,QTc延长 (P <0 .0 0 5 ) ;(2 )QTc在 0 .4 0～ 0 .4 7s复律者 34例 ,无一例出现心脏方面副作用 ,QTc≥ 0 .4 8s复律者 6例 ,均出现心脏副作用 (P <0 .0 0 1)。结论 口服胺碘酮转复心房颤动需监测QTc ,防止出现严重心脏方面副作用。

Objective\ To study changes in QTc of orally administered amiodarone for reversing atrial fibrillation (AF). Methods\ 40 patients received oral amiodarone 600 mg/d for one week, followed by 400 mg/d for one week, with the maintainence doses of 200 mg/d.QTc value,QRS time and heart rate were measured and compared before and after treatment.Result\ (1) After reversing to sinus rhythm, heart rate were significantly reduced(P<0.001),QTc were significantly prolonged(P<0.005),while there was no difference in QRS time (P>0.05).(2)34 patients were reversed in 0.40～0.47 secend,6 patients were in QTc above 0.48 second ,with had heart side effects (P<0.001).Conclusion\ QTc should be monitored in reversing AF with oral amiodarone treatment to prevent severe cardiac side-effect.