Niu Fan, Huang Cong-xin, Jiang Hong, Yang Bo, Guo Wen-ling, Chen Yun-xia, Jin Chun-rong, Liu Zhuo-min
Department of Cardiology People's Hospital of Wuhan University, Wuhan 430060, China.
Zhonghua Yi Xue Za Zhi. 2006 Jan 10;86(2):121-3.
To evaluate the effects and adverse reactions of amiodarone and sotalol in treatment of atrial fibrillation.
One hundred and two patients with atrial fibrillation, 56 males and 46 females, aged 56 +/- 11, were randomized into 2 equal groups: amiodarone group, taking amiodarone 600 mg/d for 7 days, 400 mg/d for 7 days, 200 mg/d for 7 days, and then 200 mg/d as maintenance dosage if conversion to sinus rhythm occurred; and sotalol group, taking sotalol 40-80 mg/d for one week, 160 mg/d for 2 weeks and then 40-80 mg/d as maintenance dosage if conversion to sinus rhythm occurred. If the cardiac rhythm failed to be converted to sinus rhythm after three week the medication was stopped. All the patients were followed up for 12-24 months and therapeutic effects were evaluated by echocardiography, electrocardiogram and Holter monitor.
(1) Conversion to sinus rhythm occurred in 40 patients in the amiodarone group with an effective rate of 78.4%, and in 36 patients in the sotalol group with an effective rate of 70.6%. (2) Conversion to sinus rhythm occurred in the first week in 34 patients of the amiodarone group and in 10 patients of the sotalol group. (3) 67.5% of the patients with conversion to sinus rhythm in the amiodarone group and 41.7% of the patients with conversion to sinus rhythm in the sotalol group maintained sinus rhythm in the following 12 months; and 44.4% patients with conversion to sinus rhythm in the amiodarone group and 26.7% of the patients with conversion to sinus rhythm in the following 24 months. (4) 10 patients in the sotalol group taking a maintenance dosage of 80 mg/d showed atrial ventricular block and severe bradycardia during the follow-up of 6-2 months, then the medication was stopped, but there was no severe arrhythmia in amiodarone group. (5) It was difficult to maintain sinus rhythm when atrial fibrillation lasting longer than 12 months was a predictive factor of failure to maintain sinus rhythm.
There is no significant difference between amiodarone and sotalol in converting atrial fibrillation to sinus rhythm. However, amiodarone is more effective in maintenance of sinus rhythm than sotalol. The adverse reaction of amiodarone on heart is less severe than that of sotalol.
评估胺碘酮与索他洛尔治疗心房颤动的疗效及不良反应。
102例心房颤动患者，男56例，女46例，年龄56±11岁，随机分为两组：胺碘酮组，先予胺碘酮600mg/d，连用7天，继以400mg/d，连用7天，再以200mg/d，连用7天，若转为窦性心律，则以200mg/d作为维持剂量；索他洛尔组，先予索他洛尔40 - 80mg/d，连用1周，继以160mg/d，连用2周，若转为窦性心律，则以40 - 80mg/d作为维持剂量。若3周后心律未转为窦性心律，则停药。所有患者随访12 - 24个月，通过超声心动图、心电图及动态心电图监测评估疗效。
（1）胺碘酮组40例转为窦性心律，有效率78.4%；索他洛尔组36例转为窦性心律，有效率70.6%。（2）胺碘酮组34例在第1周转为窦性心律，索他洛尔组10例在第1周转为窦性心律。（3）胺碘酮组67.5%转为窦性心律者在随后12个月维持窦性心律，索他洛尔组41.7%转为窦性心律者在随后12个月维持窦性心律；胺碘酮组44.4%转为窦性心律者在随后24个月维持窦性心律，索他洛尔组26.7%转为窦性心律者在随后24个月维持窦性心律。（4）索他洛尔组10例服用80mg/d维持剂量的患者在随访6 - 2个月期间出现房室传导阻滞及严重心动过缓，随后停药，但胺碘酮组未出现严重心律失常。（5）房颤持续时间超过12个月是难以维持窦性心律的预测因素。
胺碘酮与索他洛尔在转复心房颤动为窦性心律方面无显著差异。然而，胺碘酮在维持窦性心律方面比索他洛尔更有效。胺碘酮对心脏的不良反应比索他洛尔轻。
