Zhao Fu, Feng Shao-xian, Zhao Ping, Ma Hong
Department of Cardiology, First Municipal Hospital of Guangzhou, Guangzhou 510080, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2006 Apr;26(4):521-2.
To observe the efficacy and safety of oral cordarone dir reversing persistent atrial fibrillation (AF). METHODS; Eighty-two symptomatic chronic AF out-patients without history of acute diseases or severe hepatic/thyroid dysfunction were given oral cordarone at the loading dose of 200 mg thrice a day for 1-4 weeks followed by a twice-daily administration for another 1-4 weeks, with the maintenance dose of 200 or 100 mg once a day. The incidence of stroke and cardiac events and the mortality rate were compared between 43 patients with restored rhythm on cordarone and 39 patients on digoxin and/or betaloc for ventricular rhythm control.
Among the 82 patients, sinus rhythm restoration was achieved in 43, with a successful rate of 52%. In 18 patients, the ejection fraction increased from (32+/-8)% to (46+/-10)%, left atrium diameter decreased from (4.6+/-1.1) cm to (4.1+/-0.8) cm. Except for slight T4 increase, QT prolongation and bradycardia in 3 cases, severe side effects were not observed in this study. Only one patient with restored sinus rhythm required rehospitalization after half a year for worsened heart failure, but in patients with controlled ventricular rhythm, 1 developed stroke, 1 experienced heart attack and 1 died of heart failure with bleeding.
For patients with symptomatic reversible persistent AF, active treatment with cordarone can be convenient, effective and safe for sinus rhythm restoration.
观察口服胺碘酮转复持续性心房颤动（房颤）的疗效及安全性。方法：82例有症状的慢性房颤门诊患者，无急性疾病史或严重肝/甲状腺功能障碍，给予口服胺碘酮，负荷剂量为每日3次，每次200mg，共1 - 4周，随后每日2次，再用1 - 4周，维持剂量为每日200mg或100mg。比较43例胺碘酮转复心律患者与39例使用地高辛和/或倍他乐克控制心室率患者的卒中、心脏事件发生率及死亡率。
82例患者中，43例恢复窦性心律，成功率为52%。18例患者射血分数从（32±8）%增至（46±10）%，左心房直径从（4.6±1.1）cm降至（4.1±0.8）cm。本研究除3例有轻微T4升高、QT间期延长及心动过缓外，未观察到严重副作用。仅1例恢复窦性心律的患者半年后因心力衰竭加重再次住院，但在心室率控制组，1例发生卒中，1例发生心脏病发作，1例因心力衰竭伴出血死亡。
对于有症状的可逆性持续性房颤患者，积极应用胺碘酮治疗转复窦性心律方便、有效且安全。
