Chandhok Sheetal, Schwartzman David
Cardiovascular Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
J Cardiovasc Electrophysiol. 2007 Jul;18(7):714-8. doi: 10.1111/j.1540-8167.2007.00847.x. Epub 2007 May 30.
Amiodarone has been advocated as an effective "long-term" therapy for atrial rhythm control in patients with atrial fibrillation (AF). We sought to assess the sustainability of this therapeutic strategy.
Retrospective analysis of a consecutive, single-center cohort (n = 168) with symptomatic AF who were treated with amiodarone and followed for 3 years. The incidence of amiodarone cessation was evaluated at 1, 2, and 3 years and attributed principally to drug inefficacy, intolerance, or toxicity. A gradual diminution in the number of patients on therapy was observed, such that by 3 years, only 45% remained. This was attributable to inefficacy (25%), intolerance (12%), or toxicity (18%). Pulmonary toxicity was surprisingly common, occurring in at least 7% of patients.
These data challenge the notion of amiodarone as a reasonable "destination" therapy for AF.
胺碘酮已被推荐作为心房颤动（AF）患者心房节律控制的有效“长期”治疗方法。我们试图评估这种治疗策略的可持续性。
对连续的单中心队列（n = 168）有症状的AF患者进行回顾性分析，这些患者接受胺碘酮治疗并随访3年。在1年、2年和3年时评估胺碘酮停药的发生率，主要归因于药物无效、不耐受或毒性。观察到接受治疗的患者数量逐渐减少，到3年时，仅45%的患者仍在接受治疗。这归因于无效（25%）、不耐受（12%）或毒性（18%）。肺毒性出人意料地常见，至少7%的患者发生。
这些数据对胺碘酮作为AF合理的“目标”治疗方法的观念提出了挑战。
