Burckhardt D, Robertson A, Hoffmann A, Pfisterer M
Division of Cardiology, University Hospital Basel/Switzerland.
J Clin Pharmacol. 1991 Nov;31(11):1105-8. doi: 10.1002/j.1552-4604.1991.tb03679.x.
A group of 34 consecutive patients with coronary artery disease (n = 29) or dilated cardiomyopathy (n = 5) (3 women, 31 men, age 38-80 yr) who had severely impaired left ventricular function (left ventricular ejection fraction less than or equal to 40%) and high-grade ventricular ectopic activity (sustained or nonsustained ventricular tachycardia or ventricular fibrillation) were treated with amiodarone (mean dose: 206 mg/d) and followed for 1-117 (mean: 49) months. In the total group, there were seven sudden deaths, five deaths due to pump failure, one non-cardiac death, and two successful heart transplantations during follow-up. Thus the annual cardiac mortality in these carefully selected and followed patients was 8, 6%, the annual cardiac event rate was 10, 1%. The cumulative cardiac survival-rate was 62% after 5 years and 41% after 10 years. In five patients, treatment was interrupted after 10 to 43 months, three of the patients were alive at follow-up and two suffered cardiac death, resulting in an annual cardiac death rate of 12% in this subgroup of treatment. Based on the results of this retrospective analysis we conclude that in patients with low left ventricular ejection fraction and nonsustained or sustained ventricular tachycardia treated with low dose amiodarone, mortality was unexpectedly low. Thus, it may be the antiarrhythmic treatment to be considered in patients with ventricular tachycardia and severe left ventricular dysfunction.
一组连续的34例冠心病患者（n = 29）或扩张型心肌病患者（n = 5）（3名女性，31名男性，年龄38 - 80岁），这些患者左心室功能严重受损（左心室射血分数小于或等于40%）且有高级别室性异位活动（持续性或非持续性室性心动过速或心室颤动），接受了胺碘酮治疗（平均剂量：206 mg/d），并随访1 - 117（平均：49）个月。在整个组中，随访期间有7例猝死，5例死于泵衰竭，1例非心源性死亡，2例成功进行了心脏移植。因此，在这些经过精心挑选和随访的患者中，年心脏死亡率为8.6%，年心脏事件发生率为10.1%。5年后累积心脏生存率为62%，10年后为41%。5例患者在10至43个月后中断治疗，其中3例在随访时存活，2例发生心脏死亡，该治疗亚组的年心脏死亡率为12%。基于这项回顾性分析的结果，我们得出结论，对于左心室射血分数低且伴有非持续性或持续性室性心动过速的患者，采用低剂量胺碘酮治疗，死亡率意外地低。因此，对于室性心动过速和严重左心室功能障碍的患者，胺碘酮可能是一种可考虑的抗心律失常治疗药物。
