Patel Chinmay, Yan Gan-Xin, Kowey Peter R
Main Line Health Heart Center and Lankenau Hospital, Wynnewood, PA 19096, USA.
Circulation. 2009 Aug 18;120(7):636-44. doi: 10.1161/CIRCULATIONAHA.109.858027.
Amiodarone is the most effective antiarrhythmic drug for maintaining sinus rhythm for patients with atrial fibrillation. Extra-cardiac side effects have been a limiting factor, especially during chronic use, and may offset its benefits. Dronedarone is a noniodinated benzofuran derivative of amiodarone that has been developed for the treatment of atrial fibrillation and atrial flutter. Similar to amiodarone, dronedarone is a potent blocker of multiple ion currents, including the rapidly activating delayed-rectifier potassium current, the slowly activating delayed-rectifier potassium current, the inward rectifier potassium current, the acetylcholine activated potassium current, peak sodium current, and L-type calcium current, and exhibits antiadrenergic effects. It has been studied for maintenance of sinus rhythm and control of ventricular response during episodes of atrial fibrillation. Dronedarone reduces mortality and morbidity in patients with high-risk atrial fibrillation, but may be unsafe in those with severe heart failure. This article will review evidence of safety and effectiveness of dronedarone in patients with atrial fibrillation.
胺碘酮是用于维持心房颤动患者窦性心律的最有效抗心律失常药物。心脏外副作用一直是一个限制因素，尤其是在长期使用期间，可能会抵消其益处。决奈达隆是胺碘酮的一种非碘化苯并呋喃衍生物，已被开发用于治疗心房颤动和心房扑动。与胺碘酮相似，决奈达隆是多种离子电流的强效阻滞剂，包括快速激活延迟整流钾电流、缓慢激活延迟整流钾电流、内向整流钾电流、乙酰胆碱激活钾电流、峰值钠电流和L型钙电流，并具有抗肾上腺素能作用。它已被研究用于维持窦性心律和控制心房颤动发作期间的心室反应。决奈达隆可降低高危心房颤动患者的死亡率和发病率，但在严重心力衰竭患者中可能不安全。本文将综述决奈达隆在心房颤动患者中的安全性和有效性证据。
