Raatikainen M J Pekka, Huikuri Heikki V
TAYS Sydänkeskus Oy, PL 2000, 33521 Tampere.
Duodecim. 2010;126(19):2255-62.
Pharmacotherapy of atrial fibrillation (AF) is demanding, because currently available antiarrhythmic drugs have low efficacy and many side effects. In drug development, the focus has been on amiodarone-like multichannel blockers, atrial-specific ion channel blockers, and novel non-channel agents targeting atrial remodelling. Dronedarone, an amiodarone analogue without iodine, was recently approved for treatment of AF. It is less effective than amiodarone, but serious adverse events are rare. Vernakalant, an atrial-selective drug with low proarrhythmic risk, is effective in cardioversion and it may also prevent AF recurrences. So-called upstream therapy with angiotensin converting enzyme and angiotensin receptor inhibitors, statins and omega-3 fatty acids needs further clinical validation.
心房颤动（AF）的药物治疗颇具挑战性，因为目前可用的抗心律失常药物疗效欠佳且副作用众多。在药物研发方面，重点一直放在胺碘酮样多通道阻滞剂、心房特异性离子通道阻滞剂以及针对心房重构的新型非通道药物上。决奈达隆是一种不含碘的胺碘酮类似物，最近被批准用于治疗心房颤动。它的疗效不如胺碘酮，但严重不良事件较为罕见。维纳卡兰是一种致心律失常风险较低的心房选择性药物，在转复心律方面有效，还可能预防心房颤动复发。使用血管紧张素转换酶抑制剂、血管紧张素受体抑制剂、他汀类药物和ω-3脂肪酸进行所谓的上游治疗尚需进一步的临床验证。
