Le Vincent K, Kavanagh Katherine M, Raj Satish R, Pollak P Timothy
Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
CJC Open. 2022 Apr 28;4(8):724-728. doi: 10.1016/j.cjco.2022.04.006. eCollection 2022 Aug.
In atrial arrhythmias, amiodarone is usually given either intravenously for acute management, requiring in-hospital monitoring, or orally for chronic control, as doses given 60 times per half-life, requiring weeks to reach full effect. A high-risk, 245-kg male with heart failure exacerbated by atrial flutter was successfully cardioverted using an atypically large, 8000-mg oral amiodarone dose. The only adverse effect was transient sinus arrest, which did not require intervention, only 24 hours of inpatient monitoring. Amiodarone's unique pharmacokinetics, including its long elimination half-life and its extensive distribution into a large volume of adipose tissue, make high-dose oral amiodarone boluses a reasonable strategy for cardioversion of atrial arrhythmias.
在房性心律失常中，胺碘酮通常用于急性处理时静脉给药，这需要住院监测；或用于慢性控制时口服给药，因为每半衰期给药60次，需要数周才能达到完全疗效。一名245公斤、因心房扑动而使心力衰竭加重的高危男性患者，使用非典型大剂量8000毫克口服胺碘酮成功转复心律。唯一的不良反应是短暂性窦性停搏，无需干预，仅需住院监测24小时。胺碘酮独特的药代动力学，包括其长消除半衰期及其在大量脂肪组织中的广泛分布，使得大剂量口服胺碘酮推注成为房性心律失常转复的合理策略。
