Reiffel James A, Robinson Victoria M, Kowey Peter R
Vagelos College of Physicians & Surgeons, Columbia University, New York City, New York.
Lankenau Heart Institute, Wynnewood Pennsylvania, and Thomas Jefferson University, Philadelphia, Pennsylvania.
Am J Cardiol. 2023 Apr 1;192:116-123. doi: 10.1016/j.amjcard.2023.01.035. Epub 2023 Feb 12.
Physicians use multiple drugs in combination to treat hypertension, heart failure, diabetes mellitus, angina, hyperlipidemia, and many other cardiovascular conditions and risk factors. However, administering antiarrhythmic drugs (AAD) in combination is rarely discussed. Yet, the possibility of increasing efficacy and/or tolerance and/or safety of AADs (by adding mechanisms, offsetting adverse mechanisms, and/or using lower doses) exists. Unfortunately, this topic has not been reviewed in any contemporary cardiac literature of which we are aware, although information regarding AAD combinations has been published. In conclusion, and accordingly, this review discusses the possibility of using AAD combinations for both ventricular arrhythmias and atrial fibrillation, in which the rationale for such combinations, considerations for such combinations, and supporting literature are covered.
医生联合使用多种药物来治疗高血压、心力衰竭、糖尿病、心绞痛、高脂血症以及许多其他心血管疾病和风险因素。然而,抗心律失常药物(AAD)联合使用的情况却很少被讨论。不过,(通过增加作用机制、抵消不良机制和/或使用更低剂量)存在提高AAD疗效和/或耐受性和/或安全性的可能性。遗憾的是,尽管已有关于AAD联合使用的信息发表,但据我们所知,当代任何心脏医学文献都未对此主题进行综述。总之,因此,本综述讨论了将AAD联合用于室性心律失常和心房颤动的可能性,其中涵盖了此类联合用药的基本原理、相关考量因素及支持文献。