Cardiology Clinic, Medicana International Ankara Hospital, Atilim University, Ankara, Turkey.
Cardiology Clinic, Saglik Bilimleri University, Gülhane Eğitim ve Araştırma Hastanesi, Ankara, Turkey.
Curr Vasc Pharmacol. 2024;22(6):386-390. doi: 10.2174/0115701611259127231208051249.
Postoperative atrial fibrillation (POAF) is associated with poor outcomes, including hemodynamic instability, stroke, myocardial infarction, and death. In hemodynamic stable patients, the rhythm-control strategy is more advantageous than rate control. Current standard intravenous amiodarone administration has limited success and a delayed effect; the acute success rate is 44% (8-12 h to several days).
The aim of this study was to evaluate the effectiveness of higher amiodarone loading dosage to restore sinus rhythm in patients with POAF after noncardiac surgery.
This is a prospective, randomized, controlled single-center study. The study included 39 patients with POAF, divided into group I (n=27) (intravenous 600 mg amiodarone loading dosage over 2 h and infusion of 50 mg/h over a 24-h period) and group II (n=12) (standard protocol; 300 mg of bolus intravenously in 30 min and infusion of 50 mg/h over a 24-h period). The primary endpoint of the study was a restoration of sinus rhythm at the 24th hour.
Baseline clinical, laboratory and echocardiographic characteristics of both groups were similar. The patients with higher loading amiodarone dosage had earlier restoration of sinus rhythm (2.38 ± 1.41 vs 8.66 ± 2.87 h, respectively; p=0.015). There was no significant difference in achieving sinus rhythm at the 24th hour between both groups.
Higher loading amiodarone dosage increased early conversions to sinus rhythm compared with standard amiodarone protocol in patients with POAF.
术后心房颤动（POAF）与不良结局相关，包括血流动力学不稳定、中风、心肌梗死和死亡。在血流动力学稳定的患者中，节律控制策略比心率控制更有利。目前标准的静脉用胺碘酮给药效果有限且起效时间延迟；急性成功率为 44%（8-12 小时至数天）。
本研究旨在评估在非心脏手术后 POAF 患者中，给予更高剂量胺碘酮负荷量以恢复窦性心律的效果。
这是一项前瞻性、随机、对照的单中心研究。该研究纳入了 39 例 POAF 患者，分为 I 组（n=27）（静脉用 600mg 胺碘酮负荷量，2 小时内输注，24 小时内以 50mg/h 持续输注）和 II 组（n=12）（标准方案；30min 内静脉推注 300mg，24 小时内以 50mg/h 持续输注）。该研究的主要终点是在第 24 小时恢复窦性心律。
两组患者的基线临床、实验室和超声心动图特征相似。给予更高剂量胺碘酮负荷量的患者窦性心律恢复更早（分别为 2.38±1.41 小时和 8.66±2.87 小时；p=0.015）。两组在第 24 小时达到窦性心律的比例无显著差异。
与标准胺碘酮方案相比，POAF 患者给予更高剂量胺碘酮负荷量可增加早期转为窦性心律的比例。
