"Sf. Ioan" Children's Emergency Hospital, 800487 Galati, Romania.
Doctoral School of Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, 47 Str. Domnească, 800201 Galati, Romania.
Medicina (Kaunas). 2024 Sep 2;60(9):1436. doi: 10.3390/medicina60091436.
: New-onset atrial fibrillation (NOAF) is a common cardiac condition often observed in intensive care units. When amiodarone is used to treat this condition, either to maintain sinus rhythm after electrical cardioversion or to control heart rate, complications can arise when a systemic pathology is present. Systemic pathology can result in a decrease in cardiac output and blood pressure, making the management of NOAF and septic shock challenging. Limited international research exists on the coexistence of NOAF and septic shock, making it difficult to determine the optimal course of treatment. While amiodarone is not the primary choice of antiarrhythmic drug for patients in septic shock, it may be considered for those with underlying cardiac issues. This paper aims to investigate the safety of administering amiodarone to patients with septic shock and explore whether another antiarrhythmic drug may be more effective, especially considering the cardiac conditions that patients may have. : To write this article, we searched electronic databases for studies where authors used amiodarone and other medications for heart rate control or sinus rhythm restoration. : The studies reviewed in this work have shown that for the patients with septic shock and NOAF along with a pre-existing cardiac condition like a dilated left atrium, the use of amiodarone may provide greater benefits compared to other antiarrhythmic drugs. For patients with NOAF and septic shock without underlying heart disease, the initial use of propafenone has been found to be advantageous. However, a challenge arises when deciding between rhythm or heart rate control using various drug classes. Unfortunately, there is limited literature available on this specific scenario. : NOAF is a frequent and potentially life-threatening complication occurring in one out of seven patients with sepsis, and its incidence is rising among patients with septic shock.
新发心房颤动（NOAF）是一种常见的心脏疾病，常在重症监护病房中观察到。当使用胺碘酮治疗这种疾病时，无论是在电复律后维持窦性节律还是控制心率，当存在全身病理时，都会出现并发症。全身病理可导致心输出量和血压下降，使 NOAF 和感染性休克的管理具有挑战性。国际上关于 NOAF 和感染性休克共存的研究有限，因此难以确定最佳治疗方案。虽然胺碘酮不是感染性休克患者抗心律失常药物的首选，但对于存在潜在心脏问题的患者，可能会考虑使用胺碘酮。本文旨在探讨在感染性休克患者中使用胺碘酮的安全性，并探讨另一种抗心律失常药物是否更有效，特别是考虑到患者可能存在的心脏状况。
为了撰写本文，我们搜索了电子数据库，以查找作者使用胺碘酮和其他药物控制心率或恢复窦性节律的研究。
本研究回顾的研究表明，对于患有感染性休克和 NOAF 以及扩张性左心房等预先存在的心脏疾病的患者，与其他抗心律失常药物相比，使用胺碘酮可能会带来更大的益处。对于没有潜在心脏病的患有 NOAF 和感染性休克的患者，最初使用普罗帕酮已被发现是有利的。然而，在使用各种药物类别进行节律或心率控制之间做出决定时会出现挑战。不幸的是，关于这种特定情况的文献有限。
NOAF 是一种常见且潜在危及生命的并发症，每 7 例脓毒症患者中就有 1 例发生，在感染性休克患者中的发病率正在上升。
