Gold R L, Haffajee C I, Charos G, Sloan K, Baker S, Alpert J S
Am J Cardiol. 1986 Jan 1;57(1):124-7. doi: 10.1016/0002-9149(86)90964-1.
Atrial fibrillation (AF) is a difficult arrhythmia to manage with antiarrhythmic agents. Amiodarone is highly effective in restoring and maintaining normal sinus rhythm in patients with AF. However, the mechanism and predictors of efficacy for amiodarone in treating AF have not been adequately addressed. Various measures of success or failure of amiodarone therapy were examined in 68 patients who had paroxysmal or chronic, established AF refractory to conventional antiarrhythmic agents. The patients were 25 to 75 years old (mean 59) and mean follow-up was 21 months (range 3 to 56). Maintenance amiodarone dosages were 200 to 400 mg/day. Overall, amiodarone therapy was effective long term in 54 of the 68 patients (79%). Left atrial diameter, age, gender and origin of AF were not helpful in predicting success or failure of amiodarone therapy. The presence of chronic AF for longer than 1 year was an adverse factor in maintaining normal sinus rhythm (p = 0.007), although the success rate even in this group was relatively high (57%). Thirty-five percent of the patients had adverse effects, which precluded long-term therapy with amiodarone in 10%.
心房颤动（AF）是一种使用抗心律失常药物难以控制的心律失常。胺碘酮在恢复和维持AF患者的正常窦性心律方面非常有效。然而，胺碘酮治疗AF的疗效机制和预测因素尚未得到充分探讨。在68例对传统抗心律失常药物难治的阵发性或慢性持续性AF患者中，研究了胺碘酮治疗成功或失败的各种指标。患者年龄在25至75岁之间（平均59岁），平均随访时间为21个月（范围3至56个月）。胺碘酮维持剂量为每日200至400毫克。总体而言，68例患者中有54例（79%）长期接受胺碘酮治疗有效。左心房直径、年龄、性别和AF的起源对预测胺碘酮治疗的成功或失败并无帮助。慢性AF持续超过1年是维持正常窦性心律的不利因素（p = 0.007），尽管该组的成功率相对较高（57%）。35%的患者出现不良反应，其中10%的患者因不良反应而无法长期使用胺碘酮治疗。
