Zdrenghea D, Banu E, Bogdan E, Beudean M
Department of Cardiology, Rehabilitation Hospital, Cluj-Napoca, Romania.
Rom J Intern Med. 1996 Jul-Dec;34(3-4):199-204.
The efficacy of amiodarone for atrial fibrillation (AF) prophylaxis is well established, but the large doses used until recently may be harmful during long-term therapy, especially because of the pulmonary fibrosis it generates. Recently, similar good results have been reported in using low-dose amiodarone. We studied the prophylactic effect of long-term therapy of low-dose amiodarone (200 mg/day) in 26 patients with AF of various etiologies. During a period of six months to four years, 46% of patients were free of any arrhythmic attack. The paroxysmal attacks of AF continued in 35% of patients, but with a lower frequency. In 19% of patients AF became chronic during amiodarone therapy. The best results were registered in patients over sixty, with stable sinus rhythm in 75% of cases, probably in relation to the ischemic etiology of AF and the anti-ischemic associated effect of amiodarone. The stability of sinus rhythm was greater (50% vs 38%, p < 0.05) when the treatment with amiodarone was started within the first six months from the first AF attack. Our results supported the use of low-dose amiodarone as a first-line drug for the long-term prophylaxis of AF, mainly in older patients.
胺碘酮预防心房颤动（AF）的疗效已得到充分证实，但直到最近一直使用的大剂量在长期治疗中可能有害，尤其是因其会引发肺纤维化。最近，有报道称使用低剂量胺碘酮也取得了类似的良好效果。我们研究了低剂量胺碘酮（200毫克/天）长期治疗对26例不同病因的AF患者的预防作用。在6个月至4年的时间里，46%的患者未发生任何心律失常发作。35%的患者房颤阵发性发作仍有发生，但发作频率降低。19%的患者在胺碘酮治疗期间房颤转为慢性。60岁以上患者的效果最佳，75%的病例窦性心律稳定，这可能与房颤的缺血性病因以及胺碘酮的抗缺血相关作用有关。在首次房颤发作后的前6个月内开始胺碘酮治疗时，窦性心律的稳定性更高（50%对38%，p<0.05）。我们的结果支持将低剂量胺碘酮作为长期预防房颤的一线药物，主要用于老年患者。
