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Long-term efficacy and safety of very-low-dose amiodarone treatment for the maintenance of sinus rhythm in patients with chronic atrial fibrillation after successful direct-current cardioversion

引用

Chinese Medical Journal 2006年第24期119卷 2030-2035页

作者： JONG Gwo-ping, CHANG Mu-hsin, CHANG Ting-chuan, CHOU Pesus, FU Chong-yau, TIEN Li-yun,CHEN Chung-yin and MA Tso-chiang JONG Gwo-ping CHANG Mu-hsin CHANG Ting-chuan CHOU Pesus FU Chong-yau TIEN Li-yun CHEN Chung-yin MA Tso-chiang Community Medical Research Center Institute of Public HealthNational Yang-Ming University and Division of CardiologyArmed Forces Taichung General Hospital Taipei China Community Medical Research Center and Institute of Public Health National Yang-Ming University Taipei China Institute of Public Health National Yang-Ming University TaipeiChina Division of Cardiology Kuang-Tien General Hospital TaichungChina Department of Health Service Management China Medical University Taichung China

Background Long-term maintenance of sinus rhythm after successful conversion of chronic atrial fibrillation （CAF）, often ameliorates patients＇ symptoms, reduces the risk of ischemic stroke and improves cardiovascular hemodynamics. This prospective study aims to evaluate the long-term efficacy and safety of very low-dose amiodarone （100 mg daily） for the maintenance of sinus rhythm after successful direct-current （DC） cardioversion in patients with CAF and rheumatic heart disease （RHD） post intervention. Methods This study was a randomized prospective trial. One day after successful DC cardioversion （remained normal sinus rhythm） in patients with CAF and RHD post intervention for more than six months and adequate anticoagulation, all were randomly administered either amiodarone 200 mg daily in group A or amiodarone 100 mg dally in group B. Results A total of 76 patients （40 men and 36 women） were examined from February 1998 to December 1999. The mean age of the patients was （664- 10） years, and the mean follow-up was （674-8） months （range 61 to 84 months）. Actuarial rates of the maintenance of sinus rhythm were similar in the two groups after 5 years of follow-up. Four patients （11%） in group A but none in group B experienced significant adverse effects that necessitated withdrawal of amiodarone. No death occurred during the study period. Conclusion A very low dose of amiodarone results in adequate long-term efficacy and is safe for maintaining sinus rhythm in patients with CAF and RHD post intervention after successful DC cardioversion.

关键词： chronic atrial fibrillation rheumatic heart disease cardioversion very low-dose amiodarone

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