小剂量胺碘酮治疗扩张性心肌病伴发心律失常

目的 探讨小剂量胺碘酮治疗扩张性心肌病伴发阵发性室性心动过速和预防心脏性猝死的疗效。方法 扩张性心肌病患者65例，分为小剂量胺碘酮治疗组（n=33）及对照组（n=32），基础治疗用利尿药、强心苷、血管紧张素转化酶抑制药及硝酸酯，随访12个月，用超声心动图测定心功能指数，动态心电图监测阵发性室性心动过速和猝死率，进行两组病例比较。结果 治疗12个月后，两组心功能指数均较治疗前改善，小剂量胺碘酮治疗组患者阵发性室性心动过速较对照组明显减少。两组猝死率没有明显区别。结论 小剂量胺碘酮对于改善心功能和治疗扩张性心肌病患者恶性室性心律失常有效．可减少新发室性心律失常。

The effect of amiodarone therapy on severy ventricular arrhythmias in patients with idiopathic dialated cardiomyopathy

Objectives To investigate the effects of amiodarone on non-sustained ventricular tachycardia(VT) and sudden cardiac death in patients with idiopathic dilated cardiomyopathy(DCM). Methods Sixty-five patients with DCM treated with diurctics,digitalis and angiotensin-converting enzyme inhibitors were assigned to receive minidose amiodarone(n=33) or not(n=32),Mean follow-up was 12 months. The echocardiographic indices of cardiac funtion,the incidence of non-sustained VT on Holter monitoring electrocardiograms,and sudden cardiac death rate were compared between the 2 groups. Results Comparable improvement in cardiac function on echocardiographic was found in the 2 treatment groups. The patient group treated with minidose amiodarone showed a significant reduction in the prevalence of VT and reduced the development of new episodes of VT compared to the group without minidose amiodarone. The sudden cardiac death rate did not differ between two groups. Conclusions Amiodarone is effective and safe in treatment of DCM with arrhythmia and reduct the development of new episodes of VT.