Therapeutic monitoring of amiodarone and desethylamiodarone after surgical ablation of atrial fibrillation-evaluation of the relationship between clinical effect and the serum concentration期刊界 All Journals 搜尽天下杂志传播学术成果专业期刊搜索期刊信息化学术搜索

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Therapeutic monitoring of amiodarone and desethylamiodarone after surgical ablation of atrial fibrillation-evaluation of the relationship between clinical effect and the serum concentration

Authors:	Erika Hrudikova Milan Grundmann Martin Kolek Romana Urinovska Ivana Kacirova

Institution:	1. Department of Clinical Pharmacology, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic;2. Department of Clinical Pharmacology, Department of Laboratory Medicine, University Hospital Ostrava, 17. Listopadu 1790, 708 52 Ostrava, Czech Republic;3. Department of Clinic Subjects, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic;4. Department of Cardiac Surgery, University Hospital Ostrava, 17. Listopadu 1790, 708 52 Ostrava, Czech Republic

Abstract:	BackgroundAssociation between clinical effect and serum concentration of amiodarone (AMI) and its active metabolite desethylamidarone (DEA) in patients after surgical ablation (SA) of atrial fibrillation (AF) has not yet been studied.AimsWe wanted to find a correlation between AMI and DEA serum concentration and maintaining sinus rhythm (SR) after SA of AF.MethodsSixty eight patients with AF who had undergone surgical ablation between 2014 and 2017 were included in a single-centre, prospective, observational study. Maintaining of SR was evaluated by standard 12-lead ECG and 24-hour Holter ECG monitoring at months 1, 3, 6 and 12 following surgery. Therapeutic monitoring of AMI and DEA concentrations was done to optimize therapy and adverse effects were followed up.ResultsWe have noticed a high success rate in maintaining of SR (overall 83%). The median of serum concentration of AMI was 0.81 mg/L (range 0.16–2.35 mg/L) and DEA 0.70 mg/l (range 0.19–2.63 mg/L). No significant differences were found in the serum concentratration of AMI, DEA or DEA/AMI concentratration ratios between patients with SR and persistent supraventricular tachyarrhythmia except on the second outpatient visit. We observed significant correlation between serum concentration of DEA and thyroid-stimulating hormone elevation.ConclusionWe confirmed the efficacy of AMI and DEA at the measured serum concentrations. However, analysis of these concentrations alone cannot replace assessment of the clinical response for treatment. Establishment of individual AMI (and DEA) concentrations at which the optimal therapeutic response is achieved seems to be advantageous. Therapeutic monitoring of AMI and DEA is helpful in personalised pharmacotherapy after SA of AF.

Keywords:	Amiodarone Atrial fibrillation Desethylamiodarone Maze procedure Serum concentration Sinus rhythm AMI"} {"#name":"keyword" "$":{"id":"k0040"} "$$":[{"#name":"text" "_":"amiodarone AF"} {"#name":"keyword" "$":{"id":"k0050"} "$$":[{"#name":"text" "_":"atrial fibrillation ALT"} {"#name":"keyword" "$":{"id":"k0060"} "$$":[{"#name":"text" "_":"alanine transaminase AST"} {"#name":"keyword" "$":{"id":"k0070"} "$$":[{"#name":"text" "_":"aspartate transaminase CABG"} {"#name":"keyword" "$":{"id":"k0080"} "$$":[{"#name":"text" "_":"coronary artery bypass graft DEA"} {"#name":"keyword" "$":{"id":"k0090"} "$$":[{"#name":"text" "_":"desethylamiodarone ECG"} {"#name":"keyword" "$":{"id":"k0100"} "$$":[{"#name":"text" "_":"electrocardiogram GMT"} {"#name":"keyword" "$":{"id":"k0110"} "$$":[{"#name":"text" "_":"gama glutamyl transferase SA"} {"#name":"keyword" "$":{"id":"k0120"} "$$":[{"#name":"text" "_":"surgical ablation SR"} {"#name":"keyword" "$":{"id":"k0130"} "$$":[{"#name":"text" "_":"sinus rhythm ST"} {"#name":"keyword" "$":{"id":"k0140"} "$$":[{"#name":"text" "_":"supraventricular tachyarrhythmia TDM"} {"#name":"keyword" "$":{"id":"k0150"} "$$":[{"#name":"text" "_":"therapeutic drug monitoring TSH"} {"#name":"keyword" "$":{"id":"k0160"} "$$":[{"#name":"text" "_":"thyroid-stimulating hormone
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