小剂量胺碘酮预防冠状动脉旁路移植术后心房纤颤

目的 评价小剂量胺碘酮对冠状动脉旁路移植术后心房纤颤的预防效果、耐受性和安全性。方法 对1998至1999年235例冠状动脉旁路移植术后病人进行回顾性研究分析，其中对照组155例予常规药物，试验组80例合用小剂量胺碘酮。结果 常规药物治疗组21．93％出现心房纤颤，而小剂量胺碘酮预防用药组10％出现心房纤颤(P=0．024)。小剂量胺碘酮致心律失常3例，无甲状腺及肺部并发症发生。结论 预防应用小剂量胺碘酮能明显降低术后心室率，减少心房纤颤发生率，延迟发作，缩短持续时间，促进心房纤颤转复，同时改善心功能。小剂量胺碘酮毒副作用低于大剂量胺碘酮，尤其适用于缺血性心脏病合并心肌梗死及左心功能不全者。

Low-dose amiodarone for prevention of atrial fibrillation after coronary artery bypass grafting

Objective: To evaluate the effect, tolerance and safety of low-dose oral amiodarone in the prevention of AF after coronary artery bypass grafting (CABG). Methods: Between 1998 and 1999, 235 adult patients underwent CABG. They were given 0 6 g of amiodarone (80 patients) or placebo (155 patients) daily for 7 days before surgery and 0 2g of amiodarone or placebo daily for 30 days postoperatively. Results: The incidence of postoperative AF was significantly (P=0 001) lower in treatment group (10%) as compared with placebo (21 94%). Only 3 cases had pro-arrhythmic effects and no side effects in treatment group. Conclusion: 1.Perioperative low-dose oral amiodarone significantly reduced the ventricular rate and reduced occurrence and duration of atrial fibrillation after CABG. 2.Low-dose amiodarone is well tolerated and decreased the risks of severe side effects and pro-arrhythmic effects, especially for these patients with high risk factors in perioperative period.