Improved survival with amiodarone in patients with hypertrophic cardiomyopathy and ventricular tachycardia.
Improved survival with amiodarone in patients with hypertrophic cardiomyopathy and ventricular tachycardia.
复制标题
胺碘酮可改善肥厚型心肌病和室性心动过速患者的生存率。
作者：
W. McKenna;C. Oakley;D. Krikler;J. Goodwin
在一项有历史对照的药物试验中，评估了胺碘酮对肥厚型心肌病和室性心动过速患者生存率的影响。在1976年和1977年期间，对86例连续患者进行了24小时（7小时）或48小时（79小时）心电图监测，其中24例有室性心动过速并接受了常规抗心律失常药物治疗。评估了19个临床、超声心动图和血流动力学特征。7例患者在3年随访期间突然死亡;其中5例持续室性心动过速，2例无记录室性心动过速。1978年至1979年期间，在接下来的82名肥厚性心肌病连续患者中，有21名在48小时心电图监测期间检测到室性心动过速。他们接受胺碘酮（150-400 mg/天，中位数300）;在重复48小时心电图检查期间，所有室性心动过速均得到抑制。两名患者在三年随访期间突然死亡，但均不属于胺碘酮治疗组的室性心动过速。服用胺碘酮和常规药物的患者的临床和血液动力学变量相似。胺碘酮控制室性心律失常与提高生存率显著相关的事实表明，胺碘酮可预防肥厚型心肌病和室性心动过速患者的猝死。
The effect of amiodarone on survival was assessed in patients with hypertrophic cardiomyopathy and ventricular tachycardia in a drug trial with historical controls. During 1976 and 1977, 24 hour (seven) or 48 hour (79) electrocardiographic monitoring was performed in 86 consecutive patients; 24 had ventricular tachycardia and received conventional antiarrhythmic agents. Nineteen clinical, echocardiographic, and haemodynamic features were assessed. Seven patients died suddenly during follow up of three years; of these, five had continued to have ventricular tachycardia and two had no documented ventricular tachycardia. During 1978 and 1979, ventricular tachycardia was detected during 48 hour electrocardiographic monitoring in 21 of the next 82 consecutive patients with hypertrophic cardiomyopathy. They received amiodarone (150-400 mg/day, median 300); ventricular tachycardia was suppressed in all during repeat 48 hour electrocardiographic examination. Two patients died suddenly during a three year follow up, but neither belonged to the amiodarone treated group with ventricular tachycardia. The clinical and haemodynamic variables were similar in patients taking amiodarone and conventional agents. The fact that control of ventricular arrhythmia with amiodarone is significantly associated with improved survival suggests that amiodarone may prevent sudden death in patients with hypertrophic cardiomyopathy and ventricular tachycardia.