目的:研究胺碘酮治疗心房颤动的疗效。方法:用胺碘酮治疗心房颤动患者68例(阵发性心房颤动40例,持续性心房颤动28例)。结果:连续用药治疗6个月显示治疗有效率分别为925%、75%。治疗12个月有效率分别为853%、68%。结论:胺碘酮治疗心房颤动安全有效,副作用小,可作为首选药。
【摘要】 目的 报道1例静脉滴注胺碘酮致肝肾功能不全患者。 方法 2010年10月收治1例扩张性心肌病患者，治疗过程中使用胺碘酮注射液，导致严重的肝肾功能不全。系统查阅中国期刊全文数据库及外文数据库Pubmed、Embase建库至2011年8月关于胺碘酮致肝肾功能不全的相关文献，进行静脉胺碘酮致肝肾功能不全的可能性评估，探索胺碘酮静脉滴注致肝功能不全的的作用机制。 结果 根据查阅文献结果分析，此患者静脉注射胺碘酮致肝功不全的可能性高，Naranjo概率评分分别为7分。 结论 提出临床医师和临床药师应进行胺碘酮静脉的药学监护，高度的重视胺碘酮相关的不良反应，从而及时识别和防治胺碘酮所致肝肾功能不全，减少其不良预后。【Abstract】 Objective To report a case of hepatic and renal insufficiency induced by intravenous injection with amiodarone, and to evaluate the possibility of the adverse drug reaction. Methods A patient with dilated cardiomyopathy was admitted in October, 2010. During the procedure, the use of amiodarone hydrochloride injection made the patient suffer from liver and kidney dysfunction. We retrieved the literatures about liver and kidney toxicity of amiodarone from CNKI, Pubmed, and Embase (from the establishment of the databases to November 2011). We also ssessed the possibility of the adverse drug reaction, discussed the mechanism of amiodarone-induced hepatic insufficiency. Results According to the literature, There was a great possibility of hepatic insufficiency induced by amiodarone, and the total score of the Naranjo probability score was 7. Conclusion It is important to pay more attention to the pharmaceutical care of amidarone to timely recognize and effectively prevent or treat hepatic and renal insufficiency induced by intravenous injection with amiodarone.
ObjectiveTo systematically review the efficacy of irbesartan combined with amiodarone versus amiodarone alone for paroxysmal atrial fibrillation. MethodsWe electronically searched databases including PubMed, CENTRAL, EMbase, VIP, CNKI and WanFang Data to collect randomized controlled trials (RCTs) about irbesartan combined with amiodarone versus amiodarone alone in the treatment of paroxysmal atrial fibrillation from 2000 to 2014. Two reviewers independently screened literature, extracted data and assessed the risk bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. ResultsA total of nine studies involving 998 patients were included. The results of meta-analysis showed that:Compared with the amiodarone group, the left atrial diameter was smaller (MD=-1.49, 95% CI -1.82 to -1.15), and the maintenance rates of sinus rhythm were higher (OR=3.02, 95%CI 2.21 to 4.11) in the irbesartan plus amiodarone group after 12 months. ConclusionCurrent evidence indicates that the combination treatment of irbesartan and amiodarone for paroxysmal atrial fibrillation is better than amiodarone alone in delaying the enlargement of left atrial diameter, as well as the maintenance of sinus rhythm. Due to limited quantity and quality of the included studies, more high quality studies are needed to verify the above conclusion.
Objective To evaluate efficacy of amiodarone in the prevention of atrial fibrillation after coronary artery bypass grafting. Methods CBM (from January 1978 to August 2017), CNKI (from January 1987 to August 2017), VIP (from January 1989 to August 2017), Wanfang (from January 1998 to August 2017) and PubMed (from January 1989 to August 2017) databases were searched. The articles were selected based on the inclusion and exclusion criteria. Quality of articles was assessed by improved Jadad scale. Statistical analysis was performed using RevMan 5.3. Results There were 19 articles meeting inclusion criteria including 2 817 patients and all were randomized controlled trial (RCT). There were 16 articles with high quality and 3 articles with low quality by improved Jadad scale. Compared with the placebo, amiodarone had a significant effect on reducing the incidence of atrial fibrillation after coronary artery bypass grafting (RR=0.37, 95% CI 0.28 to 0.50, P<0.000 01) and different administration models and time of amiodarone had effect on the atrial fibrillation after aterial bypass grafting (P<0.05). Conclusion Compared with the placebo, amiodarone is effective in reducing the incidence of atrial fibrillation after coronary artery bypass grafting.
ObjectiveTo systematically evaluate the efficacy and safety of radiofrequency ablation versus amiodarone in the treatment of atrial fibrillation, so as to provide reference for the chosen of clinical treatment options. MethodsWe searched PubMed, The Cochrane Library (Issue 10, 2014), CNKI, VIP and WanFang data from inception to October 2014 to collect randomized controlled trials (RCTs) comparing radiofrequency ablation versus amiodarone for atrial fibrillation. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. ResultsA total of 4 RCTs involving 511 atrial fibrillation patients were included. The results of meta-analysis showed that:compared with amiodarone, radiofrequency ablation could reduce the risk of atrial fibrillation recurrence (RR=0.35, 95%CI 0.22 to 0.55, P<0.000 01). There was no significant difference in all-cause mortality (RR=0.97, 95%CI 0.17 to 5.61, P=0.97) between both groups. The incidence of adverse events in the radiofrequency ablation group was 7.7%, and was lower than 12.7% of the amiodarone group, but there was no significant difference between the two groups. ConclusionCurrent evidence shows that, compared with amiodarona, radiofrequency ablation is related to lower recurrence rate and higher efficacy, but there is no difference in the safety between the two interventions. However, due to the limited quality and quantity of included studies, higher quality studies are needed to verify the above conclusion.
Objective To evaluate the efficacy and safety of Shen Song Yang Xin Capsule for cardiac arrhythmia. Methods Randomized controlled trials (RCTs) were searched from the following electronic databases: WanFang, CNKI, CBM, VIP, PubMed, and The Cochrane Library. Quality assessment and data extraction were conducted by two reviewers independently. Disagreement was resolved through discussion. All data were analyzed by using RevMan 5.0 software. Results Thirteen studies involving 1896 participants were included. The results of meta-analyses showed that compared with the control group, a) efficacy: Shen Song Yang Xin Capsule was superior to mexiletine (OR=2.96, 95%CI 1.79 to 4.87), and propafenone (OR=2.41, 95%CI 1.60 to 3.62), but was not superior to miodarone (OR=1.25, 95%CI 0.88 to 1.71); b) safety: Shen Song Yang Xin Capsule was superior to propafenone and miodarone in reducing the incidence of cardiac arrhythmia (OR=0.06, 95%CI 0.01 to 0.35; OR=0.05, 95%CI 0.02 to 0.17), but no significant difference was found between the two groups in incidence of gastrointestinal adverse reactions. Conclusion Based on the current studies, Shen Song Yang Xin Capsule is not inferior to the commonly-used anti-arrhythmic medicine at present. It has lower incidence of cardiac arrhythmia, and has no significant difference in the incidence of gastrointestinal adverse reactions compared with western drugs. For the quality restrictions of the included studies, more double blind RCTs with high quality are required to further assess the effects.
ObjectiveTo systematically evaluate the pharmacoeconomic value of radiofrequency ablation (RFA) versus amiodarone in the treatment of atrial fibrillation (AF), and to provide reference for treatment scheme selection, drug selection and the formulation of drug policy. MethodsWe searched databases including PubMed, The Cochrane Library, CNKI and CBM from 2000 to 2014 to collect pharmacoeconomic studies on RFA versus Amiodarone for treating AF. Two reviewers independently screened literature, extracted data, and assessed the methodological quality of included studies. The cost-effectiveness of RFA and Amiodarone for AF was compared according to the cost, effectiveness, and incremental cost-effectiveness ratio (ICER). ResultsA total of three studies were included. The results of pharmacoeconomic evaluation showed that the ICERs for each study were $7 976 to $29 068, ￡7 763 to ￡27 745, and $59 194, respectively. According to country-specific willingness to pay thresholds, the ICER of each included study was acceptable. ConclusionCompared to Amiodarone, RFA is a cost-effective therapy for AF.
ObjectiveTo investigate the effect of 5% dextrose intravenous infusion for phlebitis caused by amiodarone. MethodsA total of 136 patients treated in our hospital between June 2011 and March 2012 were randomly assigned into control group with 63 patients and intervention group with 73 patients. The control group was administrated 600 mg amiodarone with 15 drops/minute intravenous injection once daily, for 3 days, while for the intervention group patients, we added 5% dextrose solution infusion in the same channel at the same time. ResultsPhlebitis occurred in 22 patients (34.9%) in the control group, while the intervention group had only 11 (15.0%) (χ2=7.252,P=0.007). ConclusionInfusion of 5% dextrose solution can significantly reduce the occurrence of phlebitis caused by amiodarone.