决奈达隆在心房颤动导管消融空白期应用的安全性和有效性  

Safety and efficacy of dronedarone in blanking period in patients underwent atrial fibrillation catheter ablation

作　　者：方任远 杜先锋 何斌[1] 丰明俊[1] 边昶[2] 冷冰 王彬浩 卓伟东 周忠 李恒栋 孙汉泽 沈文均[6] 赵乾磊 谢达奇 吴斌 储慧民[1] FANG Ren-yuan;DU Xian-feng;HE Bin;FENG Ming-jun;BIAN Chang;LENG Bing;WANG Bin-hao;ZHUO Wei-dong;ZHOU Zhong;LI Heng-dong;SUN Han-ze;SHEN Wen-jun;ZHAO Qian-lei;XIE Da-qi;WU Bin;CHU Hui-min(The First Affiliated Hospital of Ningbo University,Ningbo ZHEJIANG 315000,China;The Second Affiliated Hospital.Zhejiang University School of Medicine,Hangzhou ZHEJIANG 310003,China;Zhejiang University Mingzhou Hospital,Ningbo ZHEJIANG 315800,China;Huamei Hospital,University of Chinese Academy of Sciences,Ningbo ZHEJIANG 315099,China;Cixi People's Hospital,Ningbo ZHEJIANG 315399,China;Ningbo Medical Center Lihuili Hospital,Ningbo ZHEJIANG 315040,China;The Affiliated People's Hospital of Ningbo University,Ningbo ZHEJIANG 315020 China;Ningbo Ninth Hospital,Ningbo ZHEJIANG 315032,China;The Second Hospital of Haishu District of Ningbo Ningbo ZHEJIANG 315099,China)

机构地区：[1]宁波大学附属第一医院,浙江宁波315000 [2]浙江大学医学院附属第二医院,浙江杭州310003 [3]浙江大学明州医院,浙江宁波315800 [4]中国科学院大学宁波华美医院,浙江宁波315099 [5]慈溪市人民医院,浙江宁波315399 [6]宁波市医疗中心李惠利医院,浙江宁波315040 [7]宁波大学附属人民医院,浙江宁波315020 [8]宁波市第九医院,浙江宁波315032 [9]宁波市海曙区第二医院,浙江宁波315099

出　　处：《中国新药与临床杂志》2024年第4期268-272,共5页Chinese Journal of New Drugs and Clinical Remedies

基　　金：浙江省医药卫生科技计划项目(2020KY821,2022KY302);宁波市科技计划项目(2022Z149)。

摘　　要：目的评估决奈达隆在心房颤动导管消融空白期应用的真实世界安全性和有效性。方法纳入2021年5月1日至2021年12月31日间在各合作中心接受导管消融治疗的心房颤动患者150例,空白期予口服决奈达隆片,每次400 mg,早晚各1次,持续3个月。术后3个月±14 d至门诊随访,复查24 h动态心电图、经胸心脏彩超、肝功能、肾功能等,记录随访期间发生的不良事件。结果与手术前相比,术后用药3个月时患者的心率、PR间期及左室射血分数无显著变化,QTc间期延长[(434.0±29.2)ms vs.(443.5±31.8)ms,P=0.017],左房内径[(40.6±6.5)mm vs.(38.4±6.0)mm,P=0.007]及左室舒张末内径[(47.9±4.3)mm vs.(46.4±5.1)mm,P=0.012]减小。6例患者空白期内停药,包括高度房室传导阻滞1例、显著心动过缓2例、QTc间期显著延长1例及消化系统症状2例。未出现与抗心律失常药物相关的心血管死亡、心力衰竭、再住院的复合终点。术后随访3个月时,患者窦性心律维持率85.3%(128/150)。结论决奈达隆在心房颤动导管消融空白期应用安全、有效,依从性好。AIM To evaluate the safety and efficacy of dronedarone in the blanking period in patients underwent atrial fibrillation catheter ablation in the real-world.METHODS A total of 15O patients with atrial fibrillation who underwent catheter ablation at co-operative centers between May 1st,2021 and December 31st,2021 were included.During the blanking period,the patients were given oral dronedarone(400 mg,morning and evening)for 3 months.At 3 months±14 days after surgery,the patients were followed up,and 24-hour Holter,transthoracic echocardiography,liver function and renal function were reviewed.The adverse events occurred during the follow-up were recorded.RESULTSSCompared with before surgery,there were no significant differences in heart rate,PR interval,and left ventricular ejection fraction were observed at 3 months after surgery,while QTc interval increased((434.0±29.2)ms vs.(443.5±31.8)ms,P=0.017).Left atrial diameter((40.6±6.5)mm vs.(38.4±6.0)mm,P=0.007)and lower left ventricular end-diastolic diameter((47.9±4.3)mm vs.(46.4±5.1)mm,P=0.012)decreased.Six patients discontinued in the blanking period(included high atrioventricular block in 1 patient,significant bradycardia in 2 patients,significant prolongation of the QTc interval in I patient,and digestive system symptoms in 2 patients).There were no composite endpoints of cardiovascular death,heart failure or rehospitalization associated with antiarrhythmic drugs.At follow-up of 3 months,the rate of sinus rhythm maintenance was 85.3%(128/150).CONCLUSION Dronedarone is safe and effective in the blanking period for patients underwent atrial fibrillation catheter ablation.Moreover,it's good in adherence.

关 键 词：决奈达隆 心房颤动 射频消融术 抗心律失常药 空白期 

分 类 号：R972.2[医药卫生—药品]