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心脏起搏器辅助监测决奈达隆与可达龙治疗阵发性心房颤动的疗效分析
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Abstract:
目的：应用心脏起搏器监测，比较决奈达隆与胺碘酮口服治疗阵发性心房颤动(后简称房颤)的临床疗效。方法：纳入安装心脏起搏器的阵发性房颤患者140例，分为决奈达隆组(观察组，70例)和胺碘酮组(对照组，70例)。比较两组药物治疗后起搏器记录的房颤事件频率、持续时间及相关并发症。结果：治疗前两组基线数据无显著差异。治疗3个月和1年后，房颤发生次数显著下降(P < 0.05)，两组间差异无统计学意义。观察组并发症发生率低，但房颤转复窦律时间显著长于对照组(P < 0.05)。结论：在房颤维持性治疗中，决奈达隆和胺碘酮疗效相当，决奈达隆具有更少的不良反应和更高依从性。在转复窦律治疗中，胺碘酮表现更优。
Objective: To utilize cardiac pacemaker monitoring to compare the clinical efficacy of oral dronedarone and amiodarone in the treatment of paroxysmal atrial fibrillation (AF). Methods: A total of 140 patients with paroxysmal AF who had cardiac pacemakers implanted were enrolled. The patients were divided into a dronedarone group (observation group, 70 cases) and an amiodarone group (control group, 70 cases). The frequency and duration of AF events recorded by pacemakers, as well as related complications, were compared between the two groups after treatment. Results: Baseline data showed no significant difference between the two groups before treatment. After 3 months and 1 year of treatment, the frequency of AF episodes significantly decreased (P < 0.05), with no statistically significant differences between the two groups. The incidence of complications was lower in the observation group, but the time to restore sinus rhythm after an AF episode was significantly longer compared to the control group (P < 0.05). Conclusion: In the maintenance therapy for AF, dronedarone and amiodarone exhibit comparable efficacy. Dronedarone is associated with fewer adverse effects and better patient compliance. However, amiodarone demonstrates superior performance in restoring sinus rhythm.
| [1] | 赵志宏, 张邢炜. 中国心房颤动流行病学调查20年[J]. 中国心脏起搏与心电生理杂志, 2023, 37(3): 232-235. |
| [2] | Chugh, S.S., Havmoeller, R., Narayanan, K., Singh, D., Rienstra, M., Benjamin, E.J., et al. (2014) Worldwide Epidemiology of Atrial Fibrillation: A Global Burden of Disease 2010 Study. Circulation, 129, 837-847. https://doi.org/10.1161/circulationaha.113.005119 |
| [3] | Lippi, G., Sanchis-Gomar, F. and Cervellin, G. (2020) Global Epidemiology of Atrial Fibrillation: An Increasing Epidemic and Public Health Challenge. International Journal of Stroke, 16, 217-221. https://doi.org/10.1177/1747493019897870 |
| [4] | Piccini, J.P., Xu, H., Cox, M., Matsouaka, R.A., Fonarow, G.C., Butler, J., et al. (2019) Adherence to Guideline-Directed Stroke Prevention Therapy for Atrial Fibrillation Is Achievable. Circulation, 139, 1497-1506. https://doi.org/10.1161/circulationaha.118.035909 |
| [5] | 徐艳莉, 田艳丰, 梁兆光. 心房颤动治疗的基石——口服抗凝药物的研究进展[J]. 心血管康复医学杂志, 2024, 33(3): 337-340. |
| [6] | Kirchhof, P., Camm, A.J., Goette, A., Brandes, A., Eckardt, L., Elvan, A., et al. (2020) Early Rhythm-Control Therapy in Patients with Atrial Fibrillation. New England Journal of Medicine, 383, 1305-1316. https://doi.org/10.1056/nejmoa2019422 |
| [7] | Heijman, J., Hohnloser, S.H. and Camm, A.J. (2021) Antiarrhythmic Drugs for Atrial Fibrillation: Lessons from the Past and Opportunities for the Future. EP Europace, 23, ii14-ii22. https://doi.org/10.1093/europace/euaa426 |
| [8] | Mujović, N., Dobrev, D., Marinković, M., Russo, V. and Potpara, T.S. (2020) The Role of Amiodarone in Contemporary Management of Complex Cardiac Arrhythmias. Pharmacological Research, 151, Article ID: 104521. https://doi.org/10.1016/j.phrs.2019.104521 |
| [9] | Saljic, A., Heijman, J. and Dobrev, D. (2022) Emerging Antiarrhythmic Drugs for Atrial Fibrillation. International Journal of Molecular Sciences, 23, Article 4096. https://doi.org/10.3390/ijms23084096 |
| [10] | Roth, G.A., Mensah, G.A., Johnson, C.O., Addolorato, G., Ammirati, E., Baddour, L.M., et al. (2020) Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update from the GBD 2019 Study. Journal of the American College of Cardiology, 76, 2982-3021. https://doi.org/10.1016/j.jacc.2020.11.010 |
| [11] | Shi, S., Tang, Y., Zhao, Q., Yan, H., Yu, B., Zheng, Q., et al. (2022) Prevalence and Risk of Atrial Fibrillation in China: A National Cross-Sectional Epidemiological Study. The Lancet Regional Health—Western Pacific, 23, Article ID: 100439. https://doi.org/10.1016/j.lanwpc.2022.100439 |
| [12] | Wang, Z., Chen, Z., Wang, X., Zhang, L., Li, S., Tian, Y., et al. (2018) The Disease Burden of Atrial Fibrillation in China from a National Cross-Sectional Survey. The American Journal of Cardiology, 122, 793-798. https://doi.org/10.1016/j.amjcard.2018.05.015 |
| [13] | 张爱丽, 侯旗旗, 韩全乐, 等. 中国北方人群心房颤动与新发慢性肾脏病发病风险的相关性研究[J]. 中国全科医学, 2023, 26(36): 4521-4526. |
| [14] | 张佳伟, 侯旗旗, 齐祺, 等. 不同年龄人群心房颤动对于新发急性心肌梗死发病风险研究[J]. 重庆医学, 2024, 53(24): 3773-3778. |
| [15] | Babatin, M., Lee, S. and Pollak, P. (2008) Amiodarone Hepatotoxicity. Current Vascular Pharmacology, 6, 228-236. https://doi.org/10.2174/157016108784912019 |
| [16] | 石创业, 张瑞文, 崔宝刚, 等. 盐酸决奈达隆的合成工艺研究[J]. 中国药物化学杂志, 2024, 34(1): 49-54. |
| [17] | Hohnloser, S.H., Crijns, H.J.G.M., van Eickels, M., Gaudin, C., Page, R.L., Torp-Pedersen, C., et al. (2009) Effect of Dronedarone on Cardiovascular Events in Atrial Fibrillation. New England Journal of Medicine, 360, 668-678. https://doi.org/10.1056/nejmoa0803778 |
| [18] | Singh, B.N., Connolly, S.J., Crijns, H.J.G.M., Roy, D., Kowey, P.R., Capucci, A., et al. (2007) Dronedarone for Maintenance of Sinus Rhythm in Atrial Fibrillation or Flutter. New England Journal of Medicine, 357, 987-999. https://doi.org/10.1056/nejmoa054686 |
| [19] | Hagens, V.E., Ranchor, A.V., Van Sonderen, E., Bosker, H.A., Kamp, O., Tijssen, J.G.P., et al. (2004) Effect of Rate or Rhythm Control on Quality of Life in Persistent Atrial Fibrillation. Results from the Rate Control versus Electrical Cardioversion (RACE) Study. Journal of the American College of Cardiology, 43, 241-247. https://doi.org/10.1016/j.jacc.2003.08.037 |
| [20] | 张婧靓. 决奈达隆对房颤射频消融术后早期复发的影响: 倾向性评分匹配分析[D]: [硕士学位论文]. 长沙: 中南大学, 2023. |
| [21] | Boriani, G., Blomström-Lundqvist, C., Hohnloser, S.H., Bergfeldt, L., Botto, G.L., Capucci, A., et al. (2019) Safety and Efficacy of Dronedarone from Clinical Trials to Real-World Evidence: Implications for Its Use in Atrial Fibrillation. EP Europace, 21, 1764-1775. https://doi.org/10.1093/europace/euz193 |
| [22] | Piccini, J.P., Hasselblad, V., Peterson, E.D., Washam, J.B., Califf, R.M. and Kong, D.F. (2009) Comparative Efficacy of Dronedarone and Amiodarone for the Maintenance of Sinus Rhythm in Patients with Atrial Fibrillation. Journal of the American College of Cardiology, 54, 1089-1095. https://doi.org/10.1016/j.jacc.2009.04.085 |
