[AF-FORUM] 79S 房颤和渐进性的系统硬化. Dr. Pereira

[AF Symposium]

我认为该患者治疗合理.我建议要密切随访甲状腺功 
能并调整优甲乐剂量.由于甲状腺的副作用可达龙这 
里已不适用.鉴于超声结果心律平也不适用.如果维拉 
帕米控制心室率效果较好,我不认为需要换药.另外,我 
认为可加用安体舒通25mg每日一次，因为该患有少量 
心包积液，且安体舒通可以抗纤维化进而帮助预防房 
颤的复发。

Dr. Luciano Pereira
巴拉圭

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79S AF and progressive systemic sclerosis. Dr. Pereira
I think that the patient is properly managed. I suggest close control
of the thyroid profile and the dose of levothyroxin. We cannot use
amiodarone due to its thyroid effects. Propafenone would not be
useful here either, considering the echocardiographic findings;
moreover, if the rate is properly controlled with verapamil, I see no
reason to change the drug. It would be interesting to add
spironolactone in 25 mg/day, given that the patient shows mild
pericardial effusion and its antifibrotic effect would help to
prevent recurrence of PAF episodes.
Kind regards,
Dr. Luciano Pereira
Paraguay

--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee