[AF-FORUM] 124E 安碘酮治疗. Dr. Klingenheben

[AF Symposium]

Poreba医生

作为一名私人医院的一生我对于门诊病人安碘酮的起 
始治疗回答如下

对于门诊病人，我们通常用较小的最大剂量值，每天 
600mg连续3周（负荷约为12g）。我在2天，1周，3周检测 
心电图QT间期。TSH在起始，一年一次或者出现可疑症 
状时检查。通常我还会在开始的时候作肺功能（弥散 
功能）检查，在患者治疗中出现可疑肺纤维化是对比 
分析。

如果患者没有症状，我并不把这些患者送到眼科医生 
哪里去检查（这儿的很多医生这样做）因为实际上 
100%的患者会出现角膜改变，但只是患者在服用这种 
药物的一个征象。

Thomas  Klingenheben, M.D.

Assistant  Professor of Medicine
Cardiology Practice
Im M=FChlenbach 2 B
DE-53127  Bonn
Germany
phone: +49-228-623324
fax:  +49-228-616881
Klingenheben在aol.com
www.bonn-kardiologie.de

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Re: [AF-FORUM] 124E Amiodarone therapy. Dr. Klingenheben

Dear Dr Poreba,

As a cardiologist in private practice may I answer your question
about  managing patients in whom AMIO is initiated on an outpatient
basis:

To start AMIO on an out-patient basis, we use a lower maximal daily
dose of 600 mg per day over 3 weeks (loading =3D 12 gr). I see the
patient at  2 days, 1 week , and 3 weeks for ECG (QT) monitoring.
TSH is measured at baseline and once per year or if symptoms  occur.
I also perform a baseline test of pulmonary CO-diffusion capacity to
have a comparison just in case the patient should develop / or have
suspicion of  pulmonary fibrosis during treatment.
I DO NOT send the patient to an ophtalmologist (which is done by
many  physicians here), as long as there are no symptoms, since
corneal changes occur  in nearly 100% of patients and are just an
indicator that the patient is indeed taking the drug.
Regards


Thomas  Klingenheben, M.D.

Assistant  Professor of Medicine
Cardiology Practice
Im M=FChlenbach 2 B
DE-53127  Bonn
Germany
phone: +49-228-623324
fax:  +49-228-616881
Klingenheben在aol.com
www.bonn-kardiologie.de

--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee