[AF-FORUM] 138S 可达龙治疗

[AF Symposium]

尊敬的Dr. Poreba：

在我们国家，可达龙的使用十分频繁，而严重副作用 
很少见。可达龙与洋地黄联合使用的经验并不多，这 
是由于我们发现数例患者发生尖端扭转性室速，尽管 
他们血钾正常。

关于这些问题：

1、  目前对于可达龙的剂量并没有规定，但在我们医 
院用于控制房颤时，通常剂量为600-800mg/天使用7-10 
天，然后减量为200-400mg/天，随后我们让患者在门诊 
治疗。第一次随访是在一周左右，然后是一月。

如果可达龙用来治疗室速，我们开始时使用1200mg/ 
天，使用10-12天，在此期间需要进行监护。然后我们 
减量至400-600mg/天，开始时必须每月定期监测，随后每 
3月进行监测。

2、  甲状腺功能测定：我们会在6-12月后或有任何甲 
状腺功能异常的症状出现时进行甲状腺功能测定。我 
们对长期使用可达龙治疗的老年房颤患者进行了一项 
研究，发现大约有30-40%的患者甲功检查有甲减但没有 
临床症状。当剂量为200-400mg/天时我们并不减量，维 
持原剂量继续随访。对于角膜色素沉着，当出现视觉 
问题时我们会暂定可达龙，否则继续使用。

3、  关于存在病窦、DDD起搏器安装术后，阵发性室上 
速、房颤患者可达龙的使用，需要仔细分析，也许可 
达龙并不是必需的，也许只要起搏器和另一种药物而 
非可达龙就已足够。

尽管可达龙是一种十分有效的药物，并且在我们国家 
它的使用并不受限制，但这仍是我们最后选择的药物。



这次座谈会十分成功，能彼此交流意见和经验十分有 
益、有趣。

这也是我们在此为世界所作的贡献。



Dr. Oscar A.Pellizzón

Sección Arritmias. HPC. 罗萨里奥.阿根廷



Dr. Sergio Dubner

科委会主席



Dr. Edgardo Schapachnik

组委会主席



潘佳君译 王玲洁校



Subject:Re: [AF-FORUM] 138S Amiodarone therapy. Dr. Pellizon


Dear Dr. Poreba,

In our country, using amiodarone is very frequent and severe  
undesirable effects are infrequently seen. Our experience is bad when  
amiodarone and digitalis are associated, since we observed several  
cases of torsade de pointes, in spite of presenting normal potassemia.

  About the questions:

1) There is no rule as to the administration dose, but in general in  
my hospital when we decide to administer amiodarone for AF, is  
600-800 mg/day for 7-10 days, and then we decrease it to 200-400 mg/  
day and we do it as outpatient treatment. The first visit is one week  
later more or less, and then one month.

If amiodarone is administered for VT, we start with 1,200 mg/day for  
10-12 days, and we do not discharge the patient until then. Later we  
decrease to 400-600 mg/day and we have periodical monthly controls at  
the beginning and then every three months.

2) Thyroid laboratory tests: we request it 6-12 months later, or if  
any symptom of thyroid dysfunction appears. We conducted a study in  
elderly patients with AF and amiodarone administered chronically,  
and  we observed that approximately 30-40% of patients had  
hypothyroidism  in lab tests without clinical symptoms, and the dose  
was not decreased when it was 200-400 mg/day and they continued the  
same in follow-up. About corneal deposits, we suspend amiodarone when  
it generates visual problems, otherwise we don't.

3) About the question regarding amiodarone, sinus node disease, DDD  
pacemaker and supraventricular paroxysmal tachycardia and AF, the  
case should be thoroughly analyzed, because maybe amiodarone is not  
necessary, and maybe only the pacemaker and another drug that is not  
amiodarone are enough.

Although amiodarone is a very efficient drug, and in our country is  
used without restrictions, it is the last drug we use.

Excellent symposium and the exchange of opinions and experience is  
very interesting.

This is our modest contribution from this part of the world.



Dr. Oscar A.Pellizzón

Sección Arritmias. HPC. Rosario. Argentina



--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee