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Sample records for amiodarone

  1. Treatment with Amiodaron

    DEFF Research Database (Denmark)

    Adelborg, Kasper; Ebbehøj, Eva; Nielsen, Jens Cosedis

    2014-01-01

    Amiodarone is an effective antiarrhythmic drug for supra-ven-tri-cular and ventricular arrhythmias. A majority of patients treated with amiodarone suffer from mild adverse events, however, serious life-threatening adverse events caused by amiodarone are also seen. This review describes the pharma...

  2. Amiodaron: Unersetzliches Rhythmusmittel oder "Teufelszeug"?

    Directory of Open Access Journals (Sweden)

    Meinertz T

    2015-01-01

    Full Text Available Die Probleme der Amiodaron-Therapie beruhen auf Handhabungsfehlern. Bei korrekter Handhabung (niedrige Dosierung, engmaschige Überwachung des Patienten ist die Häufigkeit schwerwiegender Nebenwirkungen gering. Wichtig ist die Kontrolle der Schild drü senfunktion, von Hautveränderungen, Augenveränderungen, Leberfunktionsstörungen, neuromuskulären Nebenwirkungen sowie Lungenschäden. Hauptindikation für Amiodaron sind therapierefraktäres Vorhofflimmern sowie maligne ventrikuläre Herzrhythmusstörungen, die zu häufigen ICD-Entladungen führen.

  3. Bronchiolitis obliterans organizing pneumonia during low-dose amiodarone therapy

    NARCIS (Netherlands)

    Jessurun, GAJ; Hoogenberg, K; Crijns, HJGM

    1997-01-01

    Two cases of amiodarone-induced pulmonary toxicity during a relatively short period of low-dose amiodarone treatment are reported. The toxicity risk of amiodarone is determined by cumulative factors in individual patients.

  4. Amiodarone -- waxed and waned and waxed again.

    Science.gov (United States)

    Doggrell, S A

    2001-11-01

    Amiodarone has been used as an anti-arrhythmic drug since the 1970s and has an established role in the treatment of ventricular tachyarrhythmias. Although considered to be a class III anti-arrhythmic, amiodarone also has class I, II and IV actions, which gives it a unique pharmacological and anti-arrhythmic profile. Amiodarone is a structural analogue of thyroid hormone and some of its anti-arrhythmic properties and toxicity may be attributable to interactions with nuclear thyroid hormone receptors. The lipid solubility of amiodarone gives it an exceptionally long half-life. Oral amiodarone takes days to work in ventricular tachyarrhythmias, but iv. amiodarone has immediate effect and can be used in life threatening ventricular arrhythmias. Intravenous amiodarone administered after out-of-hospital cardiac arrest due to ventricular fibrillation improves survival to hospital admission. Many survivors of myocardial infarction (MI) die during the subsequent year, probably due to ventricular arrhythmia. Amiodarone reduces sudden death after MI and this benefit is predominantly observed in patients with preserved cardiac function. Sudden cardiac death, predominantly due to ventricular arrhythmias, is also commonly seen in patients with heart failure. The Grupo de Estudio de la Sobrevida en lsuficiencia Cardiaca en Argentina (GESICA) and Estudio Piloto Argentino de Muerte Subita y Amiodarona (EPAMSA) trials showed survival benefit of amiodarone in heart failure, whereas Congestive Heart Failure-Survival Trial of Anti-arrhythmic Therapy (CHF-STAT) did not. Subsequent meta-analysis established a survival benefit of amiodarone in heart failure. Implanted Cardioverter Def ibrillators (ICDs) also give survival benefit to patients at risk of sudden death. In patients with a history of ventricular fibrillation or haemodynamically-compromising ventricular tachycardia, ICDs have been shown to be superior to anti-arrhythmic drugs, principally amiodarone. Further analysis has been

  5. Acute pancreatitis and amiodarone: A case report

    Institute of Scientific and Technical Information of China (English)

    Yen-Yuan Chen; Ching-Yu Chen; Kai-Kuen Leung

    2007-01-01

    Amiodarone, a class m antiarrhythmic drug, is one of the most effective drugs used in the treatment of ventricular and paroxysmal supraventricular tachyarrhythmia. Adverse effects of amiodarone including pulmonary toxicity, hepatotoxicity, aggravation of arrhythmia, and thyroid diseases are well understood. A 66-year old woman with acute pancreatitis was admitted to our hospital with the complaint of epigastralgia radiating to both flanks for two months. Her symptoms and elevation of pancreatic enzymes did not respond to conventional medical treatment of pancreatitis for 18 d. No known causal factors for pancreatitis such as biliary tract stone, hypertriglyceridemia and alcohol consumption could be identified. Under the suspicion of amiodarone-induced acute pancreatitis, amiodarone was substituted by propafenone. Her symptoms soon alleviated and serum lipase level declined. Three months after hospital discharge, the abdominal pain did not recur. Amiodarone was approved to treat recurrent ventricular fibrillation or sustained ventricular tachyarrhythmia that has been resistant to other medications since 1986. Pancreatitis is a very rare adverse effect associated with the use of amiodarone, and only four cases of amiodarone-induced pancreatitis have been reported in literature. We report a patient who developed acute pancreatitis during amiodarone therapy.

  6. Anticonvulsant and hypnotic effects of amiodarone

    Institute of Scientific and Technical Information of China (English)

    Gunnur OZBAKIS-DENGIZ; Aysegul BAKIRCI

    2009-01-01

    Amiodarone hydrochloride is a potent anti-arrhythmic agent, known as a multiple ion-channel blocker in the heart.Although it has been detected in the rat brain, there are no data related to its central nervous system (CNS) effects. In this study, we evaluated anticonvulsant and hypnotic effects of amiodarone. Convulsions were induced by phentylenetetrazole (PTZ) (100 mg/kg) or caffeine (300 mg/kg) in mice. In both models, amiodarone prolonged both latency period and time to death, and acted as an anticonvulsant drug. It was found to be more effective in the PTZ model than in the caffeine model; none of the animals treated with 150 mg/kg dose amiodarone had died in the PTZ model. For hypnotic effect, sleeping was induced with pentobarbital (35 mg/kg) in rats. Amiodarone dose-dependently increased the sleeping time (677.7%~725.9%). In the sleeping test, all rats in 200 mg/kg amiodarone group died. In conclusion, anticonvulsant and hypnotic effects of amiodarone have shown the depressant effects on CNS. These effects may be dependent on its pharmacological properties.

  7. Amiodaron: Effektivität und Sicherheit

    Directory of Open Access Journals (Sweden)

    Hofmann R

    2009-01-01

    Full Text Available Aufgrund neutraler Nettoeffekte auf Herz-Kreislaufparameter hat sich Amiodaron wie kein konventionelles oder neu entwickeltes Antiarrhythmikum zur Behandlung verschiedener Tachyarrhythmien bewährt. Intravenöses Amiodaron ist guidelinekonform das Antiarrhythmikum der Wahl zur Behandlung von bedrohlichen ventrikulären Tachyarrhythmien. Patienten mit hoher Ventrikelfrequenz bei Vorhofflimmern profitieren von einer unmittelbaren Frequenzkontrolle sowie einem Potenzial zur Kardioversion ohne wesentliche Kompromittierung der Hämodynamik. Orales Amiodaron hat eine symptomatische Bedeutung bei Patienten mit ventrikulären Arrhythmien, eine Beeinflussung der Prognose konnte nicht nachgewiesen werden. Bei Patienten mit nichtpermanentem Vorhofflimmern ist Amiodaron das wirksamste Antiarrhythmikum und vor allem bei bestehender Herzinsuffizienz die einzige medikamentöse Option. Die Inzidenz klinisch relevanter Nebenwirkungen wurde historisch überbewertet und reduziert sich abgesehen von Einzelfällen auf Haut- und funktionelle Schilddrüsenveränderungen.

  8. Compound list: amiodarone [Open TG-GATEs

    Lifescience Database Archive (English)

    Full Text Available amiodarone AM 00033 ftp://ftp.biosciencedbc.jp/archive/open-tggates/LATEST/Human/in_vitro/amio...darone.Human.in_vitro.Liver.zip ftp://ftp.biosciencedbc.jp/archive/open-tggates/LATEST/Rat/in_vitro/amio...darone.Rat.in_vitro.Liver.zip ftp://ftp.biosciencedbc.jp/archive/open-tggates/LATEST/Rat/in_vivo/Liver/Single/amio...ve/open-tggates/LATEST/Rat/in_vivo/Liver/Repeat/amiodarone.Rat.in_vivo.Liver.Repeat.zip ...

  9. Amiodarone

    Science.gov (United States)

    ... nervousness irritability intolerance to heat or cold thinning hair excessive sweating changes in menstrual cycle swelling in ... to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in ...

  10. Amiodarone Induced Morphological Changes in Rabbit Pneumocytes

    Directory of Open Access Journals (Sweden)

    Fereshteh Mehraein

    2009-01-01

    Full Text Available Objective: Amiodarone as an iodinated benzofuran derivative is a potent antiarrhythmicagent currently used for the treatment of ventricular arrhythmias. Pulmonary toxicityis one of the complications of Amiodarone therapy. The aim of this study was todetermine the toxicity of Amiodarone for pneumocytes.Materials and Methods: 14 male white New Zealand rabbits were divided in a controlgroup and an experimental group. The experimental group was subjected to intraperitoneal injection with a single daily dose of 80 mg/kg Amiodarone for two weeks.The control group received only normal saline. At the end of the injection period, thetwo groups were anesthetized and perfused with Karnovsky fixative. The lung tissuewas removed and fixed, then prepared for light and electron microscope studies.Morphometric studies were made on sections to find nucleus profile dimensions.Results: Light microscope observation showed acute changes in the alveolus includingcongestion of alveolar capillaries and infiltration of red blood cells (RBCs intothe lumen of the alveoli. Electron microscope study of lung tissue revealed abnormalinclusion bodies within type ΙΙ & Ι pneumocytes. The micrographs also showedthe presence of vacuoles in 5% of the type ΙΙ pneumocytes. Morphometric studiesshowed that the nucleus of the cells in the experimental group were smaller than inthe control group (p<0.01.Conclusion: These results indicate that Amiodarone administration can cause damageto pnuemocytes and the alveolus of rabbit lung, so the effectiveness of Amiodaronein long term treatment of heart failure patients is limited because of the developmentof lung toxicity.

  11. Amiodarone for ACLS: a critical evaluation.

    Science.gov (United States)

    Stewart, C E

    2001-09-01

    Years ago, William Osler taught physicians, "Be not the first nor the last to adopt a therapy." This continues to be sage advice. Clinicians should be cautious in considering the use of amiodarone in a field setting for cardiac arrest until studies clearly show a benefit over drugs currently in use. The endpoint of the only cardiac arrest study available shows improved survival when amiodarone is combined with other drugs over placebo until the patient gets to the emergency department, but is not a comparison with other current drugs nor had any effect on long-term survival or functioning neurologic status. As previously cited, amiodarone was comparable with bretylium in treating recurrent VT/VF in one controlled study. Further study of this and other ACLS drugs is imperative. In summary, amiodarone should be reclassified as either a class indeterminate agent when used alone ("no harm but no benefit ... evidence insufficient to support final class decision") or a class IIb agent ("acceptable and useful ... supported by fair to good evidence") when used in addition to other therapies in the treatment of ventricular fibrillation and pulseless ventricular tachycardia. There is not sufficient evidence to move amiodarone to first-line therapy in the "out-of-hospital" cardiac arrest. This evidence may be available in the future and would then change this recommendation.

  12. Continuous vs episodic prophylactic treatment with amiodarone for the prevention of atrial fibrillation : a randomized trial

    NARCIS (Netherlands)

    Ahmed, Sheba; Rienstra, Michiel; Crijns, Harry J. G. M.; Links, Thera P.; Wiesfeld, Ans C. P.; Hillege, Hans L.; Bosker, Hans A.; Lok, Dirk J. A.; Van Veldhuisen, Dirk J.; Van Gelder, Isabelle C.

    2008-01-01

    Context Amiodarone effectively suppresses atrial fibrillation but causes many adverse events. Objective To compare major events in patients randomized to receive episodic amiodarone treatment with those who received continuous amiodarone treatment while still aiming to prevent atrial fibrillation. D

  13. Vorhofflimmern und Herzinsuffizienz - Die Rolle von Amiodaron

    Directory of Open Access Journals (Sweden)

    Scherr D

    2015-01-01

    Full Text Available Vorhofflimmern (VHF und Herzinsuffizienz (HI sind häufige kardiale Erkrankungen mit jeweils prognostischen Implikationen und gegenseitiger Beeinflussung/Verstärkung. Bei Patienten mit VHF und HI ist in den meisten Fällen die Frequenzkontrolle die Therapie der Wahl des VHF, jedoch bei ausgeprägter Symptomatik durch VHF, Zunahme der HI durch VHF oder bei Vorliegen einer Tachykardiomyopathie kann der Versuch der Rhythmisierung (Sinusrhythmus, SR angestrebt werden. In diesem Fall ist Amiodaron bei HI-Patienten das Antiarrhythmikum der Wahl zur Rezidivprophylaxe des VHF. Einer 45%igen 5-Jahres-Rate des SR-Erhalts bei Patienten mit VHF unter Amiodaron steht eine ca. 20%ige Nebenwirkungsrate gegenüber. Aber auch bei einer Strategie der Frequenzkontrolle des VHF ist Amiodaron bei HI-Patienten eine Second-line- Therapieoption. Zudem ist Amiodaron i. v. eine medikamentöse Therapieoption im Rahmen der akuten Rhythmuskontrolle (Kardioversion wie auch im Rahmen der akuten Frequenzkontrolle (tachykardes VHF bei HI-Patienten.

  14. Amiodaron-induced pulmonary toxicity with fatal outcome

    Energy Technology Data Exchange (ETDEWEB)

    Brachtel, D.; Krischel, W.

    1984-12-01

    Three month after initiation of amiodarone treatment wih 1000 mg daily a 62 years old man with refractory ventricular tachycardia developed increasing dyspnea. Chest X-ray findings consisted of patchy alveolar infiltrates and interstitial changes. Despite withdrawal of amiodarone and institution of prednisolone treatment the patient died of cardiorespiratory failure. Chest X-ray examinations at frequent intervals should be performed during the first year of high dose amiodarone therapy to detect early signs of pulmonary toxicity.

  15. Amiodarone supplants lidocaine in ACLS and CPR protocols.

    Science.gov (United States)

    Mizzi, Anna; Tran, Thanh; Mangar, Devanand; Camporesi, Enrico M

    2011-09-01

    Amiodarone is an antiarrhythmic medication used to treat and prevent certain types of serious, life-threatening ventricular arrhythmias. Amiodarone gained slow acceptance outside the specialized field of cardiac antiarrhythmic surgery because the side-effects are significant. Recent adoption of amiodarone in the ACLS (Advanced Cardiac Life Support) protocol has somewhat popularized this class of antiarrhythmics. Its use is slowly expanding in the acute medicine setting of anesthetics. This article summarizes the use of Amiodarone by anesthesiologists in the operating room and during cardiopulmonary resuscitation.

  16. The Incidence and Risk of Inducing Hyperthyroidism Following Amiodarone Treatment

    Directory of Open Access Journals (Sweden)

    Cozlea D L

    2013-06-01

    Full Text Available Introduction: Amiodarone, a frequently used antiarrhythmic drug in cardiology, is very efficient in the treatment of ventricular and supraventricular tachiarrithmyas. The iodine content of amiodarone is 39%. Its chemical structure is similar to tyrosine. It is estimated that 1-23% of patients treated with amiodarone can develop hyperthyroidism. The purpose of this study is to assess and monitor the incidence of hyperthyroidism induced by amiodarone in patients admitted for various types of cardiac dysrhythmias, considering that most of the patients included in the study came from an endemic goitre area.

  17. Drug induced lung disease - amiodarone in focus

    Directory of Open Access Journals (Sweden)

    Vasić Nada R.

    2014-01-01

    Full Text Available More than 380 medications are known to cause pulmonary toxicity. Selected drugs that are important causes of pulmonary toxicity fall into the following classes: cytotoxic, cardiovascular, anti-inflammatory, antimicrobial, illicit drugs, miscellaneous. The adverse reactions can involve the pulmonary parenchyma, pleura, the airways, pulmonary vascular system, and mediastinum. Drug-induced lung diseases have no pathognomonic clinical, laboratory, physical, radiographic or histological findings. A drug-induced lung disease is usually considered a diagnosis of exclusion of other diseases. The diagnosis of drug-mediated pulmonary toxicity is usually made based on clinical findings. In general, laboratory analyses do not help in establishing the diagnosis. High-resolution computed tomography scanning is more sensitive than chest radiography for defining radiographic abnormalities. The treatment of drug-induced lung disease consists of immediate discontinuation of the offending drug and appropriate management of the pulmonary symptoms. Glucocorticoids have been associated with rapid improvement in gas exchange and reversal of radiographic abnormalities. Before starting any medication, patients should be educated about the potential adverse effects of the drug. Amiodarone is an antiarrhythmic agent used in the treatment of many types of tachyarrhythmia. Amiodarone-caused pulmonary toxicity is a well-known side effect (complication of this medication. The incidence of amiodarone-induced lung disease is approximately 5-7%.

  18. CT aspects of amiodarone intoxication; Computertomographische Aspekte der Amiodaronintoxikation

    Energy Technology Data Exchange (ETDEWEB)

    Pitton, M. B. [Klinik mit Poliklinik fuer Radiologie, Universitaet Mainz (Germany); Schweden, F. [Klinik mit Poliklinik fuer Radiologie, Universitaet Mainz (Germany); Lenci, G. [3. Medizinische Klinik, Abteilung Pneumologie, Universitaet Mainz (Germany)

    1995-07-01

    Amiodarone, an antiarrhythmic drug, may cause pulmonary toxicity with typical high-attenuation-pleuro-parenchymal lesions and increased attentuation of liver and spleen. Characteristic CT findings are diagnositically significant. (orig.) [Deutsch] Amiodaron ist ein sehr potentes Antiarrhythmikum. Eine Intoxikation fuehrt fedoch zu entzuendlichen Lungengewebsveraenderungen mit hyperdensen Parenchymkonsolidierungen und typischen Dichteanhebungen in den parenchymatoesen Oberbauchorgan. Das computertomographische Erscheinungsbild ist fuer die Differentialdiagnose hilfreich. (orig.)

  19. Amiodarone-induced acute lung toxicity in an ICU setting.

    Science.gov (United States)

    Skroubis, G; Skroubis, T; Galiatsou, E; Metafratzi, Z; Karahaliou, A; Kitsakos, A; Nakos, G

    2005-04-01

    Amiodarone is a highly effective antiarrhythmic drug, albeit notorious for its serious pulmonary toxicity. The incidence of amiodarone-induced pulmonary toxicity (APT) appears to be 1% per year (1). We report a case of very acute APT in a man suffering from postoperative atrial fibrillation.

  20. Chronic amiodarone remodels expression of ion channel transcripts in the mouse heart

    Institute of Scientific and Technical Information of China (English)

    S.LEBOUTER; A.ELHARCHI; C.MARIONNEAU; C.BELLOCQ; A.CHAMBELLAN; K.LEQUANG; JCBELLOCQ; JCCHEVALIER; GLANDE; JJLEGER; FCHARPENTIER; DESCANDE; SDEMOLOMBE

    2004-01-01

    AIM: The basis for the unique effectiveness of chronic amiodarone on cardiac arrhythmias is incompletely understood. The present study investigated the pharmacogenomics profile of amiodarone on genes encoding ion channel subunits. METHODS AND RESULTS: Adult male mice were treated for 6 weeks with vehicle or oral amiodarone at 30,90,or 180 mg·kg-1·d-1, Plasma and myocardial levels of amiodarone and n-desethyl-amiodarone in

  1. Increased Density of the Liver and Amiodarone-Associated Phospholipidosis

    Directory of Open Access Journals (Sweden)

    Sunao Kojima

    2009-01-01

    Full Text Available This is a case report in which a 60-year-old man who suffered from ventricular tachycardia with dilated cardiomyopathy was prescribed amiodarone. After taking amiodarone, liver enzymes were increased and computed tomographic (CT scanning of the abdomen showed a significant increase in the density of the liver without contrast medium. He was suspected as hemochromatosis and liver biopsy was performed. An abnormal high density of liver tissue may be observed in an unenhanced CT in patients treated with amiodarone and we suggest that periodic monitoring of liver function and/or liver biopsy is warranted before an irreversible stage is reached.

  2. Amiodarone-Induced Thyrotoxic Thyroiditis: A Diagnostic and Therapeutic Challenge

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    Umang Barvalia

    2014-01-01

    Full Text Available Amiodarone is an iodine-based, potent antiarrhythmic drug bearing a structural resemblance to thyroxine (T4. It is known to produce thyroid abnormalities ranging from abnormal thyroid function testing to overt hypothyroidism or hyperthyroidism. These adverse effects may occur in patients with or without preexisting thyroid disease. Amiodarone-induced thyrotoxicosis (AIT is a clinically recognized condition commonly due to iodine-induced excessive synthesis of thyroid, also known as type 1 AIT. In rare instances, AIT is caused by amiodarone-induced inflammation of thyroid tissue, resulting in release of preformed thyroid hormones and a hyperthyroid state, known as type 2 AIT. Distinguishing between the two states is important, as both conditions have different treatment implications; however, a mixed presentation is not uncommon, posing diagnostic and treatment challenges. We describe a case of a patient with amiodarone-induced type 2 hyperthyroidism and review the current literature on the best practices for diagnostic and treatment approaches.

  3. Amiodarone-induced pulmonary toxicity - Predisposing factors, clinical symptoms and treatment

    NARCIS (Netherlands)

    Jessurun, GAJ; Boersma, WG; Crijns, HJGM

    1998-01-01

    Amiodarone is frequently used for the treatment of cardiac arrhythmias. Although the therapeutic efficacy of amiodarone has been established, its use is limited by its safety profile. Amiodarone-induced pulmonary toxicity is one of the most life-threatening complications of this therapy. It is a rel

  4. Amiodarone: Effects on thyroid function and the peripheral metabolism of the thyroid hormones

    Energy Technology Data Exchange (ETDEWEB)

    Braverman, L.E.; Safran, M.; Bambini, G.; Pinchera, A.; Martino, E.

    1985-11-01

    In addition to the effects of Amiodarone on the peripheral metabolism of the thyroid hormones and on pituitary TSH secretion, a major complication of therapy is the relatively high frequency of iodide-induced thyroid dysfunction. The mean T/sub 4/ and T/sub 3/ concentration following Amiodarone application was measured in euthyroid, hypothyroid and hyperthyroid patients and in control patients with and without cardiac disorders. Furthermore, the serum TSH was determined in euthyroid Amiodarone-treated euthyroid patients. /sup 131/I uptake was studied in patients with Amiodarone-associated thyrotoxicosis. The difficulties of the therapy of Amiodarone-induced hyperthyroidism are outlined. Preliminary studied of the effect of Amiodarone and its analogues on the metabolism of thyroid hormones in the rat indicate that Amiodarone may act as a thyroid hormone agonist in the pituitary. (MG).

  5. Amiodarone-Induced Pulmonary Toxicity – A Frequently Missed Complication

    Science.gov (United States)

    Sweidan, Alexander J.; Singh, Navneet K.; Dang, Natasha; Lam, Vinh; Datta, Jyoti

    2016-01-01

    INTRODUCTION Amiodarone is often used in the suppression of tachyarrhythmias. One of the more serious adverse effects includes amiodarone pulmonary toxicity (APT). Several pulmonary diseases can manifest including interstitial pneumonitis, organizing pneumonia, acute respiratory distress syndrome, diffuse alveolar hemorrhage, pulmonary nodules or masses, and pleural effusion. Incidence of APT varies from 5–15% and is correlated to dosage, age of the patient, and preexisting lung disease. DESCRIPTION A 56-year-old male with a past medical history of coronary artery disease and chronic obstructive pulmonary disease was admitted for a coronary artery bypass graft. Post-operatively, the patient was admitted to the ICU for ventilator management and continued to receive his home dose of amiodarone 400 mg orally twice daily, which he had been taking for the past 3 months. The patient was found to be hypoxemic with a PaO2 52 mmHg and bilateral infiltrates on chest x-ray. Patient also complained of new onset dyspnea. Physical exam found bilateral rhonchi with bibasilar crackles and subcutaneous emphysema along the left anterior chest wall. Daily chest x-rays showed worsening of bilateral interstitial infiltrates and pleural effusions. A chest high-resolution computed tomography on post-operative day 3 showed extensive and severe bilateral ground glass opacities. APT was suspected and amiodarone was discontinued. A course of oral prednisone without antibiotics was initiated, and after one week of treatment the chest film cleared, the PaO2 value normalized and dyspnea resolved. DISCUSSION APT occurs via cytotoxic T cells and indirectly by immunological reaction. Typically the lungs manifest a diffuse interstitial pneumonitis with varying degrees of fibrosis. Infiltrates with a ‘ground-glass’ appearance appreciated on HRCT are more definitive than chest x-ray. Pulmonary nodules can be seen, frequently in the upper lobes. These are postulated to be accumulations of

  6. Dronedarone and Amiodarone Induce Dyslipidemia and Thyroid Dysfunction in Rats

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    Li-Qin Jiang

    2016-05-01

    Full Text Available Background/Aims: Amiodarone, a thyroid hormone-like molecule, can induce dyslipidemia and thyroid dysfunction. However, the effects of dronedarone on lipid metabolism and of both dronedarone and amiodarone on thyroid function and lipid metabolism remain unknown. Methods: Fifty male Sprague-Dawley rats were randomly divided into 5 groups (10 in each group: normal control (NC, amiodarone-treated (AMT, dronedarone-treated (DRT, rats treated with amiodarone combined with polyene phosphatidylcholine (AC, and rats treated with dronedarone combined with polyene phosphatidylcholine (DC. Rats were given amiodarone (120 mg/kg/d, dronedarone (120 mg/kg/d, and polyene phosphatidylcholine (200 mg/kg/d for 13 weeks. At the end of weeks 4, 8, 12, and 13, plasma-free triiodothyronine (FT3, free thyroxine (FT4, triglycerides (TG, total cholesterol (TC, low-density lipoprotein cholesterol (LDL-c, and high-density lipoprotein cholesterol (HDL-c were determined. At the end of this protocol, rats were sacrificed and the thyroid glands were isolated, weighed, and examined histopathologically. The protein expression of Bcl-2 was measured by immunochemical staining. The mRNA expression of thyroglobulin (Tg, type-1 deiodinase (D1, and thyroid peroxidase (TPO were detected by polymerase chain reaction (PCR. Results: Compared with the NC group, FT3 and FT4 levels in the DRT and DC groups significantly increased at week 4 but declined thereafter. The AMT and AC groups had lower FT3 levels but comparable FT4 levels. The levels of TG, LDL-c, and HDL-c in the NC group were lower than those in the other groups whereas the LDL-c/HDL-c ratio was lowest in the AMT group. Bcl-2 expression significantly increased in the DRT group. The mRNA expression of Tg increased whereas the mRNA expression of D1 decreased. Dronedarone induced hyperthyroidism at the early stage and hypothyroidism at the late stage whereas amiodarone only caused hypothyroidism. Conclusion: Both dronedarone and

  7. Herb-drug interaction of Fucus vesiculosus extract and amiodarone in rats: a potential risk for reduced bioavailability of amiodarone in clinical practice.

    Science.gov (United States)

    Rodrigues, Márcio; Alves, Gilberto; Abrantes, João; Falcão, Amílcar

    2013-02-01

    Fucus vesiculosus is a seaweed claimed to be useful for obesity management. Therefore, considering the relationship between obesity and cardiovascular diseases, this work aimed to assess the potential for an herb-drug interaction among a standardized F. vesiculosus extract (GMP certificate) and amiodarone (a narrow therapeutic index drug) in rats. In a first pharmacokinetic study, rats were simultaneously co-administered with a single-dose of F. vesiculosus (575 mg/kg, p.o.) and amiodarone (50 mg/kg, p.o.); in a second study, rats were pre-treated during 14 days with F. vesiculosus (575 mg/kg/day, p.o.) and received amiodarone (50 mg/kg, p.o.) on the 15th day. Rats of the control groups received the corresponding volume of vehicle. After analysis of the pharmacokinetic data it deserves to be highlighted the significant decrease in the peak plasma concentration of amiodarone (55.4%) as well as the reduction of systemic exposure to the parent drug (~30%) following the simultaneous co-administration of F. vesiculosus extract and amiodarone. This paper reports, for the first time, the herb-drug interaction between F. vesiculosus and amiodarone, which determined a considerable decrease on amiodarone bioavailability in rats. Therefore, the therapeutic efficacy of amiodarone may be compromised by the concurrent administration of herbal slimming medicines/dietary supplements containing F. vesiculosus.

  8. Effects of amiodarone on the pharmacokinetics and toxicity of digoxin in laboratory animals.

    Science.gov (United States)

    Staneva-Stoytcheva, D; Kristeva, E

    1992-04-01

    Some pharmacokinetic interactions between digoxin and amiodarone were studied in experiments on rabbits. An increase of digoxin serum levels was established in amiodarone-treated rabbits (amiodarone 30 mg/kg s.c. for five days alone or together with digoxin). The calculated elimination half-life (t 1/2) and the area under the curve (AUC) of digoxin were increased and the digoxin clearance was decreased, being most pronounced in animals receiving amiodarone-digoxin combination for five days. There were no changes either in digoxin toxicity in amiodarone-treated guinea pigs or in serum levels of T4, T3 and TTH. The possible mechanisms of digoxin-amiodarone interactions are discussed.

  9. [Intravenous amiodarone in the therapy of paroxysmal supraventricular tachycardias].

    Science.gov (United States)

    Storelli, A; Andriulo, C; Chisena, A; De Giorgi, M; De Giorgio, N A; Gallone, V; Guadalupi, M; Lupis, O; Nadovezza, S; Tarentini, A

    1985-03-01

    The Authors evaluated the effectiveness and the tolerance of intravenous Amiodarone in 50 cases of recent onset paroxysmal supraventricular tachyarrhythmias. Fifty consecutive patients, aged 17 to 84 (mean 52 years), presenting with paroxysmal supraventricular tachycardia (PSVT, 33 cases) or atrial flutter (11 cases) or atrial fibrillation (6 cases), were given 300 mg of Amiodarone intravenously within 2 min, followed in 4 patients by 150 mg after 15 min. All patients were monitored for 1 hour; ECG and blood pressure were recorded at fixed times. Within 15 min sinus rhythm was restored in 88% of PSVT, in 27% of atrial flutter and in 17% of atrial fibrillation cases; the other cases of atrial flutter and fibrillation always showed a 48-81% reduction of the average heart rate within 15 min. We have evidenced neither significant modifications of blood pressure and ECG parameters (P-Q, QRS and Q-T duration) nor particular side effects, except for 2 cases in which brief hot flushes were reported. The Authors believe Amiodarone to be an effective and well tolerated drug for the above mentioned arrhythmias, particularly promptly acting in PSVT cases, in whom sinus rhythm was restored within 15 min in 88% and within 1 hour in 100% of the cases.

  10. Treatment of Amiodarone-Induced Thyrotoxicosis Type 2 : A Randomized Clinical Trial

    NARCIS (Netherlands)

    Eskes, Silvia A.; Endert, Erik; Fliers, Eric; Geskus, Ronald B.; Dullaart, Robin P. F.; Links, Thera P.; Wiersinga, Wilmar M.

    2012-01-01

    Context: Amiodarone-induced thyrotoxicosis (AIT) type 2 is self-limiting in nature, but most physicians are reluctant to continue amiodarone. When prednisone fails to restore euthyroidism, possibly due to mixed cases of AIT type 1 and 2, perchlorate (ClO4) might be useful because ClO4 reduces the cy

  11. Interactions of amiodarone with model membranes and amiodarone-photoinduced peroxidation of lipids.

    Science.gov (United States)

    Sautereau, A M; Tournaire, C; Suares, M; Tocanne, J F; Paillous, N

    1992-06-23

    The potent antiarrhythmic drug, amiodarone (AMIO) exhibits phototoxicity, which is thought to be related to its interaction with biological membranes. We report here a spectroscopic study of the interactions of this drug with phosphatidylglycerol (PG) and phosphatidylcholine (PC) liposomes used as membrane model systems. A linear increase in absorbance at 300 nm was observed with increasing addition of AMIO to dimyristoyl-DL-PC (DMPC) liposomes over all the drugs-lipid molar ratio (Ri)s tested. In contrast, in the dimyristoyl-DL-PG (DMPG) liposomes, there was a dramatic increase in absorbance at values of Ri above unity. Light scattering by DMPG liposomes at 350 nm increased with increasing AMIO concentration up to a Ri = 1, and then decreased with increasing drug concentration. Such changes were not observed with the DMPC liposomes. Moreover, addition of AMIO changed the fluorescence polarization rate of 1,6-diphenyl 1,3,5-hexatriene embedded in these liposomes. It reduced the rate below the phase transition temperature (Tt) of the lipid, but increased it above this temperature. These effects on the lipidic phases observed at low Ri were more pronounced on the DMPG than on the DMPC liposomes. The strong interactions of AMIO with phospholipids, especially the acidic ones, were confirmed by liposome size determinations. All these data strongly suggest that the drug was incorporated in the core of the lipid bilayers. Such a penetration would favor a drug-photoinduced peroxidation of lipids. Indeed, UV irradiation of AMIO-DOPG mixtures led to the disappearance of the unsaturated fatty acids of phospholipids, checked by gas chromatography measurements, which was correlated with the amount of oxygen consumed. This showed that AMIO did photosensitize phospholipid peroxidation.

  12. Effect of amiodarone therapy on mortality in patients with left ventricular dysfunction and asymptomatic complex ventricular arrhythmias: Argentine Pilot Study of Sudden Death and Amiodarone (EPAMSA).

    Science.gov (United States)

    Garguichevich, J J; Ramos, J L; Gambarte, A; Gentile, A; Hauad, S; Scapin, O; Sirena, J; Tibaldi, M; Toplikar, J

    1995-09-01

    The efficiency of prophylactic antiarrhythmic treatment with amiodarone in reducing 1-year mortality in patients with reduced left ventricular ejection fraction ( < 35%) and asymptomatic ventricular arrhythmias (Lown classes 2 and 4) was investigated in a prospective, multicenter, randomized, controlled study. Among 127 patients who entered the study, 61 were assigned to no antiarrhythmic therapy (control group [CG] and 66 to amiodarone treatment (amiodarone group [AG]). Amiodarone was administered at a dosage of 800 mg/day for 2 weeks followed by 400 mg/day thereafter. A 12-month follow-up was completed for 106 patients (57 in the AG and 49 in the CG). Amiodarone reduced the overall mortality rate, which was 10.5% in the AG versus 28.6% in the CG (odds ratio [OR] 0.29; 95% confidence interval [CI] 0.10 to 0.84; log-rank test 0.02) and sudden death rate, which was 7.0% in the AG versus 20.4% in the CG (OR 0.29; 95% CI 0.08 to 1.00; log-rank test 0.04). Side effects were rare, and in only three patients did amiodarone treatment have to be discontinued.

  13. Amiodarone and metabolite MDEA inhibit Ebola virus infection by interfering with the viral entry process.

    Science.gov (United States)

    Salata, Cristiano; Baritussio, Aldo; Munegato, Denis; Calistri, Arianna; Ha, Huy Riem; Bigler, Laurent; Fabris, Fabrizio; Parolin, Cristina; Palù, Giorgio; Mirazimi, Ali

    2015-07-01

    Ebola virus disease (EVD) is one of the most lethal transmissible infections characterized by a high fatality rate, and a treatment has not been developed yet. Recently, it has been shown that cationic amphiphiles, among them the antiarrhythmic drug amiodarone, inhibit filovirus infection. In the present work, we investigated how amiodarone interferes with Ebola virus infection. Wild-type Sudan ebolavirus and recombinant vesicular stomatitis virus, pseudotyped with the Zaire ebolavirus glycoprotein, were used to gain further insight into the ability of amiodarone to affect Ebola virus infection. We show that amiodarone decreases Ebola virus infection at concentrations close to those found in the sera of patients treated for arrhythmias. The drug acts by interfering with the fusion of the viral envelope with the endosomal membrane. We also show that MDEA, the main amiodarone metabolite, contributes to the antiviral activity. Finally, studies with amiodarone analogues indicate that the antiviral activity is correlated with drug ability to accumulate into and interfere with the endocytic pathway. Considering that it is well tolerated, especially in the acute setting, amiodarone appears to deserve consideration for clinical use in EVD.

  14. Dantrolene versus amiodarone for cardiopulmonary resuscitation: a randomized, double-blinded experimental study

    Science.gov (United States)

    Wiesmann, Thomas; Freitag, Dennik; Dersch, Wolfgang; Eschbach, Daphne; Irqsusi, Marc; Steinfeldt, Thorsten; Wulf, Hinnerk; Feldmann, Carsten

    2017-01-01

    Dantrolene was introduced for treatment of malignant hyperthermia. It also has antiarrhythmic properties and may thus be an alternative to amiodarone for the treatment of ventricular fibrillation (VF). Aim of this study was to compare the return of spontaneous circulation (ROSC) with dantrolene and amiodarone in a pig model of cardiac arrest. VF was induced in anesthetized pigs. After 8 min of untreated VF, chest compressions and ventilation were started and one of the drugs (amiodarone 5 mg kg−1, dantrolene 2.5 mg kg−1 or saline) was applied. After 4 min of initial CPR, defibrillation was attempted. ROSC rates, hemodynamics and cerebral perfusion measurements were measured. Initial ROSC rates were 7 of 14 animals in the dantrolene group vs. 5 of 14 for amiodarone, and 3 of 10 for saline). ROSC persisted for the 120 min follow-up in 6 animals in the dantrolene group, 4 after amiodarone and 2 in the saline group (n.s.). Hemodynamics were comparable in both dantrolene group amiodarone group after obtaining ROSC. Dantrolene and amiodarone had similar outcomes in our model of prolonged cardiac arrest, However, hemodynamic stability was not significantly improved using dantrolene. Dantrolene might be an alternative drug for resuscitation and should be further investigated. PMID:28098197

  15. Effects of Combination Therapy of Amiodarone and Bisoprolol in Patients With Paroxysmal Atrial Fibrillation

    Institute of Scientific and Technical Information of China (English)

    Rong-qiang YAN; Fang-sheng ZHENG; Qing-hai ZHANG

    2009-01-01

    Objectives To examine the long-term efficacy of combination therapy of amiodarone and bisoprolol in patients with paroxysmal atrial fibrillation (P-AF). Methods Eighty-eight patients with P-AF were divided into two groups: 44 pa-tients treated with bisoprolol and amiodarone were enrolled in group A; 44 patients treated with amiodarone alone were enrolled in group B. Survival rates, rates of conversing to permanent atrial fibrillation (AF), subjective symptom im-provement rates and secondary bradyarrhythmia rates of the two groups were measured and analyzed. Results At 12 and 24 months, the survival rates for patients free from atrial fibrillation recurrence were 75 % and 59. 1% in group A, and 54.5 % and 36.4 % in group B (P0.05, group A vs. Group B). Conclusions In patients with P-AF, bisoprolol appears to enhance the efficacy of amiodarone therapy in maintaining sinus rhythm and improving subjective symptoms.

  16. Effects of amiodarone and thoracic epidural analgesia on atrial fibrillation after coronary artery bypass grafting

    DEFF Research Database (Denmark)

    Nygård, Eigil; Sørensen, Lars H; Hviid, Lamia B;

    2004-01-01

    OBJECTIVE: This study was designed to assess the effects of a perioperative dosing regimen of amiodarone administration, high thoracic epidural anesthesia (TEA), or a combination of the 2 regimens on atrial fibrillation (AF) after coronary artery bypass grafting (CABG). DESIGN AND SETTING......: The study was prospective, controlled, and randomized and was performed in a tertiary health care center associated with a university. PARTICIPANTS: One hundred sixty-three patients scheduled for coronary artery bypass graft surgery. INTERVENTIONS: In this 2 x 2 factorial-designed study the patients were...... randomized to 1 of 4 regimens in which group E had perioperative TEA, group E+A had TEA and amiodarone, group A had amiodarone, and group C served as control. The epidural catheter was inserted at T1-3 the day before surgery. TEA groups received TEA for 96 hours. The amiodarone regimen consisted of a single...

  17. Acute Amiodarone Pulmonary Toxicity after Drug Holiday: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ahmed Abuzaid

    2015-01-01

    Full Text Available Amiodarone is reported to cause a wide continuum of serious clinical effects. It is often challenging to detect Amiodarone-induced pulmonary toxicity (AIPT. Typically, the diagnosis is made based on the clinical settings and may be supported by histopathology results, if available. We describe a 57-year-old patient who developed severe rapidly progressive respiratory failure secondary to AIPT with acute bilateral infiltrates and nodular opacities on chest imaging. Interestingly, Amiodarone was discontinued 3 weeks prior to his presentation. He had normal cardiac filling pressures confirmed by echocardiography. To our knowledge, this is the first case of isolated acute lung injury induced by Amiodarone, three weeks after therapy cessation, with adequate clinical improvement after supportive management and high dose steroid therapy.

  18. Acute amiodarone promotes drift and early termination of spiral wave re-entry.

    Science.gov (United States)

    Nakagawa, Harumichi; Honjo, Haruo; Ishiguro, Yuko S; Yamazaki, Masatoshi; Okuno, Yusuke; Harada, Masahide; Takanari, Hiroki; Sakuma, Ichiro; Kamiya, Kaichiro; Kodama, Itsuo

    2010-07-01

    Intravenous application of amiodarone is commonly used in the treatment of life-threatening arrhythmias, but the underlying mechanism is not fully understood. The purpose of the present study is to investigate the acute effects of amiodarone on spiral wave (SW) re-entry, the primary organization machinery of ventricular tachycardia/fibrillation (VT/VF), in comparison with lidocaine. A two-dimensional ventricular myocardial layer was obtained from 24 Langendorff-perfused rabbit hearts, and epicardial excitations were analyzed by high-resolution optical mapping. During basic stimulation, amiodarone (5 microM) caused prolongation of action potential duration (APD) by 5.6%-9.1%, whereas lidocaine (15 microM) caused APD shortening by 5.0%-6.4%. Amiodarone and lidocaine reduced conduction velocity similarly. Ventricular tachycardias induced by DC stimulation in the presence of amiodarone were of shorter duration (sustained-VTs >30 s/total VTs: 2/58, amiodarone vs 13/52, control), whereas those with lidocaine were of longer duration (22/73, lidocaine vs 14/58, control). Amiodarone caused prolongation of VT cycle length and destabilization of SW re-entry, which is characterized by marked prolongation of functional block lines, frequent wavefront-tail interactions near the rotation center, and considerable drift, leading to its early annihilation via collision with anatomical boundaries. Spiral wave re-entry in the presence of lidocaine was more stabilized than in control. In the anisotropic ventricular myocardium, amiodarone destabilizes SW re-entry facilitating its early termination. Lidocaine, in contrast, stabilizes SW re-entry resulting in its persistence.

  19. Ameliorative effect of grapefruit juice on amiodarone-induced cytogenetic and testicular damage in albino rats

    Institute of Scientific and Technical Information of China (English)

    Saber Abdelruhman Sakr; Mohamed El-said Zoil; Samraa Samy El-shafey

    2013-01-01

    Objective:To evaluate the ameliorative role of grapefruit juice on the cytogenetic and testicular damage induced by the antiarrythmic drug amiodarone in albino rats. Methods: Animals were divided into four groups. Group I was considered as control. Group II was given grapefruit juice at a dose level of 27 mL/kg body weight. Group III was orally administered amiodarone (18 mg/kg body weight) daily for 5 weeks. Animals were sacrificed after 5 weeks of treatment. Bone marrow was collected from the femurs for analysis of chromosomal aberrations and mitotic indices. Testes were removed and stained with H&E for histological examination. Sperms were collected from epidedymis for detection of sperm head abnormalities. Comet assay was used to detect DNA damage. Results: Amiodarone treatment caused a significant increase in the percentage of chromosomal aberrations, decreased the mitotic index and increased DNA damage. The testis showed many histopathological alterations, inhibition of spermatogenesis and morphometric changes. The number of sperm head abnormalities was increased. Treating animals with amiodarone and grapefruit juice caused a reduction in chromosomal aberrations, mitotic index, DNA damage and testicular alterations caused by amiodarone. Conclusions:The results of this study indicated that grapefruit juice ameliorates the cytotoxicty and testicular alterations induced by amiodarone in albino rats and this is may be due to the potent antioxidant effects of its components.

  20. Acute lung affection in an endurance-trained man under amiodarone medication

    Directory of Open Access Journals (Sweden)

    Saurbier, Bernward

    2005-06-01

    Full Text Available Patients undergoing treatment with amiodarone can develop severe pulmonary side effects. This effect, which is often highly underestimated, can lead to dyspnea, pneumonitis, and further fibrosis. A recent change in the labeling of amdiodarone by the American Food and Drug Administration (FDA supports this suspicion. Tracing the symptoms back to the causing agent can be difficult, as shown in our report. The subject of this case report is an endurance-trained 65 year old male marathon runner who appeared with atrial fibrillation during a routine check up in autumn 2003. After medical cardioversion with flecainide a complaint free interval of 8 months was followed by a relapse, which resulted in a change of medication to amiodarone. Due to misunderstandings the patient kept on taking the amiodarone loading dose for six weeks and returned with severe dyspnea on exertion. Losses in CO diffusing capacity, a lowered macrophages count and a positive lymphocyte transformation test were the only first hand clinical evidence of amiodarone intoxication, despite the sensation of dyspnea. This case shows that special care has to be taken in treatment with amiodarone. Side effects can be hard to trace and do not evidently show a clear connection to amiodarone.

  1. Amiodarone for the treatment and prevention of ventricular fibrillation and ventricular tachycardia

    Directory of Open Access Journals (Sweden)

    Hugo Van Herendael

    2010-06-01

    Full Text Available Hugo Van Herendael, Paul DorianDivision of Cardiology, St. Michael’s Hospital, University of Toronto, Toronto, CanadaAbstract: Amiodarone has emerged as the leading antiarrhythmic therapy for termination and prevention of ventricular arrhythmia in different clinical settings because of its proven efficacy and safety. In patients with shock refractory out-of-hospital cardiac arrest and hemodynamically destabilizing ventricular arrhythmia, amiodarone is the most effective drug available to assist in resuscitation. Although the superiority of the transvenous implantable cardioverter defibrillator (ICD over amiodarone has been well established in the preventive treatment of patients at high risk of life-threatening ventricular arrhythmias, amiodarone (if used with a beta-blocker is the most effective antiarrhythmic drug to prevent ICD shocks and treat electrical storm. Both the pharmacokinetics and the electrophysiologic profile of amiodarone are complex, and its optimal and safe use requires careful patient surveillance with respect to potential adverse effects.Keywords: amiodarone, ventricular fibrillation, unstable ventricular tachycardia

  2. Herb-Drug Interaction of Paullinia cupana (Guarana) Seed Extract on the Pharmacokinetics of Amiodarone in Rats

    Science.gov (United States)

    Rodrigues, Márcio; Alves, Gilberto; Lourenço, Nulita; Falcão, Amílcar

    2012-01-01

    Paullinia cupana is used in weight-loss programs as a constituent of medicinal/dietary supplements. This study aimed to assess a potential herb-drug interaction among a standardized (certified) Paullinia cupana extract and amiodarone (narrow therapeutic index drug) in rats. In a first pharmacokinetic study rats were simultaneously coadministered with a single dose of Paullinia cupana (821 mg/kg, p.o.) and amiodarone (50 mg/kg, p.o.), and in a second study rats were pretreated during 14 days with Paullinia cupana (821 mg/kg/day, p.o.) receiving amiodarone (50 mg/kg, p.o.) on the 15th day. Rats of the control groups received the corresponding volume of vehicle. Blood samples were collected at several time points after amiodarone dosing, and several tissues were harvested at the end of the experiments (24 h after dose). Plasma and tissue concentrations of amiodarone and its major metabolite (mono-N-desethylamiodarone) were measured and analysed. A significant reduction in the peak plasma concentration (73.2%) and in the extent of systemic exposure (57.8%) to amiodarone was found in rats simultaneously treated with Paullinia cupana and amiodarone; a decrease in tissue concentrations was also observed. This paper reports for the first time an herb-drug interaction between Paullinia cupana extract and amiodarone, which determined a great decrease on amiodarone bioavailability in rats. PMID:23304200

  3. Herb-Drug Interaction of Paullinia cupana (Guarana Seed Extract on the Pharmacokinetics of Amiodarone in Rats

    Directory of Open Access Journals (Sweden)

    Márcio Rodrigues

    2012-01-01

    Full Text Available Paullinia cupana is used in weight-loss programs as a constituent of medicinal/dietary supplements. This study aimed to assess a potential herb-drug interaction among a standardized (certified Paullinia cupana extract and amiodarone (narrow therapeutic index drug in rats. In a first pharmacokinetic study rats were simultaneously coadministered with a single dose of Paullinia cupana (821 mg/kg, p.o. and amiodarone (50 mg/kg, p.o., and in a second study rats were pretreated during 14 days with Paullinia cupana (821 mg/kg/day, p.o. receiving amiodarone (50 mg/kg, p.o. on the 15th day. Rats of the control groups received the corresponding volume of vehicle. Blood samples were collected at several time points after amiodarone dosing, and several tissues were harvested at the end of the experiments (24 h after dose. Plasma and tissue concentrations of amiodarone and its major metabolite (mono-N-desethylamiodarone were measured and analysed. A significant reduction in the peak plasma concentration (73.2% and in the extent of systemic exposure (57.8% to amiodarone was found in rats simultaneously treated with Paullinia cupana and amiodarone; a decrease in tissue concentrations was also observed. This paper reports for the first time an herb-drug interaction between Paullinia cupana extract and amiodarone, which determined a great decrease on amiodarone bioavailability in rats.

  4. The Characteristics of Amiodarone-induced Thyrotoxicosis in a Moderate Iodine Deficit Area

    Directory of Open Access Journals (Sweden)

    Ancuța-Elena Cota

    2013-08-01

    Full Text Available Introduction: Amiodarone (AMI, a class III anti-arrhythmic drug, is associated with a number of side effects, including thyroid dysfunction (both hypo- and hyperthyroidism, which is due to amiodarone's high iodine content and its direct toxic effect on the thyroid. Objective: To evaluate the incidence of Amiodarone induced thyrotoxicosis (AIT (type, rate of occurrence and to identify the risk factors involved in its occurrence. Material and method: We examined patients treated with amiodarone, between January 2002 and December 2011, who presented to our Department of Endocrinology Târgu Mures for thyroid dysfunctions. Results: The retrospective study included 87 patients with thyroid dysfunctions; 58 (66.7% patients had AIT and 29 (33.3% had Amiodarone induced hypothyroidism (AIH. In the AIT group: 35 were women (60.3%, 23 were men (39.7%; the average age was 61.60 ± 12.39 years. Risk factors identified for the AIT group were male gender (RR = OR = 3.8; Chi-squer = 5.7, p = 0.004 and pre-existing thyroid abnormalities (RR = 2.5, Chi-square = 4.1, p = 0.005. The thyroid dysfunction occurrence was heterogeneous (0.2-183 months. The patients with previous thyroid abnormalities developed earlier thyroid dysfunction compared to those with an apparently normal thyroid gland (22.25 ± 4.14 months versus 32.09 ± 7.69 months, p = 0.02, T test. Conclusion: In the context of the specific iodine geoclimatic intake and the area of origin, amiodarone - induced thyroid dysfunction spectrum is dominated by thyrotoxicosis. Screening and monitoring of thyroid function for patiens under chronic amiodarone treatment is necessary

  5. Comparative efficacy of amiodarone with ivabradin combination or amiodarone with bisoprolol combination in the prevention of atrial fibrillation recurrence in pa- tients with left ventricular diastolic dysfunction

    Directory of Open Access Journals (Sweden)

    K. G. Adamyan

    2015-11-01

    Full Text Available Aim. To study the efficacy of use of amiodarone with ivabradine combination or amiodarone with bisoprolol combination in the prevention of atrial fibrillation (AF recurrence in patients (pts with left ventricular diastolic dysfunction (LVDD after conversion to sinus rhythm. Material and methods. 65 patients (40 males, 25 females aged 53±8 years with persistent AF and LVDD were included into the study and randomized into 3 groups to receive ivabradine and amiodarone (22 pts, bisoprolol and amiodarone (22 pts or amiodarone alone (21 pts. Left atrium (LA volume indices, LA longitudinal strain rate (LASR in systole, LV mass index, mean heart rate (HR, 24-hour HR variability and the incidence of AF by 96 h ECG monitoring were measured after the titration period, and after 3 and 6 months of follow-up. Results. After 6 months of follow-up group 1 revealed significantly lower maximum LA volume index (21.3±2.4 vs 25.2±3.0 and 28.7±3.6 ml/m2 in the 2nd and control groups, respectively, P-wave LA volume index (15.3±3.5 versus 18.1±3.8 and 20.4±4.0 ml/m2 in the 2nd and control groups, respectively, and LA systolic volume index (7.3±1.2 versus 9.4±1.6 and 9.6±1.7 ml/m2 in 2nd and control groups, respectively. The incidence of side effects in group 1 was significantly less than that in group 2 and was not different compared with control group. Conclusion. Ivabradine and amiodarone combination provides better prevention of AF recurrence and less side-effects in pts with LVDD and persistent AF after sinus rhythm restoration as compared with bisoprolol and amiodarone combination, it also reduces LA maximum, conduit and systolic volumes, and increases LASR.

  6. Comparative efficacy of amiodarone with ivabradin combination or amiodarone with bisoprolol combination in the prevention of atrial fibrillation recurrence in pa- tients with left ventricular diastolic dysfunction

    Directory of Open Access Journals (Sweden)

    K. G. Adamyan

    2015-01-01

    Full Text Available Aim. To study the efficacy of use of amiodarone with ivabradine combination or amiodarone with bisoprolol combination in the prevention of atrial fibrillation (AF recurrence in patients (pts with left ventricular diastolic dysfunction (LVDD after conversion to sinus rhythm. Material and methods. 65 patients (40 males, 25 females aged 53±8 years with persistent AF and LVDD were included into the study and randomized into 3 groups to receive ivabradine and amiodarone (22 pts, bisoprolol and amiodarone (22 pts or amiodarone alone (21 pts. Left atrium (LA volume indices, LA longitudinal strain rate (LASR in systole, LV mass index, mean heart rate (HR, 24-hour HR variability and the incidence of AF by 96 h ECG monitoring were measured after the titration period, and after 3 and 6 months of follow-up. Results. After 6 months of follow-up group 1 revealed significantly lower maximum LA volume index (21.3±2.4 vs 25.2±3.0 and 28.7±3.6 ml/m2 in the 2nd and control groups, respectively, P-wave LA volume index (15.3±3.5 versus 18.1±3.8 and 20.4±4.0 ml/m2 in the 2nd and control groups, respectively, and LA systolic volume index (7.3±1.2 versus 9.4±1.6 and 9.6±1.7 ml/m2 in 2nd and control groups, respectively. The incidence of side effects in group 1 was significantly less than that in group 2 and was not different compared with control group. Conclusion. Ivabradine and amiodarone combination provides better prevention of AF recurrence and less side-effects in pts with LVDD and persistent AF after sinus rhythm restoration as compared with bisoprolol and amiodarone combination, it also reduces LA maximum, conduit and systolic volumes, and increases LASR.

  7. SEVERE AMIODARONE-INDUCED BRADICARDIA CONCEALES SICK SINUS SYNDROME: CASE REPORT.

    Science.gov (United States)

    Crăcană, Irina; Vasilcu, T F; Mardare, Alexandra; Alexa, Ioana Dana; Marcu, D T M

    2016-01-01

    Sinus node dysfunction is one of the most common arrhythmias in elderly patients; it is usually associated with intermittent and variable symptoms, thus making it difficult to diagnose. We present the case of an elderly female patient with a personal history of atrial fibrillation treated for the last three years with amiodarone; she was admitted to the Geriatric Clinic for non-specific symptoms with onset two months previously for which she had already sought care in different medical services. Clinical examination showed severe bradycardia; ECG and Holter ECG on admission confirmed severe bradycardia, with a heart rate between 29 and 50 beats/min (bpm). Given her long-term treatment with amiodarone we looked for and found hyperthyroidism; the endocrine examination led to the diagnosis of mixed type Amiodarone-induced thyrotoxicosis and initiation of corticosteroid and antithyroid treatment. The evolution of cardiac arrhythmia was monitored with the help of several Holter ECGs performed after amiodarone washout and return to the euthyroid state, which revealed a tachycardia-bradycardia syndrome initially masked by the side effects of the unsupervised therapy with amiodarone, and properly treated by the implantation of a pacemaker.

  8. Hyperacute drug-induced hepatitis with intravenous amiodarone: case report and review of the literature.

    Science.gov (United States)

    Nasser, Mohammad; Larsen, Timothy R; Waanbah, Barryton; Sidiqi, Ibrahim; McCullough, Peter A

    2013-01-01

    Amiodarone is a benzofuran class III antiarrhythmic drug used to treat a wide spectrum of ventricular tachyarrhythmias. The parenteral formulation is prepared in polysorbate 80 diluent. We report an unusual case of acute elevation of aminotransaminase concentrations after the initiation of intravenous amiodarone. An 88-year-old Caucasian female developed acute hepatitis and renal failure after initiating intravenous amiodarone for atrial fibrillation with a rapid ventricular response in the setting of acutely decompensated heart failure and hepatic congestion. Liver transaminases returned to baseline within 7 days after discontinuing the drug. Researchers hypothesized that this type of injury is related to liver ischemia with possible superimposed direct drug toxicity. The CIOMS/RUCAM scale identifies our patient's acute hepatitis as a highly probable adverse drug reaction. Future research is needed to understand the mechanisms by which hyperacute drug toxicity occurs in the setting of impaired hepatic perfusion and venous congestion.

  9. Development and X-ray morphology of amiodarone pneumopathy. Die Entwicklung und Roentgenmorphologie der Amiodaronpneumopathie

    Energy Technology Data Exchange (ETDEWEB)

    Billmann, P. (Kreiskrankenhaus Lahr (Germany, F.R.). Radiologisches Inst.); Fleischmann, D. (Kreiskrankenhaus Lahr (Germany, F.R.). Kardiologische Klinik); Baumeister, L. (Sankt-Josefs-Krankenhaus, Offenburg am Main (Germany, F.R.). Radiologische Abt.)

    1991-04-01

    Besides general extracardiac physical side effects, the antiarrhythmic amiodarone hydrochloride gives rise to morphologically manifest organ changes. Pneumopathy has been reported in up to 8% of the patients treated with this preparation. Radiologically and histologically, the clinical picture can resemble that of exogenous allergic alveolitis. When the course is protracted there is interstitial fibrotic degeneration of the pulmonary parenchyma with a corresponding morphological correlate in the X-ray. The extent to which the changes observed result from dose-dependent toxicity of amiodarone has not been completely elucidated even now, since pulmonary changes suggestive of an immune process can occur even at low doses. When there is reason suspect the presence of amiodarone pneumopathy, the preparation should be discontinued. Radiological and clinical findings generally regress with cortisone treatment. (orig.).

  10. Acutely Onset Amiodarone-Induced Angioedema in a Patient with New Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Hossein Vakili

    2014-01-01

    Full Text Available A 50-year-old man was admitted to our emergency department due to new episode of palpitation. He had history of angioplasty of right coronary artery (RCA with drug eluting stent 2 years ago. His electrocardiogram revealed atrial fibrillation (AF. Intravenous amiodarone 150 mg during 10 minutes and then 1 mg/min infusion were started to achieve rate control and pharmacologic conversion to sinus rhythm. After 60 minutes of starting amiodarone infusion, he developed swelling of the skin around his mouth and eyes, and also mucosa of the mouth, eyes and tongue. To conclude, angioedema should be considered a rare side effect of amiodarone which is used broadly in cardiovascular field.

  11. Drug-induced lupus: simvastatin or amiodarone? A case report in elderly

    Directory of Open Access Journals (Sweden)

    Mauro Turrin

    2013-03-01

    Full Text Available Reports of systemic lupus erythematosus (SLE seen during treatment with amiodarone are rare in the literature. SLE or immunological abnormalities induced by treatment with statins are more frequent. In this issue we report a case of a 81-year-old male who, after a 2-year therapy with amiodarone, developed a clinical and serologic picture of drug-induced SLE (DILE. He was admitted for congestive heart failure in mechanical aortic valve prosthesis, permanent atrial fibrillation (anticoagulation with warfarin, hypercholesterolaemia, and hypothyroidism. Amiodarone was started two years earlier for polymorphic ventricular tachycardia, statin and L-thyroxine the following year. At admission he presented pleuro-pericardical effusion detected by CT-scan (also indicative of interstitial lung involvement and echocardiography. Serological main indicative findings were: elevation of inflammatory markers, ANA (Anti-Nuclear Antibodies titers = 1:320 (indirect immune-fluorescence – IIF – assay on HEp-2, homogeneous/fine speckled pattern, anti-dsDNA titers = 1:80 (IIF on Crithidia luciliae, negative ENA (Extractable Nuclear Antigens and antibodies anti-citrulline, rheumatoid factor = 253 KU/l, normal C3-C4, negative HbsAg and anti-HCV, negative anticardiolipin antibodies IgG and IgM, negative anti-beta2GPI IgG and IgM. Amiodarone was discontinued and methylprednisolone was started, since the patient was severely ill. At discharge, after a month, the patient was better and pleuro-pericardical effusion was reduced. Readmitted few weeks later for bradyarithmia and worsening of dyspnoea, pericardial effusion was further reduced but he died for refractory congestive heart failure and pneumonia. Clinical picture (sierositis, neither skin nor kidney involvement, other typical side effects of amiodarone (hypothyroidism and lung interstitial pathology and serological findings are suggestive of amiodarone-induced SLE.

  12. Rhythminotropic Reactions of Human Myocardium in Ischemic and Rheumatic Heart Diseases against the Background of Amiodarone

    Directory of Open Access Journals (Sweden)

    Boris N. Kozlov, PhD, ScD

    2012-03-01

    Full Text Available In human heart failure, Ca2+ homeostasis gets disturbed due to a decrease in the function of the sarcoplasmic reticulum (SR. We studied the differences in the SR function in patients with rheumatic and coronary heart disease, against the background of amiodarone. Cardiac preparations from the atrium of 21 patients with coronary artery disease (CAD and 14 patients with rheumatic heart disease (RHD were used in this study. Myocardial strips perfused with oxygenated Krebs-Henzelait solution without and with amiodarone (1 mM/l at 37°C. The steady state stimulation rate of the muscle strips was 0.5 Hz. The single extraordinary impulse was given as 0.2-1.5 sec after the steady state beat. Then, the first beat after a 4- to 60-sec rest period was evaluated. The extrasystoles of the myocardium in both groups, after long intervals, were decreased after amiodarone treatment. The amplitude of post extrasystoles of amiodarone-treated myocardium showed differences only after long intervals in both groups. Two types of inotropic responses of a failing myocardium after rest periods were observed. Type I post-rest contractions maintained the steady state amplitude after all rests. However, type II was characterized by a reduction in the amplitude of the contractions. Amiodarone treatment of the myocardium showing type I reactions led to an increase in the potentiation after rests, but showed no effect on the reaction of the muscle with the type II response. The results suggested that SR dysfunction was different in CAD and RHD. The realization of the therapeutic effect of amiodarone was found to be dependent on the functional activity of the SR.

  13. Effect of Lidocaine and Amiodarone on Transmural Heterogeneityricular Repolarization in Isolated Rabbit Hearts Model of Sustained Global Ischemia

    Institute of Scientific and Technical Information of China (English)

    YOU Binquan; PU Jun; LIU Nian; YU Ronghui; RUAN Yanfei; LI Yang; WANG Lin

    2005-01-01

    To study the effect of of lidocaine and amiodarone on the transmural heterogeneity of ventricular repolarization in isolated rabbit hearts model of sustained global ischemia and to explore the mechanisms underlying the antiarrhythmic activity of lidocaine and amiodarone, rabbits were randomly divided into 4 groups: control group, ischemia group, lidocaine group and amiodarone group. By the monophasic action potential (MAP) recording technique, MAPs of recorded across the left ventricular free wall in rabbit hearts perfused transmural dispersion of repolarization (TDR) and arrhythmic induced by ischemia. Our results showed that TDR of three myocardial layers in ischemia group were significantly lengthened after ischemia. TDR was increased from 17.5±3.9 ms to 31.2±4.6 ms at the time that concided with the onset of sustained ventricle arrhythmic. Amiodarone could decrease TDR, but lidocaine could increase TDR at initial ischemia, and no significant difference was found at other ischemia time points. 5 cases had ventriclar arrhythmia in ischemia group (62.5 %), but no case in lidocaine group (P<0.01) and only 1 case in amiodarone group had ventrilar arrhythmia (P< 0.01). No significant difference was found between amiodarone group and lidocaine group. It is concluded that TDR of of three myocardial layers increases significantly at ischemia and it is closely associated with development of ventricular arrhythmia, and amiodarone could decrease TDR, but lidocaine could increase TDR at initial ischemia and has no effects at other ischemia time points.

  14. Comparison of Ventricular Electrophysiological Effects of Amiodarone in Canine Models With Congestive Heart Failure and Normal Dogs

    Institute of Scientific and Technical Information of China (English)

    Shuxian Zhou; Yuling Zhang; Juan Lei; Wei Wu; Xuming Zhang

    2008-01-01

    Objectives This study compared the effects of amiodarone on ventricular electrophysiological properties in normal dogs and CHF dogs.Methods Dogs(n=44) were randomized into four groups:Group 1(n=10)was the control.Group 2(n=10) was given amiodarone orally 300 mg·d-1 for4 to 5 weeks.Group 3(n=12)was the congestive heart failure(CHF)models induced by right ventricular rapid pacing(240 pulses·rain-1 for 4 to 5 weeks).Group 4 (n=12) was the CHF models given amiodarone orally 300 mg·d-1 for 4 to 5 weeks.The ventricular electrophysiological variables were evaluated by standard electric stimulation and monophasic action potential(MAP)recording.Results Amiodarone prolonged sinus cycle length(SCL),intra-ventricular conduction time(IVCT),MAP duration(MAPD90),ventricular effective period(VERP),ventricular activation time(VAT)and ventficular recovery time(VRT)without significant effects on the ratio of VERP to MAPD90 (VERP/MAPD90),ventricular fibrillation threshold(VFT),the dispersion of VRT(VRTD),and ventricular late repolarization duration(VLRD)in normal dogs.However,amiodarone did not further prolong the prolonged SCL,MAPD90,VERP,VAT and VRT,but further prolonged IVCT in CHF dogs.Amiodarone normalized the abnormal ventficular electrophysiological properties in CHF dogs as manifested by increasing the decreased VERP/MAPD90 and VFT,shortening the prolonged VLRD,and decreasing the increased VRTD.Amiodarone did not worsen the hemodynamic parameters in normal and CHF dogs.Conclusions Amiodarone had different effects on ventricular electrophysiological properties in normal and CHF dogs.The favorable effects of amiodarone in normalizing some abnormal cardiac electrophysiological properties in CHF models may have potential value on the prevention and treatment of ventricular arrhythmias and sudden cardiac death in CHF.

  15. Effects of Amiodarone plus Losartan on Electrical Remodeling in Rapid Atrial Pacing in Rabbits

    Institute of Scientific and Technical Information of China (English)

    Liye Wei; Yue Xia; Guoqing Qi; Qingwen Zhang

    2008-01-01

    Objectives To investigate the electrical remodeling and the effects of amiodarone and losartan on electrical remode-ling in rapid atrial pacing on rabbit model. Methods 40 normal rabbits were randomly divided into 4 groups: the sa-line group (control group), amiodarone group, losartan group, ami + los group. All rabbits were raised drugs in a week. The atrial effective refractory period (AERP) was measured. Then, take a rapid atrial pacing (600 bpm) and the AERP was measured after 0. 5, 1, 2, 4, 6 and 8 hours pacing and 30 minutes after the termination of rapid pacing. Results ① In control group, after 8 hours rapid pacing, AERP 200 and AERP 150 were significantly shortened 16. 11%± 3. 1% (P <0. 01) and 9. 99%±4. 2% (P <0. 01). And the degree of AERP shortening induced by rapid pacing was greater at basic cycle lengths of 200 ms (BCL200) than that at BCL150. The AERP of amiodarone, losartan group and anti + los group were not shortened during rapid pacing.② In the control group, after the termination of rapid pacing, the AERP gradually increased. The AERP at all of the BCLS examined recovered to almost the 95.78% and 96. 76% of baseline values within the first 10 minutes and recovered to almost the 99. 07% and 99. 39% of baseline values within the first 30 minutes. Condusions Short-term atrial rapid pacing can induce the atrial electrical remodeling. Amiodarone and losartan can prevent the electrical remodeling.

  16. Hyperacute drug-induced hepatitis with intravenous amiodarone: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Nasser M

    2013-09-01

    Full Text Available Mohammad Nasser, Timothy R Larsen, Barryton Waanbah, Ibrahim Sidiqi, Peter A McCullough Providence Hospitals and Medical Centers, Department of Medicine, Division of Cardiology, Southfield and Novi, MI, USA Abstract: Amiodarone is a benzofuran class III antiarrhythmic drug used to treat a wide spectrum of ventricular tachyarrhythmias. The parenteral formulation is prepared in polysorbate 80 diluent. We report an unusual case of acute elevation of aminotransaminase concentrations after the initiation of intravenous amiodarone. An 88-year-old Caucasian female developed acute hepatitis and renal failure after initiating intravenous amiodarone for atrial fibrillation with a rapid ventricular response in the setting of acutely decompensated heart failure and hepatic congestion. Liver transaminases returned to baseline within 7 days after discontinuing the drug. Researchers hypothesized that this type of injury is related to liver ischemia with possible superimposed direct drug toxicity. The CIOMS/RUCAM scale identifies our patient’s acute hepatitis as a highly probable adverse drug reaction. Future research is needed to understand the mechanisms by which hyperacute drug toxicity occurs in the setting of impaired hepatic perfusion and venous congestion. Keywords: intravenous amiodarone, acute hepatotoxicity, liver transaminases, drug-induced liver toxicity

  17. Amiodarone is a cost-neutral way of preventing atrial fibrillation after surgery for lung cancer

    DEFF Research Database (Denmark)

    Riber, Lars P; Christensen, Thomas D; Pilegaard, Hans K

    2013-01-01

    OBJECTIVES: Our aim was to estimate the costs and health benefits of routinely administered postoperative amiodarone as a prophylactic agent in reducing the risk of atrial fibrillation in patients undergoing surgery for lung cancer. METHODS: This was a cost-effectiveness study, based on the rando......OBJECTIVES: Our aim was to estimate the costs and health benefits of routinely administered postoperative amiodarone as a prophylactic agent in reducing the risk of atrial fibrillation in patients undergoing surgery for lung cancer. METHODS: This was a cost-effectiveness study, based...... on the randomized, controlled, double-blinded PASCART study, using avoidance of atrial fibrillation as the measure of benefit. Two hundred and fifty-four eligible, consecutively enrolled patients, undergoing surgery for lung cancer at the department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital.......23). There were no signs of adverse developments referable to amiodarone in this prophylactic regime. CONCLUSIONS: For patients undergoing surgery for lung cancer, routine use of postoperative prophylactic intravenous bolus and five subsequent days of oral amiodarone therapy reduces the risk of atrial...

  18. Effect of prophylactic amiodarone in patients with rheumatic valve disease undergoing valve replacement surgery

    Directory of Open Access Journals (Sweden)

    Kar Sandeep

    2011-01-01

    Full Text Available The study was carried out to evaluate the effect of prophylactic single-dose intravenous amiodarone in patients undergoing valve replacement surgery. Maintenance of sinus rhythm is better than maintenance of fixed ventricular rate in atrial fibrillation (AF especially in the presence of irritable left or right atrium because of enlargement. Fifty-six patients with valvular heart disease with or without AF were randomly divided into two groups. Group I or the amiodarone group (n=28 received amiodarone (3 mg/kg in 100 ml normal saline and group II or the control group received same volume of normal saline. The standardized protocol for cardiopulmonary bypass was maintained for all the patients. AF occurred in 7.14% patients in group I, and in group II, 28.57% (P=0.035; ventricular tachycardia/fibrillation was observed in 21.43% patients in group I and 46.43% patients in group II (P=0.089 after release of aortic clamp. Most of the patients in group I (92.86% maintained sinus rhythm without cardioversion or defibrillation after release of aortic cross clamp (P=0.002. Defibrillation or cardio version was needed in 7.14% patients in group I and 28.57% patients in group II (P=0.078. A single prophylactic intraoperative dose of intravenous amiodarone decreased post bypass arrhythmia in this study in comparison to the control group. Single dose of intraoperative amiodarone may be used to decrease postoperative arrhythmia in open heart surgery.

  19. Acceleration of ventricular rate by amiodarone in atrial fibrillation associated with the Wolff-Parkinson-White syndrome

    Science.gov (United States)

    Sheinman, Bryan D; Evans, Tom

    1982-01-01

    Amiodarone has proved to be a valuable drug in atrial fibrillation associated with the Wolff-Parkinson-White syndrome. When it was administered to a patient with this syndrome in atrial fibrillation, who had previously suffered an inferior myocardial infarction, the ventricular rate accelerated from 170 to 230 beats/minute. This unusual case emphasises the need for full electrophysiological assessment of patients with the Wolff-Parkinson-White syndrome for whom amiodarone treatment is being considered. Imagesp1000-a PMID:6812745

  20. Amiodarone inhibits the mitochondrial beta-oxidation of fatty acids and produces microvesicular steatosis of the liver in mice

    Energy Technology Data Exchange (ETDEWEB)

    Fromenty, B.; Fisch, C.; Labbe, G.; Degott, C.; Deschamps, D.; Berson, A.; Letteron, P.; Pessayre, D. (Institut National de la Sante et de la Recherche Medicale U24, Clichy (France))

    1990-12-01

    Amiodarone has been shown to produce microvesicular steatosis of the liver in some recipients. We have determined the effects of amiodarone on the mitochondrial oxidation of fatty acids in mice. In vitro, the formation of 14C-acid-soluble beta-oxidation products from (U-14C)palmitic acid by mouse liver mitochondria was decreased by 92% in the presence of 125 microM amiodarone and by 94% in the presence of 125 microM N-desethylamiodarone. Inhibition due to 100 or 150 microM amiodarone persisted in the presence of 5 mM acetoacetate, whereas acetoacetate totally relieved inhibition due to 15 microM rotenone. In vivo, exhalation of (14C)CO2 from (U-14C)palmitic acid was decreased by 31, 40, 58 and 78%, respectively, in mice receiving 19, 25, 50 and 100 mg.kg-1 of amiodarone hydrochloride 1 hr before the administration of (U-14C)palmitic acid. One hour after 100 mg.kg-1, the exhalation of (14C)CO2 from (1-14C)palmitic acid, (1-14C)octanoic acid or (1-14C)butyric acid was decreased by 78, 72 and 53%, respectively. Exhalation of (14C)CO2 from (1-14C)palmitic acid was normal between 6 and 9 hr after administration of 100 mg.kg-1 of amiodarone hydrochloride, but was still inhibited by 71 and 37%, 24 and 48 hr after 600 mg.kg-1. Twenty four hours after the latter dose of amiodarone, hepatic triglycerides were increased by 150%, and there was microvesicular steatosis of the liver. We conclude that amiodarone inhibits the mitochondrial beta-oxidation of fatty acids and produces microvesicular steatosis of the liver in mice.

  1. Is the Preoperative Administration of Amiodarone or Metoprolol More Effective in Reducing Atrial Fibrillation: After Coronary Bypass Surgery?

    Science.gov (United States)

    Onk, Oruc Alper; Erkut, Bilgehan

    2015-10-01

    This study examined the influence of preoperative administration of amiodarone and metoprolol in preventing postoperative atrial fibrillation (AF) after coronary artery bypass grafting (CABG) surgery.The study comprised 251 patients who underwent CABG surgery at our hospital between January 2012 and May 2014. The patients were randomly divided into 2 groups: amiodarone therapy group (n = 122 patients) and metoprolol therapy group (n = 129 patients).In the amiodarone group, the patients received amiodarone tablet orally 1 week before coronary bypass surgery and during the postoperative period. In the metoprolol group, the patients received metoprolol tablet orally 1 week before surgery and during the postoperative period. The AF development rate was retrospectively evaluated between the first 3 days and 4 weeks after surgery.AF developed in 14 patients in the amiodarone group and 16 patients in the metoprolol group 4 weeks after the operation (P = 0.612).No significant difference was observed between the groups in terms of intensive care unit and hospital stay. Furthermore, hospital charges were similar in both groups (P = 0.741).The results of the logistic regression analysis showed age, left ventricular ejection fraction, left atrial diameter, and aortic cross-clamping time to be predictors for postoperative AF.This study demonstrates that amiodarone and metoprolol have similar effects in prevention of AF after cardiac surgery. However, larger-scale studies need to be conducted to substantiate these findings.

  2. The effect of beta-naphthoflavone on the metabolism of amiodarone by hepatic and extra-hepatic microsomes.

    Science.gov (United States)

    Elsherbiny, Marwa E; El-Kadi, Ayman O S; Brocks, Dion R

    2010-06-02

    Amiodarone is a potent antiarrhythmic drug with several limiting side effects, some of which have been correlated with increased levels of its more toxic metabolite, desethylamiodarone. Elevated serum desethylamiodarone to amiodarone ratios are associated with a risk of amiodarone-induced pulmonary toxicity. Polycyclic aromatic hydrocarbons such as beta-naphthoflavone are known to increase desethylamiodarone levels in rat in vivo. In this article we investigated if this increase was solely due to increased formation as a result of cytochrome P450 (CYP) 1A1 and 1A2 induction in different rat hepatic and extra-hepatic tissues. Additionally, the effect of amiodarone treatment on CYP1A1 and 1A2 gene expression and activity was investigated. In rats, beta-naphthoflavone was found to increase desethylamiodarone forming activity in lung and kidney microsomes. Amiodarone increased beta-naphthoflavone mediated induction of CYP1A1 gene expression in liver, lung and kidney. However, there was no significant change in CYP1A activity. As expected, the data indicated that the increase in desethylamiodarone levels in vivo was partly due to increased formation through CYP1A1 induction, although increased formation was only evident in some extra-hepatic tissues. Amiodarone treatment did not affect basal or induced CYP1A activity.

  3. [Total thyroidectomy in patients with amiodarone-induced hyperthyroidism: when does the risk of conservative treatment exceed the risk of surgery?].

    Science.gov (United States)

    Meerwein, C; Vital, D; Greutmann, M; Schmid, C; Huber, G F

    2014-02-01

    Amiodarone plays a pivotal role in the treatment of ventricular and supraventricular arrhythmias. However, amiodarone-induced hyperthyroidism (AIH) is one of the most feared complications, which necessitates interdisciplinary treatment and careful balancing of the risks of conservative treatment against those of total thyroidectomy. In this article we discuss the pharmacological aspects of amiodarone and its diverse effects on the thyroid. Furthermore, we present diagnostic and therapeutic strategies and report our positive experiences with total thyroidectomy in patients with AIH. Particularly in patients for whom continuation of amiodarone treatment is compulsory, a well-timed total thyroidectomy is a reliable therapeutic option, with minimal complication rates and immediate amelioration of symptoms.

  4. Amiodarone cost effectiveness in preventing atrial fibrillation after coronary artery bypass graft surgery

    DEFF Research Database (Denmark)

    Zebis, Lars R; Christensen, Thomas D; Hjortdal, Vibeke E

    2008-01-01

    BACKGROUND: The purpose of this study was to estimate the costs and health benefits of routinely administered postoperative amiodarone as prevention of atrial fibrillation for patients undergoing coronary artery bypass grafting (CABG) for stable angina. METHODS: This cost-effectiveness study...... was based on a randomized, controlled, double-blind trial (the RASCABG study) using avoidance of atrial fibrillation as the measure of benefit at the Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Skejby, Denmark. Two hundred and fifty eligible consecutively enrolled CABG...... of atrial fibrillation compared with 32 in the control group (p cost per patient was 7,639 euros in the amiodarone group and 7,814 euros in the placebo group (p

  5. Interaction of rivaroxaban with amiodarone, verapamil and diltiazem in patients with atrial fibrillation: terra incognita

    Directory of Open Access Journals (Sweden)

    S. N. Bel'diev

    2016-01-01

    Full Text Available Currently there are no generally accepted guidelines for the use of rivaroxaban together with amiodarone, verapamil or diltiazem in patients with creatinine clearance (CrCl<80 ml/min. Some researchers suggest that in renal failure amiodarone, verapamil and diltiazem contribute to a significant increase in plasma concentrations of rivaroxaban that is accompanied by increased risk of bleeding. According to preliminary calculations, it seems rational to reduce the dose of rivaroxaban when co-administered with these drugs: to 15 mg/day in patients with ClCr 50-79 ml/min and to 10 mg/day in patients with ClCr<50 ml/min.

  6. Comparative in vitro and in vivo evaluation of three tablet formulations of amiodarone in healthy subjects

    Directory of Open Access Journals (Sweden)

    J Emami

    2010-09-01

    Full Text Available "nBackground and the purpose of the study:The relative in vivo bioavailability and in vitro dissolution studies of three chemically equivalent amiodarone generic products in healthy volunteers was evaluated in three separate occasions. The possibility of a correlation between in vitro and in vivo performances of these tablet formulations was also evaluated. "nMethods: The bioequivalence studies were conducted based on a single dose, two-sequence, cross over randomized design. The bioavailability was compared using AUC0-72, AUC0-∞, Cmax and Tmax. Similarity factor, dissolution efficiency (DE, and mean dissolution time (MDT was used to compare the dissolution profiles. Polynomial linear correlation models were tested using either MDT vs mean residence time (MRT or fraction of the drug dissolved (FRD vs fraction of the drug absorbed (FRA. "nResults: Significant differences were found in the dissolution performances of the tested formulations and therefore they were included in the development of the correlation. The 90% confidence intervals of the log-transformed AUC0-72, AUC0-∞, and Cmax of each two formulations in each bioequivalence studies were within the acceptable range of 80-125%. Differences were not observed between the untransformed Tmax values. Poor correlation was found between MRT and MDT of the products. A point-to-point correlation which is essential for a reliable correlation was not obtained between pooled FRD and FRA. The dissolution condition which was used for amiodarone tablets failed for formulations which were bioequivalent in vivo and significant difference between the dissolution characteristics of products (f2<50 did not reflect their in vivo properties. Major conclusions: Bioequivalence studies should be considered as the only acceptable way to ensure the interchangeability and in vivo equivalence of amiodarone generic drug products. The dissolution conditions used of the present study could be used for routine and in

  7. Trastornos tiroideos por amiodarona The effects of amiodarone on the thyroid

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    M. Toni

    2009-12-01

    (59% vs 41%, lo que puede estar justificado por ser Navarra una comunidad con déficit de yodo. Es necesario el seguimiento de la función tiroidea durante al menos 2-3 años después del inicio del tratamiento con amiodarona.Background. Amiodarone is a drug widely used for the treatment of arrhythmias. In 16% of amiodarone-treated patients it causes changes in the thyroid function. The aim of this study was to determine the importance of amiodarone-induced thyroid dysfunction in the population of Navarre, studied between 2001 and 2007. Methods. We present a retrospective study that considers the characteristics of 182 amiodarone-treated patients with thyroid dysfunction who had been referred to our Institute. We determined a series of biochemical and instrumental investigations (measurement of thyrotrophin, free thyroid hormones and thyroid autoantibodies; thyroid sonography and thyroid scintigraphy uptake. Results. Screening of the thyroid function, recommended before starting amiodarone treatment, was carried out in only 20.9 % of the patients. Forty-one percent of patients developed amiodarone induced hypothyroidism; in 76% of them the drug was withdrawn. Hypothyroidism appears after 21 (± 12 months of amiodarone treatment. Forty-eight point six developed permanent hypothyroidism. This group of patients had higher serum levels of TSH (thyrotropin and were treated for less time with amiodarone. Fifty-nine percent of patients developed amiodarone induced thyrotoxicosis; 59.4 % were diagnosed with thyrotoxicosis (AIT type 1, 30.6% AIT type 2 and the remaining 10 % were diagnosed with mixed thyrotoxicosis. Thyrotoxicosis appears after 29.5 (± 17 months of amiodarone treatment. The serum levels of free thyroxine were significantly higher in the AIT type 2 than in the AIT type1. All patients were treated with antithyroid drugs and/or corticoids. Some patients were admitted to hospital due to the severity of their illness. Conclusions. In our study, amiodarone induced

  8. In vitro study of lovastatin interactions with amiodarone and with carbon tetrachloride in isolated rat hepatocytes

    Institute of Scientific and Technical Information of China (English)

    AZ Krasteva; MK Mitcheva; MS Kondeva-Burdina; VA Descatoire

    2007-01-01

    AIM: To investigate the interactions at a metabolic level between lovastatin, amiodarone and carbon tetrachloride in isolated rat hepatocytes.METHODS: For cell isolation two-step collagenase liver perfusion was performed. Lovastatin was administered alone in increasing concentrations (1 μmol/L, 3 μmol/L,5 μmol/L and 10 μmol/L) and in combination with CCl4 (86 μmol/L). The cells were also pretreated with 14 μmol/Lamiodarone and then the other two compounds were added.RESULTS: Lovastatin promoted concentration-dependent significant toxicity estimated by decrease in cell viability and GSH level by 45% and 84%, respectively. LDH-activity increased by 114% and TBARS content by 90%. CCl4 induced the expected severe damage on the examined parameters. CCl4 induced toxicity was attenuated after lovastatin pretreatment, which was expressed in less increased values of LDH activity and TBARS levels, as well as in less decreased cell viability and GSH concentrations. However, the pretreatment of hepatocytes with amiodarone abolished the protective effect of lovastatin.CONCLUSION: We suggest that the observed cytoprotective effect was due to interactions between lovastatin,CCl4 and amiodarone at a metabolic level.

  9. Catalytic Adsorptive Stripping Voltammetry at a Carbon Paste Electrode for the Determination of Amiodarone

    Institute of Scientific and Technical Information of China (English)

    LIU Ning; GAO Wei; SONG Jun-Feng

    2006-01-01

    Voltammetry using solid electrodes usually suffers from the contamination due to the deposition of the redox products of analytes on the electrode surface. The contamination has resulted in poor reproducibility and overelaborate operation procedures. The use of the chemical catalysis of oxidant on the reduction product of analyte not only can eliminate the contamination of analyte to solid electrodes but also can improve the faradaic response of analyte. This work introduced both the catalysis of oxidant K2S2O8 and the enhancement of surfactant Triton X-100 on the faraday response of amiodarone into an adsorptive stripping voltammetry at a carbon paste electrode for the determination of amiodarone. The method exhibits high sensitivity, good reproducibility and simple operation procedure. In 0.2 mol·L-1 HOAc-NaOAc buffer (pH=5.3) containing 2.2 × 10-2 mol·L-1 K2S2O8 and 0.002% Triton X-100, the 2.5th-order derivative stripping peak current of the catalytic wave at 0.3 V (vs. Ag/AgCl) is rectilinear to amiodarone concentration in the range of 2.0× 10-10-2.3× 10-8 mol·L-1 with a detection limit of 1.5× l0-10 mol·L-1 after accumulation at 0 V for 30 s.

  10. Effect of Stem Cell Therapy on Amiodarone Induced Fibrosing Interstitial Lung Disease in Albino Rat

    Science.gov (United States)

    Zaglool, Somaya Saad; Zickri, Maha Baligh; Abd El Aziz, Dalia Hussein; Mabrouk, Doaa; Metwally, Hala Gabr

    2011-01-01

    Background and Objectives: The fibrosing forms of interstitial lung disease (ILD) are associated with significant morbidity and mortality. ILD may be idiopathic, secondary to occupational, infection, complicate rheumatic diseases or drug induced. Efficacy of antifibrotic agents is as far as, limited and uncertain. No effective treatment was confirmed for pulmonary fibrosis except lung transplantation. The present study aimed at investigating the possible effect of human cord blood mesenchymal stem cell (MSC) therapy on fibrosing ILD. This was accomplished by using amiodarone as a model of induced lung damage in albino rat. Methods and Results: Seventeen adult male albino rats were divided into 3 groups. Rats of amiodarone group were given 30 mg/kg of amiodarone orally 6 days/ week for 6 weeks. Rats of stem cell therapy group were injected with stem cells in the tail vein following confirmation of lung damage and left for 4 weeks before sacrifice. Obstructed bronchioles, thickened interalveolar septa and thickened wall of pulmonary vessels were found and proved morphometrically. Reduced type I pneumocytes and increased area% of collagen fibers were recorded. All findings regressed on stem cell therapy. Conclusions: Cord blood MSC therapy proved definite amelioration of fibrosing interstitial lung disease provided therapy starts early in the development of the pathogenesis. PMID:24298346

  11. Correlation of Biomicroscopic Findings with Confocal Microscopy in Eyes with Amiodarone-Induced Cornea Verticillata

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    Emine Kaya

    2014-01-01

    Full Text Available Objectives: To investigate the correlation between biomicroscopic and confocal microscopic findings in eyes with amiodarone-induced cornea verticillata. Materials and Methods: Sixteen eyes of 8 patients with amiodarone-induced cornea verticillata were evaluated. Eyes with keratopathy were staged according to Orlando slit-lamp microscopy classification. Confocal laser-scanning microscopy was performed by Rostock cornea modulated to HRT II (Heidelberg Engineering GmbH, Heidelberg, Germany, and staging was done according to Falke’s classification that is based on the degree of epithelial basal cell deposit accumulation. The relation between biomicroscopic staging and corneal involvement detected on confocal microscopy was assessed by Spearman correlation analysis. Results: The mean age of the 8 patients (5 male, 3 female was 63.1±7.2 (50 to 69 years. The mean duration of drug treatment was 12.1±11.8 (3 to 36 months, and the mean drug treatment dose was 312.5±223.2 (100 to 800 mg/day. At the time of examination, 50% of the patients had already given up the treatment at a mean of 29.5±15.8 (6 to 40 months ago, whereas the other 50% were still on amiodarone therapy. Hyper-reflecting deposits were observed in the basal epithelium, anterior-, mid-and deep-stroma, and in the endothelium on confocal microscopic examination. Correlation was detected between biomicroscopic and confocal microscopic stages (r=0.770, p<0.001. Frequency of detecting deposits in the stroma and endothelium was found to be increasing as the biomicroscopic stage increased (r=0.844; p<0.001 and r=0.551; p<0.01, respectively. Conclusion: In amiodarone-induced cornea verticillata, correlated results were detected between biomicroscopic and confocal microscopic staging. Therefore, in clinics where confocal microscopy is not available, biomicroscopic staging can be used as a guiding parameter in eyes with amiodarone-induced cornea verticillata. (Turk J Ophthalmol 2014; 44: 63-67

  12. A randomized active-controlled study comparing the efficacy and safety of vernakalant to amiodarone in recent-onset atrial fibrillation

    DEFF Research Database (Denmark)

    Camm, A John; Capucci, Alessandro; Hohnloser, Stefan H;

    2011-01-01

    with 32.8% of amiodarone patients; p = 0.0012). Serious adverse events or events leading to discontinuation of study drug were uncommon. There were no cases of torsades de pointes, ventricular fibrillation, or polymorphic or sustained ventricular tachycardia. Conclusions Vernakalant demonstrated efficacy......Objectives This randomized double-blind study compared the efficacy and safety of intravenous vernakalant and amiodarone for the acute conversion of recent-onset atrial fibrillation (AF). Background Intravenous vernakalant has effectively converted recent-onset AF and was well tolerated in placebo...... superior to amiodarone for acute conversion of recent-onset AF. Both vernakalant and amiodarone were safe and well tolerated in this study. (A Phase III Superiority Study of Vernakalant vs Amiodarone in Subjects With Recent Onset Atrial Fibrillation...

  13. Dysfunction of the thyroid gland during amiodarone therapy: a study of 297 cases

    Directory of Open Access Journals (Sweden)

    Czarnywojtek A

    2016-04-01

    Full Text Available Agata Czarnywojtek,1,2,* Maria Teresa Płazińska,3,* Małgorzata Zgorzalewicz-Stachowiak,4 Kosma Woliński,1 Adam Stangierski,1 Izabela Miechowicz,5 Joanna Waligórska-Stachura,1 Paweł Gut,1 Leszek Królicki,3 Maja Zioncheck,6 Marek Ruchała1 1Department of Endocrinology, Metabolism and Internal Medicine, 2Department of Pharmacology, Poznan University of Medical Sciences, Poznan, 3Nuclear Medicine Department, Medical University of Warsaw, Warsaw, 4Department of Health Prophylaxis, Laboratory of Medical Electrodiagnostics, 5Department of Computer Science and Statistics, 6Poznan University of Medical Sciences, Poznan, Poland *These authors contributed equally to this work Aim: This study aims to explore and compare the efficacy of radioiodine treatment (RIT in hyperthyroid and euthyroid patients who have been treated with amiodarone (AM in the past or are currently undergoing AM treatment. Clinical observation of a group of patients with amiodarone-induced hypothyroidism during a 12-month follow-up period was used for comparison.Design: This was a observational, two-centered study. Patients were assessed at baseline and at 2 months, 6 months, 8 months, and 12 months after RIT.Patients: Group A: At baseline (61 males [M] and 17 females [F], mean age 50±19 years, there were 78 euthyroid patients with cardiac arrhythmias, who were treated with AM and developed amiodarone-induced thyrotoxicosis, and currently require retreatment with AM. Group B: Hyperthyroid patients (92 M and 26 F, mean age 72±11.8 years after AM therapy in the past. Group C: Hyperthyroid patients (66 M and 13 F, mean age 63.9±13.2 years currently treated by AM. Group D: Hypothyroid patients (6 M and 16 F, mean age 61.4±10.4 years after AM therapy. The patients from Groups A, B, and C were retreated with AM after ~3–6 weeks of RIT.Results: In Group A, after 12 months of RIT therapy, recurrent thyrotoxicosis was observed in six (7.7% cases, and persistent

  14. Amiodarona y disfunción tiroidea Amiodarone and thyroid dysfunction

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    Leonardo F. L. Rizzo

    2012-02-01

    Full Text Available La amiodarona es un análogo estructural de la hormona tiroidea, y algunas de sus propiedades antiarrítmicas como así también su toxicidad son atribuibles a su interacción con los receptores nucleares de las hormonas tiroideas. Por ser muy lipofílica, la amiodarona se concentra en muchos tejidos y se elimina, por consecuencia, muy lentamente. Se emplea preferentemente para el tratamiento de arritmias graves tales como fibrilación y taquicardia ventriculares. Otras indicaciones incluyen la fibrilación auricular y el aleteo, la insuficiencia cardíaca congestiva grave, la prevención de la fibrilación auricular recurrente y situaciones de emergencia médica como la prevención de muerte súbita cardiaca¹. Nuestro objetivo es proporcionar un enfoque actualizado sobre la amiodarona y su influencia sobre la fisiología tiroidea y discutir y analizar en profundidad sus potenciales efectos adversos como el hipotiroidismo y la tirotoxicosis.Amiodarone is a structural analogue of thyroid hormone, and some of its anti-arrhythmic actions and toxicity are attributable to its interaction with nuclear receptors of thyroid hormones. Being highly lipophilic, amiodarone is concentrated in many tissues and is eliminated, consequently, very slowly. It is preferably employed to manage life-threatening arrhythmias, including ventricular fibrillation and unstable ventricular tachycardia. Other indications include atrial fibrillation and flutter, severe congestive heart failure, prevention of atrial fibrillation recurrence, and even in emergency medical situations to prevent sudden cardiac death. The aim of this review is to provide an updated approach on amiodarone and its influence on thyroid physiology and to discuss and analyze in depth its potential and not infrequent thyroidal adverse effects such as hypothyroidism and thyrotoxicosis.

  15. Effects of amiodarone therapy on thyroid iodine content as measured by x-ray fluorescence

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    Fragu, P.; Schlumberger, M.; Davy, J.M.; Slama, M.; Berdeaux, A.

    1988-04-01

    Thyroid iodine content (TIC) was measured by x-ray fluorescence in 68 patients who had received amiodarone treatment for varying intervals (1 g/week for 1-120 months). Thirty-six patients were euthyroid; the mean TIC of the patients (n = 15), who had been treated for less than 12 months was 30 +/- 19 (+/- SD) mg, twice the normal mean value (14.6 +/- 5.0 mg), and it was 39 +/- 17 mg in those (n = 16) who had been treated for 12-60 months and 29 +/- 6 mg in those (n = 5) who had been treated longer (greater than 60 months). Nineteen patients were hyperthyroid and had elevated TIC values. Of them, 6 patients had a goiter; their TIC (50 +/- 19 mg) was not significantly different from that of the hyperthyroid patients with no goiter (55 +/- 29 mg), but they became hyperthyroid more rapidly. Thirteen patients were hypothyroid; none had TIC values above the normal range, and it was below 2.5 mg in 5 patients. A sequential study was undertaken in 11 euthyroid patients who had no detectable antithyroid antibodies. TIC did not increase during treatment in 2 patients; both developed hypothyroidism, which was transient in 1 despite continuation of amiodarone treatment. The TIC initially increased during amiodarone treatment in the other 9 patients, leveling off at the end of the first year. The TIC rose well above the upper limit of the normal range in 4 patients, of whom 2 became hyperthyroid during the second year of treatment. TIC remained within the normal range in the other 5 patients, of whom 3 became hypothyroid after 12-24 months of treatment (1 subclinical, 2 overt). Although the TIC was significantly higher in the patients with hyperthyroidism than in the patients who remained euthyroid, the TIC test cannot be used to predict the occurrence of hyperthyroidism.

  16. Cardiac arrest provoked by itraconazole and amiodarone interaction: a case report

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    Betrosian Alex

    2011-07-01

    Full Text Available Abstract Introduction Azoles, and specifically itraconazole, are often prescribed for the treatment of fungal diseases or empirically for persistent sepsis in patients who are neutropenic or in intensive care. Occasional cardiovascular adverse events have been associated with itraconazole use, and are usually attributed to the interaction of itraconazole with cisapride, terfenadine or digoxin. Its interaction with amiodarone has not been previously described. Case presentation A 65-year-old Caucasian man was admitted to the Intensive Care Unit at our facility for an extensive ischemic stroke associated with atrial fibrillation. Due to rapid ventricular response he was started on intravenous amiodarone and few days later itraconazole was also prescribed for presumed candidemia. After receiving the first dose our patient became profoundly hypotensive but responded rapidly to fluids and adrenaline. Then, two months later, itraconazole was again prescribed for confirmed fungemia. After receiving the first dose via a central venous catheter our patient became hypotensive and subsequently arrested. He was resuscitated successfully, and as no other cause was identified the arrest was attributed to septic shock and his antifungal treatment was changed to caspofungin. When sensitivity test results became available, antifungal treatment was down-staged to itraconazole and immediately after drug administration our patient suffered another arrest and was once again resuscitated successfully. This time the arrest was related to itraconazole, which was discontinued, and from then on our patient remained stable until his discharge to our neurology ward. Conclusions Itraconazole and amiodarone coadministration can lead to serious cardiovascular adverse events in patients who are critically ill. Intensivists, pharmacists and medical physicians should be aware of the interaction of these two commonly used drugs.

  17. How frequently should a patient taking amiodarone be screened for thyroid dysfunction?

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    A. Pazin-Filho

    2009-08-01

    Full Text Available Amiodarone-induced thyroid dysfunction (AITD is a common complication of amiodarone therapy and its prevalence varies according to iodine intake, subclinical thyroid disorders and the definition of AITD. There is no consensus about the frequency of screening for this condition. We evaluated 121 patients on chronic regular intake of amiodarone (mean intake = 248.5 ± 89 mg; duration of treatment = 5.3 ± 3.9 years, range = 0.57-17 years and with stable baseline cardiac condition. Those with no AITD were followed up for a median period of 3.2 years (range: 0.6-6.7 and the incidence rate of AITD, defined by clinical and laboratorial findings as proposed by international guidelines, was obtained (62.8 per 1000 patients/year. We applied the Cox proportional hazard model to adjust for potential confounding factors and used sensitivity analysis to identify the best screening time for follow-up. We detected thyroid dysfunction in 59 (48.7% of the 121 patients, amiodarone-induced hypothyroidism in 50 (41.3% and hyperthyroidism in 9 (7.5%. Compared with patients without AITD, there was no difference regarding dosage or duration of therapy, heart rhythm disorder or baseline cardiac condition. During the follow-up of the 62 patients without AITD at baseline evaluation, 11 developed AITD (interquartile range, IR: 62.8 (95%CI: 31.3-112.3 cases per 1000 patients/year, 9 of them with hypothyroidism - IR: 11.4 (95%CI: 1.38-41.2, and 2 hyperthyroidism - IR: 51.3 (95%CI: 23.4-97.5. Age, gender, dose, and duration of treatment were not significant after adjustment. During the first 6 months of follow-up the incidence rate for AITD was 39.3 (9.2-61.9 cases per 1000 patients/year. These data show that AITD is quite common, and support the need for screening at 6-month intervals, unless clinical follow-up dictates otherwise or further information regarding the prognosis of untreated subclinical AITD is available.

  18. A CASE REPORT OF AMIODARONE INDUCED MYOPATHY IN A PATIENT OF VENTRICULAR ARRHYTHMIA

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    Rajat

    2014-09-01

    Full Text Available Myopathies are disorders with structural changes or functional impairment of muscle. Voluntary muscle is subject to a range of hereditary and acquired disorders affecting either its structure, or the biochemical processes which convert the chemical energy derived from cell metabolism into mechanical energy in a controlled manner. These disorders present in a limited number of ways, most commonly a symmetrical weakness of the large, power-generating proximal muscles. Drug induced myopathy comes under acquired causes of myopathy. Here we shall be presenting a case of Amiodarone induced myopathy in a 40 years old male patient of ventricular arrhythmia. We shall also discuss the further management of this presentation.

  19. Uninhibited thyroidal uptake of radioiodine despite iodine excess in amiodarone-induced hypothyroidism

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    Wiersinga, W.M.; Touber, J.L.; Trip, M.D.; van Royen, E.A.

    1986-08-01

    Iodine excess is associated with a low thyroidal radioiodine uptake due to dilution of the radioisotope by the increased stable iodide pool. We studied thyroidal uptake of radioisotopes in cardiac patients with iodine excess due to amiodarone treatment. /sup 99m/Tc-pertechnetate scintigraphy was performed in 13 patients receiving long term amiodarone therapy. Five patients had a clearly visible thyroid gland, and 8 patients had no or a very faint thyroid image. All patients with positive scans had an increased plasma TSH level, whereas all patients with negative scans had a normal or absent TSH response to TRH. Thyroidal uptake and discharge of 123I were studied in 30 other patients. Group I (n = 11) had normal plasma TSH responses to TRH and no iodine excess, group II (n = 7) had normal TSH responses to TRH and excess iodine from metrizoate angiography in the previous month, group III (n = 7) had normal or decreased TSH responses to TRH while receiving long term amiodarone therapy, and group IV (n = 5) had increased TSH responses to TRH while receiving long term amiodarone therapy. The mean radioiodine uptake value in group I (5.4 +/- 0.8% (+/- SE) at 60 min) was higher than those in group II (2.3 +/- 0.7%; P = 0.009) and group III (0.8 +/- 0.3%; P = 0.0005), but not different from that in group IV (5.3 +/- 1.2%; P = NS). Radioiodine discharge after perchlorate (expressed as a percentage of the 60 min uptake) in group I (10.1 +/- 2.2%) was lower than those in group II (24.9 +/- 10.6%; P = 0.05) and group III (28.8 +/- 5.3%; P less than 0.005), whereas discharge in group IV (58.0 +/- 6.1%) was greater than those in group II (P less than 0.05) and group III (P less than 0.01). In conclusion, 1) thyroid visualization by /sup 99m/Tc-pertechnetate and thyroid radioiodine uptake during iodine excess are decreased in euthyroid and hyperthyroid patients, but preserved in hypothyroid patients.

  20. Hepatic and renal failure associated with amiodarone infusion in a patient with hereditary fructose intolerance.

    Science.gov (United States)

    Curran, B J; Havill, J H

    2002-06-01

    Hereditary fructose intolerance is a rare inherited metabolic disorder. Although fructose intolerance usually presents in the paediatric age group, individuals can survive into adulthood by self.manipulation of diet. Hospitalisation can become a high.risk environment for these individuals because of loss of control of their strict dietary constraints and the added danger of administration of medications containing fructose, sucrose and sorbitol. We report a case of hereditary fructose intolerance in an adult presenting with hepatic and renal failure associated with an amiodarone infusion and explore the possibility of polysorbate 80 as a cause of this patient's hepatic and renal failure.

  1. Effect of single intraoperative dose of amiodarone in patients with rheumatic valvular heart disease and atrial fibrillation undergoing valve replacement surgery

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    Selvaraj Thiruvenkadam

    2009-01-01

    Full Text Available Maintenance of sinus rhythm (SR is superior to rate control in atrial fibrillation (AF. In order to achieve SR, we administered single-dose intravenous amiodarone intraoperatively and evaluated its effect on conversion of rheumatic AF to SR in patients undergoing valvular heart surgery. Patients were randomly assigned to amiodarone ( n = 42 or control ( n = 40 group in a double blind manner. The amiodarone group received amiodarone (3 mg/kg intravenously prior to the institution of cardiopulmonary bypass and the control group received the same volume of normal saline. In the amiodarone group, the initial rhythm after the release of aortic cross clamp was noted to be AF in 14.3% ( n = 6 and remained so in 9.5% ( n = 4 of patients till the end of surgery. In the control group, the rhythm soon after the release of aortic cross clamp was AF in 37.5% ( n = 15 ( p = 0.035 and remained so in 32.5% ( n = 13 of patients till the end of surgery ( p = 0.01. At the end of first post-operative day 21.4% ( n = 9 of patients in amiodarone group and 55% ( n = 22 of patients in control group were in AF ( p = 0.002. The requirement of cardioversion/defibrillation was 1.5 (±0.54 in amiodarone group and 2.26 (±0.73 in the control group ( p = 0.014, and the energy needed was 22.5 (±8.86 joules in the amiodarone group and 40.53 (±16.5 in the control group ( p = 0.008. A single intraoperative dose of intravenous amiodarone increased the conversion rate of AF to normal sinus rhythm, reduced the need and energy required for cardioversion/defibrillation and reduced the recurrence of AF within one day.

  2. Comparative Study of Nifekalant Versus Amiodarone for Shock-Resistant Ventricular Fibrillation in Out-of-Hospital Cardiopulmonary Arrest Patients

    NARCIS (Netherlands)

    M. Amino; K. Yoshioka; T. Opthof; S. Morita; S. Uemura; K. Tamura; T. Fukushima; S. Higami; H. Otsuka; K. Akieda; M. Shima; D. Fujibayashi; T. Hashida; S. Inokuchi; I. Kodama; T. Tanabe

    2010-01-01

    Background: In Japan, intravenous nifekalant ( NIF) was often used for direct current cardioversion-resistant ventricular fibrillation (VF), until the use of intravenous amiodarone (AMD) was approved in 2007. The defibrillatory efficacy of NIF and AMD has thus far not been compared for resuscitation

  3. Amiodarone-induced pulmonary toxicity. Immunoallergologic tests and bronchoalveolar lavage phospholipid content.

    Science.gov (United States)

    Nicolet-Chatelain, G; Prevost, M C; Escamilla, R; Migueres, J

    1991-02-01

    Amiodarone (A) is a widely-used antiarrhythmic drug. Pulmonary toxicity is the most serious adverse effect with an estimated mortality of 1 to 33 percent. In order to determine an element helpful for diagnosis, we examined four patients with amiodarone-induced pulmonary toxicity, three patients treated with A, without evidence of pulmonary toxicity but with a main underlying pulmonary disease, and four healthy volunteers. Daily and cumulative doses or duration of treatment were similar in the first two groups. Pulmonary function tests (spirometry, CO-diffusing capacity, arterial blood gases), roentgenographic examinations, pulmonary biopsies or immunoallergologic tests (skin reaction, lymphoblastic transformation test and human basophile degranulation test) did not provide any discriminatory element. In APT+, we observed an increased cellularity of the bronchoalveolar lavage. Neither the differential cell count nor the presence of foamy macrophages were distinguishable between APT+ and APT-. The phospholipid composition of BAL fluid showed a decreased total phospholipid and phospholipid/protein ratio in all patients compared to normal subjects. These changes reflect more the severity of pulmonary disease than the specificity of the causative agent. However, we observed that the unique PL which decreases in APT- and remains normal in APT+ is phosphatidyl-serine + phosphatidylinositol (PS + PI). This has to be confirmed and should be evaluated at different stages of the disease to determine an eventual specific element. We conclude that there are no data currently available to establish the diagnosis of APT except perhaps for the analysis of BAL PL content.

  4. Block of inactivated sodium channels and of depolarization-induced automaticity in guinea pig papillary muscle by amiodarone.

    Science.gov (United States)

    Mason, J W; Hondeghem, L M; Katzung, B G

    1984-09-01

    The electrophysiological effects of amiodarone were studied in guinea pig papillary muscle by means of the single sucrose gap voltage clamp technique. The first time derivative of the upstroke of the action potential was measured as an indicator of the sodium current. The preparations were not voltage clamped during the action potential upstroke. Acute effects of amiodarone (4.4 X 10(-5) M and 8.8 X 10(-5) M; six experiments each) and effects of chronic administration at a single dose level (nine experimental vs. eight control animals) were studied. Results were qualitatively the same for all experimental conditions, and concentration dependent in the acute studies. Amiodarone caused marked use-dependent depression of the first time derivative of the upstroke of the action potential during stimulus trains. For example, at normal resting potential, chronic amiodarone treatment reduced the first time derivative of the upstroke of the action potential of the 16th beat of trains of cycle length 300 msec to 70 +/- 15% (mean +/- SD) of the initial value. This blocking effect was accentuated at more depolarized holding potentials and reduced at hyperpolarized holding potentials. Reduction of the first time derivative of the upstroke of the action potential was found to depend upon sodium channel inactivation. For all experiments, the mean normalized first time derivative of the upstroke of the action potential following a 1-second clamp in the -20 to +20 mV range was 0.92 +/- 0.08 in the control condition and 0.66 +/- 0.20 in the presence of amiodarone (less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

  5. Antiarrhythmic effect of the Ca(2+)-activated K(+) (SK) channel inhibitor ICA combined with either amiodarone or dofetilide in an isolated heart model of atrial fibrillation

    DEFF Research Database (Denmark)

    Kirchhoff, Jeppe Egedal; Diness, Jonas Goldin; Abildgaard, Lea;

    2016-01-01

    whether a combination of the SK channel blocker N-(pyridin-2-yl)-4-(pyridin-2-yl)thiazol-2-amine (ICA) together with either dofetilide or amiodarone provided a synergistic effect. The duration of AF was reduced with otherwise subefficacious concentrations of either dofetilide or amiodarone when combined......Dose is an important parameter in terms of both efficacy and adverse effects in pharmacological treatment of atrial fibrillation (AF). Both of the class III antiarrhythmics dofetilide and amiodarone have documented anti-AF effects. While dofetilide has dose-related ventricular side effects......, amiodarone primarily has adverse non-cardiac effects. Pharmacological inhibition of small conductance Ca(2+)-activated K(+) (SK) channels has recently been reported to be antiarrhythmic in a number of animal AF models. In a Langendorff model of acutely induced AF on guinea pig hearts, it was investigated...

  6. Antiarrhythmic effect of the Ca(2+)-activated K(+) (SK) channel inhibitor ICA combined with either amiodarone or dofetilide in an isolated heart model of atrial fibrillation

    DEFF Research Database (Denmark)

    Kirchhoff, Jeppe Egedal; Diness, Jonas Goldin; Abildgaard, Lea;

    2016-01-01

    Dose is an important parameter in terms of both efficacy and adverse effects in pharmacological treatment of atrial fibrillation (AF). Both of the class III antiarrhythmics dofetilide and amiodarone have documented anti-AF effects. While dofetilide has dose-related ventricular side effects...... that combination of subefficacious concentrations of an SK channel blocker and either dofetilide or amiodarone can maintain anti-AF properties, while the risk of ventricular arrhythmias is reduced....

  7. The protective effect of amiodarone in lung tissue of cecal ligation and puncture-induced septic rats: a perspective from inflammatory cytokine release and oxidative stress.

    Science.gov (United States)

    Polat, Beyzagul; Cadirci, Elif; Halici, Zekai; Bayir, Yasin; Unal, Deniz; Bilgin, Bulent Caglar; Yuksel, Tugba Nurcan; Vancelik, Serhat

    2013-07-01

    Sepsis is a serious medical condition that is characterized by a whole-body inflammatory state and the presence of a known or suspected infection. Amiodarone is a class III antiarrhythmic agent, a multichannel blocker (Ca++, Na+, and K+), and a noncompetitive α- and β-adrenergic blocker in cardiac cells. The present study aimed to determine whether amiodarone was protective against experimentally induced cecal ligation and puncture sepsis in rat lung tissue. The relationship between its probable protective effect and antioxidant/anticytokine action biochemically and histopathologically was also examined. Five groups of rats were used, each composed of 20 rats: (1) the sham-operated control group; (2) the CLP group; (3) the 25-mg/kg amiodarone-treated control healthy group; (4) the 50-mg/kg amiodarone-treated CLP group; and (5) the 50-mg/kg amiodarone-treated CLP group. A CLP polymicrobial sepsis model was applied to the rats. All groups were sacrificed 16 h later, and lung and blood samples were analyzed histopathologically and biochemically. Twenty-five and 50 mg/kg amiodarone decreased the level of interleukin (IL)-1β, IL-6, and tumor necrosis factor-α in serum and 8-iso-prostaglandin F2α level in lung tissue. They increased the activities of superoxide dismutase and levels of total glutathione in lung tissues of rats. Histopathological scores and examinations were in accordance with the biochemical results. Histopathological analysis revealed significant differences in inflammation scores between the sepsis group and the other groups. The CLP + amiodarone 50 mg/kg group had the lowest inflammation score among CLP groups. Our results indicate that administration of amiodarone prevented oxidative stress and cytokine action and protected lung tissue during sepsis cascade.

  8. Randomised trial of low-dose amiodarone in severe congestive heart failure. Grupo de Estudio de la Sobrevida en la Insuficiencia Cardiaca en Argentina (GESICA)

    Science.gov (United States)

    Doval, H C; Nul, D R; Grancelli, H O; Perrone, S V; Bortman, G R; Curiel, R

    1994-08-20

    In severe heart failure many deaths are sudden and are presumed to be due to ventricular arrhythmias. The GESICA trial evaluated the effect of low-dose amiodarone on two-year mortality in patients with severe heart failure. Our prospective multicentre trial included 516 patients on optimal standard treatment for heart failure. Patients were randomised to 300 mg/day amiodarone (260) or to standard treatment (256). Intention-to-treat analysis showed 87 deaths in the amiodarone group (33.5%) compared with 106 in the control group (41.4%) (risk reduction 28%; 95% CI 4%-45%; log rank test p = 0.024). There were reductions in both sudden death (risk reduction 27%; p = 0.16) and death due to progressive heart failure (risk reduction 23%; p = 0.16). Fewer patients in the amiodarone group died or were admitted to hospital due to worsening heart failure (119 versus 149 in the control group; risk reduction 31%; 95% CI 13-46%; p = 0.0024). The decrease in mortality and hospital admission was present in all subgroups examined and independent of the presence of non-sustained ventricular tachycardia. Side-effects were reported in 17 patients (6.1%); amiodarone was withdrawn in 12. Low-dose amiodarone proved to be an effective and reliable treatment, reducing mortality and hospital admission in patients with severe heart failure independently of the presence of complex ventricular arrhythmias.

  9. Twenty-four hour radioactive iodine uptake in 35 patients with amiodarone associated thyrotoxicosis

    Energy Technology Data Exchange (ETDEWEB)

    Martino, E.; Aghini-Lombardi, F.; Lippi, F.; Baschieri, L.; Safran, M.; Braverman, L.E.; Pinchera, A.

    1985-12-01

    Amiodarone associated thyrotoxicosis (AAT) occurs in approximately 10% of patients treated with this iodine rich drug in areas of mild iodine deficiency. The thyroid radioactive iodine uptake (RAIU) is usually undetectable or very low in iodine-induced thyrotoxicosis. In the present study, 35 patients with AAT were evaluated. Twelve patients had no thyroid abnormalities by physical exam and all had 24-hr RAIU less than or equal to 4%. In contrast, nine of 11 patients with AAT and diffuse goiters and eight of 12 patients with AAT and nodular goiters had RAIU values greater than 8%. In patients with AAT and goiter it appears possible that the thyroid fails to adapt normally to the excess iodide load, resulting in an inappropriately high RAIU in the presence of excess plasma iodine.

  10. Concurrent Chagas’ disease and borderline disseminated cutaneous leishmaniasis: The role of amiodarone as an antitrypanosomatidae drug

    Directory of Open Access Journals (Sweden)

    Alberto E Paniz-Mondolfi

    2008-06-01

    Full Text Available Alberto E Paniz-Mondolfi1,4, Alexandra M Pérez-Álvarez1, Oscar Reyes-Jaimes2, Gustavo Socorro1, Olga Zerpa3, Denisa Slova4, Juan L Concepción51Laboratorio de Estudio de Antígenos, Instituto de Biomedicina, “Hospital José Gregório Hernández”, Instituto Venezolano de los Seguros Sociales, Caracas, Venezuela; 2Departamento de Dermopatología, Instituto de Biomedicina, 3Sección de Leishmaniasis, Instituto de Biomedicina, Caracas, Venezuela; 4Department of Pathology and Laboratory Medicine, St. Luke’s – Roosevelt - Beth Israel Medical Center, University Hospital of Columbia University College of Physicians and Surgeons, New York, USA; 5Laboratorio de Enzimología de Parásitos, Facultad de Ciencias, Universidad de Los Andes, Mérida, VenezuelaAbstract: The occurrence of mixed infections of Trypanosoma cruzi and Leishmania spp. is becoming a common feature in Central and South America due to overlapping endemic areas. Unfortunately, the possibilities for treating flagellated kinetoplastid infections are still very limited and most of the available drugs exhibit severe side effects. Although the development of new drugs for Leishmania has markedly improved in the last years, the tendency is still to employ antimonial compounds. On the other hand, treatment for Chagas’ disease is only available for the acute phase with no effective therapeutical options for chronic stage disease. The following case report substantiates the recently discovered effect of amiodarone as a nonconventional antiparasitic drug, particularly against Leishmania, breaching a new perspective in the therapeutic management of these important infectious parasitic diseases.Keywords: Chagas’ disease, leishmaniasis, chemotherapy, amiodarone

  11. A model predicting fluindione dose requirement in elderly inpatients including genotypes, body weight, and amiodarone.

    Science.gov (United States)

    Moreau, Caroline; Pautas, Eric; Duverlie, Charlotte; Berndt, Celia; Andro, Marion; Mahé, Isabelle; Emmerich, Joseph; Lacut, Karine; Le Gal, Grégoire; Peyron, Isabelle; Gouin-Thibault, Isabelle; Golmard, Jean-Louis; Loriot, Marie-Anne; Siguret, Virginie

    2014-04-01

    Indandione VKAs have been widely used for decades, especially in Eastern Europe and France. Contrary to coumarin VKAs, the relative contribution of individual factors to the indandione-VKA response is poorly known. In the present multicentre study, we sought to develop and validate a model including genetic and non-genetic factors to predict the daily fluindione dose requirement in elderly patients in whom VKA dosing is challenging. We prospectively recorded clinical and therapeutic data in 230 Caucasian inpatients mean aged 85 ± 6 years, who had reached international normalized ratio stabilisation (range 2.0-3.0) on fluindione. In the derivation cohort (n=156), we analysed 13 polymorphisms in seven genes potentially involved in the pharmacological effect or vitamin-K cycle (VKORC1, CYP4F2, EPHX1) and fluindione metabolism/transport (CYP2C9, CYP2C19, CYP3A5, ABCB1). We built a regression model incorporating non-genetic and genetic data and evaluated the model performances in a separate cohort (n=74).Body-weight, amiodarone intake, VKORC1, CYP4F2, ABCB1 genotypes were retained in the final model, accounting for 31.5% of dose variability. None influence of CYP2C9 was observed. Our final model showed good performances: in 83.3% of the validation cohort patients, the dose was accurately predicted within 5 mg, i.e.the usual step used for adjusting fluindione dosage. In conclusion, in addition to body-weight and amiodarone-intake, pharmacogenetic factors (VKORC1, CYP4F2, ABCB1) related to the pharmacodynamic effect and transport of fluindione significantly influenced the dose requirement in elderly patients while CYP2C9 did not. Studies are required to know whether fluindione could be an alternative VKA in carriers of polymorphic CYP2C9 alleles, hypersensitive to coumarins.

  12. Long-term use of amiodarone before heart transplantation significantly reduces early post-transplant atrial fibrillation and is not associated with increased mortality after heart transplantation

    Directory of Open Access Journals (Sweden)

    Rivinius R

    2016-02-01

    Full Text Available Rasmus Rivinius,1 Matthias Helmschrott,1 Arjang Ruhparwar,2 Bastian Schmack,2 Christian Erbel,1 Christian A Gleissner,1 Mohammadreza Akhavanpoor,1 Lutz Frankenstein,1 Fabrice F Darche,1 Patrick A Schweizer,1 Dierk Thomas,1 Philipp Ehlermann,1 Tom Bruckner,3 Hugo A Katus,1 Andreas O Doesch1 1Department of Cardiology, Angiology and Pneumology, 2Department of Cardiac Surgery, Heidelberg University Hospital, 3Institute for Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany Background: Amiodarone is a frequently used antiarrhythmic drug in patients with end-stage heart failure. Given its long half-life, pre-transplant use of amiodarone has been controversially discussed, with divergent results regarding morbidity and mortality after heart transplantation (HTX.Aim: The aim of this study was to investigate the effects of long-term use of amiodarone before HTX on early post-transplant atrial fibrillation (AF and mortality after HTX.Methods: Five hundred and thirty patients (age ≥18 years receiving HTX between June 1989 and December 2012 were included in this retrospective single-center study. Patients with long-term use of amiodarone before HTX (≥1 year were compared to those without long-term use (none or <1 year of amiodarone. Primary outcomes were early post-transplant AF and mortality after HTX. The Kaplan–Meier estimator using log-rank tests was applied for freedom from early post-transplant AF and survival.Results: Of the 530 patients, 74 (14.0% received long-term amiodarone therapy, with a mean duration of 32.3±26.3 months. Mean daily dose was 223.0±75.0 mg. Indications included AF, Wolff–Parkinson–White syndrome, ventricular tachycardia, and ventricular fibrillation. Patients with long-term use of amiodarone before HTX had significantly lower rates of early post-transplant AF (P=0.0105. Further, Kaplan–Meier analysis of freedom from early post-transplant AF showed significantly lower rates of AF in this

  13. A Case of Type 2 Amiodarone-Induced Thyrotoxicosis That Underwent Total Thyroidectomy under High-Dose Steroid Administration

    Directory of Open Access Journals (Sweden)

    Koshi Hashimoto

    2015-01-01

    Full Text Available Amiodarone is used commonly and effectively in the treatment of arrhythmia; however, it may cause thyrotoxicosis categorized into two types: iodine-induced hyperthyroidism (type 1 amiodarone-induced thyrotoxicosis (AIT and destructive thyroiditis (type 2 AIT. We experienced a case of type 2 AIT, in which high-dose steroid was administered intravenously, and we finally decided to perform total thyroidectomy, resulting in a complete cure of the AIT. Even though steroid had been administered to the patient (maximum 80 mg of prednisolone, the operation was performed safely and no acute adrenal crisis as steroid withdrawal syndrome was found after the operation. Few cases of type 2 AIT that underwent total thyroidectomy with high-dose steroid administration have been reported. The current case suggests that total thyroidectomy should be taken into consideration for patients with AIT who cannot be controlled by medical treatment and even in those under high-dose steroid administration.

  14. Simultaneous determination of amiodarone and its metabolite desethylamiodarone by high-performance liquid chromatography with chemiluminescent detection

    Energy Technology Data Exchange (ETDEWEB)

    Perez-Ruiz, Tomas [Department of Analytical Chemistry, Faculty of Chemistry, University of Murcia, 30071 Murcia (Spain)], E-mail: tpr@um.es; Martinez-Lozano, Carmen; Garcia-Martinez, Maria Dolores [Department of Analytical Chemistry, Faculty of Chemistry, University of Murcia, 30071 Murcia (Spain)

    2008-08-08

    A novel method was developed for the determination of amiodarone and desethylamiodarone by high-performance liquid chromatography (HPLC) coupled with chemiluminescent (CL) detection. The procedure is based on the post-column photolysis of the analytes into photoproducts which are active in the tris(2,2'-bipyridyl)ruthenium(III) [Ru(bpy){sub 3}{sup 3+}] CL system. Ru(bpy){sub 3}{sup 3+} was on-line generated by photo-oxidation of the Ru(II) complex in the presence of peroxydisulfate. The separation was carried out on a Mediterranea C{sub 18} column with isocratic elution using a mixture of methanol and 0.017 mol L{sup -1} ammonium sulfate buffer of pH 6.8. Under the optimum conditions, analytical curves, based on standard solutions, were linear over the range 0.1-50 {mu}g mL{sup -1} for amiodarone and 0.5-25 {mu}g mL{sup -1} for desethylamiodarone. The detection limits of amiodarone and desethylamiodarone were 0.02 and 0.11 {mu}g mL{sup -1}, respectively. Intra- and inter-day precision values of 0.9% relative standard deviation (R.S.D.) (n = 10) and 1.6% R.S.D. (n = 15), respectively, were obtained. The method was applied successfully to the determination of these compounds in serum and pharmaceutical formulations.

  15. New viewpoint of clinical treatment of amiodarone%胺碘酮临床治疗的新观点

    Institute of Scientific and Technical Information of China (English)

    朱彩玲

    2015-01-01

    Amiodarone is widely used in clinical.It has an important role in the treatment of arrhythmia and anti angina pectoris and so on.It has good treatment effect,at the same time,amiodarone also has more adverse reactions,which should arouse the attention of clinicians.In this paper,the author briefly introduces the new viewpoint of clinical treatment of amiodarone,to provide study for clinical.%胺碘酮在临床有着广泛的应用,其在治疗心律失常和抗心绞痛等方面有着重要的作用.在发挥较好治疗作用的同时,胺碘酮也有着较多的不良反应,应引起临床医生的注意.本文简要介绍胺碘酮临床治疗的新观点,为临床提供依据.

  16. 静注胺碘酮治疗心律失常%Static note Amiodarone Treatment of Arrhythmia

    Institute of Scientific and Technical Information of China (English)

    陈淑华

    2014-01-01

    胺碘酮是一种广谱抗心律失常药物,具有许多独立的药理特性,虽属III类抗心律失常药,但它对多个离子通道均有阻断作用,同时具有 I及IV类抗心律失常药性质。近年来静脉注射胺碘酮治疗难治性室上性心律失常、顽固性室性心动过速,室颤疗效甚佳。本文对本科30例心律失常患者使用静脉注射胺碘酮。现将其治疗结果记录如下。%Amiodarone is a broad-spectrum anti-arrhythmic drugs,has many pharmacological characteristics of independent,although department class III anti-arrhythmic drugs,but its effect on multiple ion channels are blocked ,at the same time is in the nature of class I and IV anti -arrhythmic drugs.In recent years the in-travenous amiodarone be well in treatment of refractory room on cardiac arrhythmia,refractory ventricular tachycardia,ventricular fibrillation in good curative effect.In this paper,the undergraduate course of 30 patients with arrhythmia intravenous amiodarone.It is presently as follows the treatment result record.

  17. Effects of Amiodarone on Transmural Dispersion of Ventricular Effective Refractory Periods across Myocardial Layers in the Normal and Hypertrophic Canine Heart

    Institute of Scientific and Technical Information of China (English)

    WANG Lan; L(U) Jiagao; ZHANG Fanzhi; BAI Rong; WANG Lin

    2006-01-01

    The effects of amiodarone on transmural dispersion of ventricular effective refractory periods (ERPs) in the normal and hypertrophic canine heart were investigated in vivo. By using the programmed stimulation protocol, the ERPs of epicardium (Epi), midmyocardium (Mid) and endocardium (Endo) were measured by inserting specially-designed electrodes into the three myocardial layers before and after mainlining of amiodarone. No significant ERPs-dispersion was observed in the three layers before and after mainlining of amiodarone in the normal group. In contrast, ERPs of all the three layers were prolonged in the hypertrophic heart, while the ERPs-dispersion was reduced significantly after mainlining of amiodarone. The ERPs-dispersion was significantly increased in the hypertrophic heart but not in the normal heart using "long-short" and "short-long" interval stimulation technique. It was concluded that (1) the differences in ERPs-dispersion among the three layers were significant in hypertrophic heart, and differences were not significant in normal canine heart;(2) ERPs of each three-myocardial layers were significantly prolonged after using amiodarone, but the ERPs-dispersion decreased in hypertrophic heart and (3) the programmed extrastimulus technique of "long-short" and "short-long" intervals increased the transmural ERPs-dispersion in the hypertrophic heart.

  18. Efficacy and safety in pharmacological cardioversion of recent-onset atrial fibrillation: a propensity score matching to compare amiodarone vs class IC antiarrhythmic drugs.

    Science.gov (United States)

    Bonora, Antonio; Turcato, Gianni; Franchi, Elena; Taioli, Gabriele; Dilda, Alice; Zerman, Germana; Maccagnani, Antonio; Pistorelli, Claudio; Olivieri, Oliviero

    2016-07-06

    The acute management of recent-onset (IC antidysrhythmic agents vs amiodarone in a propensity score matched series of patients acutely treated for AF in the emergency department. During a 3-year period, we retrospectively evaluated all episodes of recent-onset (IC group in terms of efficacy and safety that is conversion to sinus rhythm rates within 12 and 48 h after starting treatment, time to conversion, and adverse drug effects. An overall number of 817 episodes of recent-onset AF were collected (amiodarone group = 406, class IC group = 411). After matching, we obtained 358 episodes equally divided (amiodarone group = 179 and class IC group = 179). Conversion rates within 12 h were 139 (53.1 %) in amiodarone group and 95 (72.6 %) in class IC group (p IC group (p IC agents, when compared with amiodarone, proved to be more rapid and effective, and equally safe in the acute management of recent-onset AF.

  19. Low-dose amiodarone for the prevention of atrial fibrillation after coronary artery bypass grafting in patients older than 70 years

    Institute of Scientific and Technical Information of China (English)

    GU Song; SU Pi-xiong; LIU Yan; YAN Jun; ZHANG Xi-tao; WANG Tian-you

    2009-01-01

    Background Atrial fibrillation (AF) is one of the most common arrhythmia after coronary artery bypass grafting (CABG), which not only increases the suffering of the patients, but also prolongs hospital stay and enhances cost of care, especially for patients older than 70 years. This study was designed to evaluate the efficacy and safety of low-dose amiodarone in the prevention of AF after CABG, especially for the elderly.Methods Two hundred and ten senile patients undergoing off-pump CABG were included in this prospective, randomized, double-blind and placebo controlled study. Patients were given 10 mg/kg of amiodarone (low-dose amiodarone group, n=100) or placebo (control group, n=110) daily for 7 days before surgery and followed by 200 mg of amiodarone or placebo daily for 10 days postoperatively.Results Postoperative AF occurred in 16 patients (16%) receiving amiodarone and in 36 (37.7%) patients receiving placebo (P=0.006). AF occurred at (58.13±16.63) hours after CABG in the low-dose amiodarone group and at (45.03±17.40) hours in the control group (P=0.018). The maximum ventricular rate during AF was significantly slower in the low-dose amiodarone group ((121.42±28.91) beats/min) than in the control group ((134.11 ±30.57) beats/min, P=0.036). The duration of AF was (10.92±9.56) hours for the low-dose amiodarone group compared with (14.81 ±10.37) hours for the control group (P=0.002). The postoperative left ventricular ejection fraction (LVEF) was significantly improved in the low-dose amiodarone group (from (59.9 ±10.3)% to (63.4±11.4)%, P=0.001), and significantly higher compared with the control group ((58.5±10.7)%, P=0.002). Both groups had a similar incidence of complication other than rhythm disturbances (12.0% vs 16.4%, P=0.368). The low-dose amiodarone group patients had shorter hospital stays ((11.8±3.2) days vs (13.8±4.7) days, P=0.001) and lower cost of care (RMB (79 115±16 673) Yuan vs RMB (84 997±21 587) Yuan, P=0.031) than that of

  20. 胺碘酮长期应用致间质性肺炎%Interstitial pneumonitis due to long-term amiodarone use

    Institute of Scientific and Technical Information of China (English)

    任晓蕾; 贺真; 李玉珍

    2011-01-01

    1例62岁女性患者,因心房颤动服用胺碘酮300mg/d,4年后出现咳嗽、咯痰、发热。胸部CT检查示双肺间质弥漫性病变。考虑为药物性间质性肺炎,与胺碘酮有关。停用胺碘酮,给予泼尼松治疗。患者病情逐渐好转。%A 62-year-old woman presented with cough, expectoration, and fever after receiving amiodarone 300 mg/d for 4 yearsfor atria] fibrillation. A chest CT scan revealed bilateral pulmonary diffuse interstitial infiltrations. Drug-induced interstitial pneumonitiswas considered to be related to amiodarone. Amiodarone was discontinued, and prednisone was given. Her condition graduallyimproved.

  1. Comparative effect of amiodarone and amiodarone combined with other drugs in treatment of atrial fibrillation%胺碘酮与胺碘酮联合用药治疗心房纤颤疗效的比较

    Institute of Scientific and Technical Information of China (English)

    陈士良; 辛卫鹏; 高谊

    2011-01-01

    AIM: To compare the effect of amiodarone alone and amiodarone combined with other drugs in treatment of atrial fibrillation ( AF). METHODS: A total of 119 patients with AF were divided into single drug group ( n = 54) and multiple drug group ( n = 65 ). The single drug group received amiodarone treatment, whereas the multiple drug group received treatment of amiodarone together with glucose-insulin-potassium and diuretics. The recovery rate of AF and the maintenance rate of sinus rhythm were observed and compared after 6 months treatment. RESULTS: A significant increase in the recovery rate (from 80% vs. 94% ) and a significant decrease in the recovery duration of sinus rhythm from (55 ± 19) h to (39 ±15) h were observed in the multiple drug group. The maintenance rate increased from 81% to 95% , left atrial diameter decreased from (46 ±6) mm to (42 ±6) mm and the left ventricular diastolic diameter decreased from (52 ±7) mm to (45 ±6) mm in the multiple drug group. However, these phenomena were not seen in the single drug group. CONCLUSION: Compared with amiodarone alone, amiodarone combined with other drugs significantly increases the recovery rate and the maintenance rate in patients with AF.%目的:观察单纯用药与联合用药对心房纤颤(房颤)治疗效果.方法:选择119例房颤患者随机分为2组:单纯用药组54例,给予静脉胺碘酮150~300 mg后,继之以口服胺碘酮维持;联合用药组65例,使用极化液、硝酸甘油和小剂量利尿剂、胺碘酮,胺碘酮使用的剂量与方法同单纯用药组.观察两组房颤转复率和窦性维持率.结果:联合用药组的房颤转复率较单纯组明显提高(80% vs.94%,P<0.05),复律时间减少[(55±19)vs.(39±15)s,P<0.05],追踪复律半年后的维持率,联合用药组明显高于单纯用药组(81% vs.95%,P<0.05).复查B超显示:联合用药后,左心房内经明显缩小,从[(46±6)mm减少到(42±6)mm,P<0.05],左心

  2. Treatment of Atrial Fibrillation with Amiodarone Combined with Simvastatin and Amiodarone: A Meta-analysis%胺碘酮联合辛伐他汀与单用胺碘酮治疗心房颤动的Meta分析

    Institute of Scientific and Technical Information of China (English)

    易欣; 黎明江

    2012-01-01

    目的 评价胺碘酮联合辛伐他汀与单用胺碘酮治疗心房颤动(房颤)的疗效.方法 计算机检索Cochrane图书馆、EMBASE及万方医学数据库等1990~2011年收录的文献,对其中胺碘酮联合辛伐他汀(试验组)与单用胺碘酮(对照组)治疗房颤的随机对照试验进行Meta分析.结果 共纳入12篇文献954例.经异质性检验发现各研究结果具有同质性(P=1.0,I2=0%),故选择固定效应模型合并进行两组疗效的Meta分析,求得OR=2.98,95%CI(2.21,4.02),对总体效应进行假设检验得Z=7.18,P<0.00001,提示试验组治疗房颤的效果较对照组好.漏斗图分析结果显示两组疗效Meta分析结果存在偏倚的可能性较小.Meta分析结果示两组治疗房颤不良反应发生率比较差异无统计学意义.结论 胺碘酮联合辛伐他汀治疗房颤较单用胺碘酮效果好.%Objective To evaluate the effectiveness of Amiodarone combined with Simvastatin and Amiodarone in treating atrial fibrillation. Methods We retrieved the literature of Cochrane Library, EMBASE and Wangfang medical Databases, etc, which were published during 1990 to 2011. A Meta-analysis was conducted on the outcomes of randomized controlled trials (RCT) of Amiodarone with simvastatin (experimental group) and Amiodarone (control group) in treating atrial fibrillation. Results We included 954 cases of 12 records in the analysis. The test for heterogeneity in all studies showed that various research results were of heterogeneity (P = 1.0,I2 =0% ) , so a fixed effect model of Meta-analysis was conducted. The total odds ratio was 2.95, 95% confidence interval (95% CI) was from 2.21 to 4.02. The test of hypothesis for overall effects: Z =7. 18, P < 0.00001. The results in treatment of atrial fibrillation were better in experimental group than in control group. There was little deflective possibility in Meta-analysis result of treatment effectiveness from infundibular schema in the two groups. Mela

  3. Antiproliferative, Ultrastructural, and Physiological Effects of Amiodarone on Promastigote and Amastigote Forms of Leishmania amazonensis

    Directory of Open Access Journals (Sweden)

    Sara Teixeira de Macedo-Silva

    2011-01-01

    Full Text Available Amiodarone (AMIO, the most frequently antiarrhythmic drug used for the symptomatic treatment of chronic Chagas' disease patients with cardiac compromise, has recently been shown to have also specific activity against fungi, Trypanosoma cruzi and Leishmania. In this work, we characterized the effects of AMIO on proliferation, mitochondrial physiology, and ultrastructure of Leishmania amazonensis promastigotes and intracellular amastigotes. The IC50 values were 4.21 and 0.46 μM against promastigotes and intracellular amastigotes, respectively, indicating high selectivity for the clinically relevant stage. We also found that treatment with AMIO leads to a collapse of the mitochondrial membrane potential (ΔΨm and to an increase in the production of reactive oxygen species, in a dose-dependent manner. Fluorescence microscopy of cells labeled with JC-1, a marker for mitochondrial energization, and transmission electron microscopy confirmed severe alterations of the mitochondrion, including intense swelling and modification of its membranes. Other ultrastructural alterations included (1 presence of numerous lipid-storage bodies, (2 presence of large autophagosomes containing part of the cytoplasm and membrane profiles, sometimes in close association with the mitochondrion and endoplasmic reticulum, and (3 alterations in the chromatin condensation and plasma membrane integrity. Taken together, our results indicate that AMIO is a potent inhibitor of L. amazonensis growth, acting through irreversible alterations in the mitochondrial structure and function, which lead to cell death by necrosis, apoptosis and/or autophagy.

  4. Screening of herbal components for attenuating amiodarone-induced hepatotoxicity on gel-entrapped rat hepatocytes.

    Science.gov (United States)

    Deng, Xudong; Shen, Chong; Meng, Qin

    2014-01-01

    Amiodarone (AMD) is a hepatotoxic drug that has been widely used as a class III antiarrhythmic drug. Because, to date, only a few kinds of protectants are able to reduce AMD hepatotoxicity, this article utilized gel-entrapped rat hepatocytes to screen effective protectants from a series of herbal compounds for their effects against AMD-induced toxicity. Herbal compounds, including matrine, silibinin, glycyrrhizic acid, schisandrin B, epigallocatechin gallate and anisodamine, were cotreated with AMD to assess their protective effect, whereas vitamin E, which has been shown to be protective in rats, was selected as a control. It was found that vitamin E, as with its function in rats, provided the best protection in gel-entrapped rat hepatocytes, whereas silibinin, a major component of silymarin, could largely reduce AMD-induced hepatotoxicity, performing a similar function as silymarin in rats. The results illustrated that gel-entrapped hepatocytes may reflect the protective effects of drugs and serve as a reliable model for screening hepatoprotectants. Moreover, matrine, a widely used monomer of the traditional Chinese medicine, Sophora flavescens, for treatment of arrhythmia, was evidenced to show some effective protections against AMD hepatotoxicity. Taken together, gel-entrapped rat hepatocytes may provide a platform for screening effective candidates from the herbal component library.

  5. EFFICACY AND SAFETY OF SINUS RHYTHM RESTORATION WITH AMIODARONE AND PROPAFENONE IN OUTPATIENTS, ECONOMIC ASPECTS (BASED ON DATA OF N.A. SEMASHKO NORTHERN MEDICAL CLINICAL CENTER

    Directory of Open Access Journals (Sweden)

    T. A. Istomina

    2010-01-01

    Full Text Available Aim. To study efficacy and safey of sinus rhythm restoration with amiodarone and propafenone in outpatients with recurrent atrial fibrillation (AF, and to estimate pharmacoeconomic efficiency of such cardioversion in comparison with hospital treatment.Material and methods. Patients (n=199; aged 59.2±1.36 with paroxysmal (73.9% or persistent (26.1% AF were included into the multicenter prospective study. Follow-up period was 13.14 months (min 1 month, max 36 months. Patients with arrhythmia relapse <48 h received outpatient cardioversion with amiodarone or propafenone orally. Daily outpatient examination, including ECG and blood pressure monitoring every 30-60 min, was carried out to evaluate efficacy of cardioversion and hemodynamics. Phone contact with patients was available. Patients with unstable hemodynamics received cardioversion in hospital. Patients received propafenone in cumulative dose of 600 mg (150-300 mg every hour, and amiodarone 600-800 mg daily. The cost/effectiveness ratio (CER was estimated. This ratio shows the cost of one unit of effect.Results. Outpatient cardioversion with amiodarone was started 24 h earlier (p=0.029 and with propafenone — 4.5 h earlier (p=0.002 than that in hospital. The average dose of amiodarone in ambulatory cardioversion was 1.3 times less (713.7±84,62 mg, p=0.345 than that in hospital cardioversion. Outpatient treatment with amiodarone restored sinus rhythm 8.7 h earlier, and with propafenone - 3.5 h earlier than the same treatments in hospital. Efficiency of hospital cardioversion with amiodarone was 70%, with propafenone - 80%, and efficiency of outpatient cardioversion — 96,1% and 98,4%, respectively. Outpatient treatment did not cause any severe side effects. Expenses for outpatient cardioversion made up 143 724.25 rubles, and for hospital cardioversion — 92 870.47 rubles. Average treatment costs for one patient in hospital was 6 times greater than for an outpatient. Outpatient

  6. Amiodarone use after acute myocardial infarction complicated by heart failure and/or left ventricular dysfunction may be associated with excess mortality

    DEFF Research Database (Denmark)

    Thomas, Kevin L; Al-Khatib, Sana M; Lokhnygina, Yuliya;

    2008-01-01

    BACKGROUND: We sought to assess the association of amiodarone use with mortality during consecutive periods in patients with post-acute myocardial infarction with left ventricular systolic dysfunction and/or HF treated with a contemporary medical regimen. METHODS: This study used data from VALIAN...

  7. Long-term efficacy of empirical chronic amiodarone therapy in patients with sustained ventricular tachyarrhythmia and structural heart disease.

    Science.gov (United States)

    Aiba, Takeshi; Kurita, Takashi; Taguchi, Atsushi; Shimizu, Wataru; Suyama, Kazuhiro; Aihara, Naohiko; Kamakura, Shiro

    2002-04-01

    The efficacy of empirical chronic oral amiodarone therapy in 129 patients with sustained ventricular tachyarrhythmia (VTNVF) and structural heart disease is evaluated. Twenty-nine patients were treated with class I drugs and monitored by electrophysiological study (EPS) and Holter electrocardiogram (ECG) (class I). The remaining 100 non-responders to the class I drugs were treated with oral amiodarone, of whom 70 were tolerant (AMD+) and 30 were intolerant (AMD-). Patients were followed up to 36 months. The primary and secondary end-points were recurrence of VT/VF and hypothetical death, respectively; whereby, hypothetical death was defined as actual death and the event of rapid VT.VF (heart rate >240beats/min) in patients with an implantable cardioverter defibrillator. Class I and AMD+ patients showed a better prognosis than AMD- patients. The VT/VF event free at 36 months in class I (64.8%) and AMD+ (56.1%) patients were significantly higher than that in AMD- (27.2%) (pAMD+ (83.6%) patients were significantly higher than that in AMD- (57.0%) (pdisease.

  8. 普罗帕酮联合胺碘酮使用对混合性心律失常控制的临床观察%Propafenone Joint Amiodarone Use of Mixed Arrhythmia Controlled Clinical Observation

    Institute of Scientific and Technical Information of China (English)

    连献杰

    2015-01-01

    Objective Observation of propafenone joint amiodarone use and separate use of amiodarone on mixed arrhythmia converting the curative effect of contrast. Methods Wil exist more than two kinds of new 34 cases of arrhythmia patients were randomly divided into into propafenone joint amiodarone group (19 cases) and amiodarone group (15 cases), the selected cases not including slow arrhythmia. Propafenone joint amiodarone group was given propafenone 35~70 mg (5~10 min after injection) intravenous injection, if invalid, 20 min after repeated 1 time, rhythm control give amiodarone after 1 mg/min to the micro pump pumping control; Amiodarone group, give amiodarone 150 mg of diluted intravenous glucose injection (10~15 min after injection), if the invalid 10~15 min after repeated injections, rhythm control give amiodarone after 1 mg/min to the micro pump pumping control. If two groups patients 3 consecutive load intravenous drug can not control the rhythm of the heart, it wil give amiodarone to the micro pump pumping 1 mg/min.Results Propafenone group joint amiodarone amiodarone and converting efficiency were 95% (18/19) and 73% (11/15) (P<0.05); Propafenone joint amiodarone group average converting time (1.2 h), amiodarone group average converting time (3.5 h). Conclusion Propafenone joint amiodarone use on converting mixed arrhythmia in curative effect is better than the separate use of amiodarone.%目的 观察普罗帕酮联合胺碘酮使用与单独使用胺碘酮对混合性心律失常转复的疗效对比.方法 将同时存在有2种以上新发心律失常的患者34例随机分为成普罗帕酮联合胺碘酮组(19例)和胺碘酮组(15例)(此次所选病例不包括缓慢型心律失常).普罗帕酮联合胺碘酮组给予普罗帕酮35~70 mg(5~10 min注完)静脉注射,若无效,20 min后重复1次,心律控制后给予胺碘酮1 mg/min持继微量泵泵入控制;胺碘酮组,给予胺碘酮150 mg以葡萄糖注射液稀释后静脉注射(10~15 min

  9. Amiodarone therapy in chronic heart failure and myocardial infarction: a review of the mortality trials with special attention to STAT-CHF and the GESICA trials. Grupo de Estudio de la Sobrevida en la Insuficiencia Cardiaca en Argentina.

    Science.gov (United States)

    Pinto, J V; Ramani, K; Neelagaru, S; Kown, M; Gheorghiade, M

    1997-01-01

    Amiodarone appears to reduce sudden death in patients with left ventricular dysfunction resulting from an acute MI or a primary dilated cardiomyopathy, particularly if complex ventricular arrhythmias are present. Amiodarone's beneficial effect on mortality in these patients could be unrelated to its antiarrhythmic effects. Multiple factors could account for the improvement in mortality such as the drug's antiischemic effects, neuromodulating effects, its effect on left ventricular function and on heart rate. Moreover, patients with LV dysfunction who have survived an episode of sudden death would potentially benefit from amiodarone therapy. Future trials are needed to determine the precise subsets(s) of patients who would benefit from the drug and the most efficacious dosing regimen for the drug. Based on available data, amiodarone is the only antiarrhythmic agent which has not been shown to increase mortality in patients with chronic heart failure.

  10. AMIODARONE INDUCES THE SYNTHESIS OF HSPS IN SACCHAROMYCES CEREVISIAE AND ARABIDOPSIS THALIANA CELLS

    Directory of Open Access Journals (Sweden)

    Pyatrikas D.V.

    2012-08-01

    Full Text Available Many biotic and abiotic stresses cause an increase of cytosolic Ca2+ level in cells. Calcium is one of the most important second messengers, regulating many various activities in the cell and was known to affect expression of stress activated genes. Mild heat shock induces the expression of heat shock proteins (Hsps which protect cell from drastic heat shock exposure. There are some literature data permitting to suggest that transient elevation of cytosolic Ca2+ level in plant cells is important for activation of Hsps expression. On the other hand mitochondria are known to regulate the intracellular calcium and reactive oxygen species signaling. It has been shown recently that mild heat shock induces hyperpolarization of inner mitochondrial membrane in plant and yeast cells and this event is critically important for activation of Hsps expression. To reveal the relationship between mitochondrial activity, intracellular calcium homeostasis and Hsps expression an antiarrhythmic drug amiodarone (AMD have been used. AMD is known to cause transient increase of cytosolic Ca2+ level in Saccharomyces cerevisiae. Obtained results have showed that AMD treatment induced the synthesis of Hsp104p in S. cerevisiae cells and Hsp101p in A. thaliana cell culture. Induction of Hsp104p synthesis leads to enhanced yeast capability to survive lethal heat shock exposure. Development of S. cerevisiae thermotolerance depended significantly on the presence of Hsp104p. Elevation of Hsp104p level in the result of AMD treatment was shown to be governed by activity of Msn2p and Msn4p transcription factors. Deletion of the MSN2 and MSN4 genes abrogated the AMD ability to induce Hsp104p synthesis. Mild heat shock and AMD treatment induced the hyperpolarization of the inner mitochondrial membrane in yeast and Arabidopsis cells which accompanied by HSP synthesis and development of thermotolerance. It was suggested that increase of cytosolic Ca2+ level after AMD treatment

  11. Comparison of use and role of adrenaline and amiodarone in cardiac arrest:Case of emergency center in Kosovo

    Institute of Scientific and Technical Information of China (English)

    Basri Lenjani; Nehat Baftiu; Ilaz Bunjaku; Kadir Hyseni; Arianit Jakupi

    2013-01-01

    Objective: To investigate application of cardiopulmonary resuscitation (CPR) measures within the golden minutes in Europe. Methods: The collected data belong to the patients with cardiac arrest that have been recorded in patients’ protocol logbook at the Emergency Clinic. During the 2010-2011 in the Emergency Center of the CUCK in Prishtina have been treated a total of 269 patients with cardiac arrest, of whom 159 or 59.1% have been treated in 2010, and 110 patients or 40.9% in 2011. Cardiac arrest cases were present during all days of the week, but most frequently cases have been reported on Monday with 32.0% of cases, and on Friday with 24.5% of cases. All patients with cardiac arrest have been treated with physiological solution. Results: In 245 or 91.1% patients adrenaline has been applied; in 64 or 23.8% amiodarone has been applied; in 12 or 4.5% cases atropine has been applied, 11 or 4.1% of cases were treated with NaHCO3; 7 or 2.6% of cases were treated with lidocaine; and 6 or 2.2% of cases were treated with dopamine. All survivors from cardiac arrest have received appropriate medical assistance within 10 minutes from attack, which implies that if cardiac arrest occurs near an health care institution (with an opportunity to provide the emergent health care) the rate of survival is higher. Conclusions: Anti-arrhythmic drugs as with vasopressors, the evidence that anti-arrhythmic drugs are of benefit in cardiac is limited. No anti-arrhythmic drug given during human cardiac arrest has been shown to increase survival to hospital discharge, although amiodarone has been shown to increase survival to hospital admission after shock-refractory VF/VT. There are no data on the use of amiodarone for shock-refractory VF/VT when single shocks are used. Despite the lack of human long-term outcome data, the balance of evidence is in favour of the use of some anti-arrhythmic drugs for the management of arrhythmias in cardiac arrest.

  12. Combined etiology of anaphylactic cardiogenic shock: Amiodarone, epinephrine, cardioverter defibrillator, left ventricular assist devices and the Kounis syndrome

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    Nicholas G Kounis

    2015-01-01

    Full Text Available Anaphylactic shock is a life-threatening condition which needs detailed and mediculous clinical assessment and thoughtful treatment. Several causes can join forces in order to degranulate mast cells. Amiodarone which is an iodine-containing highly lipophilic benzofuran can induce allergic reactions and anaphylactic shock in sensitized patients. Epinephrine is a life saving drug, but in sulfite allergic patients it should be given with caution due its metabisulfite preservative. Metals covering cardiac defibrillators and pacemakers can act as antigens attached to serum proteins and induce allergic reactions. In anaphylactic shock, myocardial involvement due to vasospasm-induced coronary blood flow reduction manifesting as Kounis syndrome should be always considered. Clinically, combined treatment targeting the primary cause of anaphylaxis together with protection of cardiac tissue seems to be of paramount importance.

  13. The safety assessment of saffron (Crocus sativus L.) on sympathovagal balance and heart rate variability; a comparison with amiodarone.

    Science.gov (United States)

    Joukar, Siyavash; Dehesh, Mohammad-Moein

    2015-12-01

    Dry stigmas of the Crocus sativus L. (Saffron) are well known in world as a popular flavouring and therapeutic agent. The anxiolytic, antidepressant, anticonvulsant and antiarrhythmic effects of saffron suggest that it may affect the autonomic control of the heart. This study assessed its safety on cardiac sympathovagal balance and heart rate variability in rat. Experimental groups were control, Saf50, Saf100, Saf200 (received saffron at dosages of 50 and 100 and 200 mg/kg/d, orally, respectively) and Amio (received 30 mg/mL/kg/d of amiodarone, orally, for 7 days) groups. On day 8, the frequency domain and time domain indices of animals' electrocardiograms were calculated. The heart rate decreased and RR interval increased in Saf200 and Amio groups (Psaffron not only has no harmful effect on activity of cardiac autonomic nervous system, but it may improve the stability of heart sympathovagal balance in normal rat.

  14. Adaptation of the QT interval to heart rate changes in isolated perfused guinea pig heart: influence of amiodarone and D-sotalol.

    Science.gov (United States)

    Padrini, R; Speranza, G; Nollo, G; Bova, S; Piovan, D; Antolini, R; Ferrari, M

    1997-05-01

    The inadequacy of the QT interval to shorten following heart rate increase is a feature of the inherited long QT syndrome and may have a role in the genesis of the typical arrhythmias associated with this syndrome (torsade des pointes). The aim of our study was to evaluate whether drugs that prolong the QT interval, such as amiodarone and D-sotalol, may also impair the ability of the QT interval to adapt to sudden heart rate changes. Experiments were carried out on isolated perfused guinea pig hearts (Langendorff preparation). Driving frequency was changed, in steps, every two minutes (Hz: 2.5-3-2.5-3.75-2.5-5-2.5), while epicardial ECG was continuously recorded on magnetic tape. QT interval was automatically measured by means of a beat-by-beat analysis program. D-sotalol was added to the perfusion medium at a concentration of 4 micrograms ml-1, while amiodarone was administered, before in vitro evaluation, for seven days (50 mg kg-1 per day, intraperitoneally). In control experiments two phases of QT adaptation were identified: an abrupt QT shortening at the first beat after frequency change (QT1), followed by a gradual, exponential QT shortening that reached a new steady state in about 1 min (half life: 13 sec). The electrical restitution curve (the relation between QT1 and the corresponding diastolic interval) had a rate constant of 57 +/- 8 ms. Neither drug changed the slow component of QT adaptation. However, both drugs increased the ability of QT to shorten upon premature stimulation: D-sotalol by increasing the rate constant of the restitution curve and amiodarone by decreasing the y-intercept. Our results indicate that D-sotalol and amiodarone do not impair QT shortening during tachycardia but, on the contrary, they may favour QT adaptation, thus reducing the likelihood of the potentially lethal 'R on T phenomenon'. This may be an additional mechanism by which these drugs can exert their antifibrillatory action.

  15. 胺碘酮联用缬沙坦治疗阵发性房颤临床观察%Effect of amiodarone combined with valsartan in treating paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    王会玖; 王智斌; 杨迅

    2011-01-01

    目的 观察口服胺碘酮联合应用血管紧张素Ⅱ受体拮抗剂(ARB)缬沙坦在阵发性心房颤动(简称房颤)复律后维持窦律的疗效及对左心房功能的影响.方法 将68例阵发性房颤患者分为单纯口服胺碘酮组(对照组,34例)和胺碘酮加缬沙坦组(治疗组,34例),疗效观察12个月.结果 共66例完成治疗,随访12个月,治疗1、3个月后两组左心房内径比较差异无统计学意义,但6、12个月后两组差异有统计学意义(P<0.05),窦性心律维持6、12个月后比较差异有统计学意义(P<0.05).结论 胺碘酮与缬沙坦联合治疗阵发性房颤维持窦性心律的疗效优于单用胺碘酮,并能延缓左心房扩大.%Objective To investigate the efficacy of amiodarone combined with angiotensin Ⅱ receptor antagonist(ARB)valsartan on paroxysmal atrial fibrillation and left atrial function.Methods A total of 68 patients with paroxysmal atrial fibrillation were randomly divided into two groups:simple amiodarone group(control group,34 cases),amiodarone + valsartan group(stydy group,34 cases),they were treated for 12 months,following-up for 12 months.Results Totally 66 cases completed the treatment.The left atrium in simple amiodarone group was significantly higher than that in amiodarone + valsartan group 6-12 months after treatment(P < 0.05); the maintenance rates of 6 months,12 months of sinus rhythm in amiodarone + valsartan group were significantly higher than those in simple amiodarone group(P < 0.05).Conclusions Amiodarone combined with valsartan can reverse expansion of left atrium,and is more effective for transfer and maintain sinus rhythm compared with simple amiodarone treatment in patients with paroxysmal atrial fibrillation.

  16. Preparation of liposomal amiodarone and investigation of its cardiomyocyte-targeting ability in cardiac radiofrequency ablation rat model

    Directory of Open Access Journals (Sweden)

    Zhuge Y

    2016-05-01

    Full Text Available Ying Zhuge,1,* Zhi-Feng Zheng,1,* Mu-Qing Xie,2 Lin Li,2 Fang Wang,1 Feng Gao2,3 1Department of Cardiology, Shanghai First People’s Hospital of Nanjing Medical University, 2Department of Pharmaceutics, School of Pharmacy, 3Shanghai Key Laboratory of Functional Materials Chemistry, East China University of Science and Technology, Shanghai, People’s Republic of China*These authors contributed equally to this workAbstract: The objective of this study was to develop an amiodarone hydrochloride (ADHC-loaded liposome (ADHC-L formulation and investigate its potential for cardiomyocyte targeting after cardiac radiofrequency ablation (CA in vivo. The ADHC-L was prepared by thin-film method combined with ultrasonication and extrusion. The preparation process was optimized by Box–Behnken design with encapsulation efficiency as the main evaluation index. The optimum formulation was quantitatively obtained with a diameter of 99.9±0.4 nm, a zeta potential of 35.1±10.9 mV, and an encapsulation efficiency of 99.5%±13.3%. Transmission electron microscopy showed that the liposomes were spherical particles with integrated bilayers and well dispersed with high colloidal stability. Pharmacokinetic studies were investigated in rats after intravenous administration, which revealed that compared with free ADHC treatment, ADHC-L treatment showed a 5.1-fold increase in the area under the plasma drug concentration–time curve over a period of 24 hours (AUC0–24 h and an 8.5-fold increase in mean residence time, suggesting that ADHC-L could facilitate drug release in a more stable and sustained manner while increasing the circulation time of ADHC, especially in the blood. Biodistribution studies of ADHC-L demonstrated that ADHC concentration in the heart was 4.1 times higher after ADHC-L treatment in CA rat model compared with ADHC-L sham-operated treatment at 20 minutes postinjection. Fluorescence imaging studies further proved that the heart

  17. 胺碘酮与西地兰控制快速心房颤动的疗效观察%Clinical effect of Amiodarone and Cedilanid in the patients with rapid atrial fibrilation

    Institute of Scientific and Technical Information of China (English)

    廖祖发

    2013-01-01

    Objective: Observe clinical effect of Amiodarone and Cedilanid in the patients with rapid atrial fibrilation.Methods: 70 patients with rapid atrial fibrilation patients were randomly divided into two groups,35 cases in each group, amiodarone and Cedilanid was used respectively in two groups.Result: atrial fibrilation cardioversion success rate of Amiodarone group (74.3%) was significantly higher than Cedilanid group (48.6%), the cardioversion successful time on amiodarone group (6.3± 1.4h) was significantly shorter than Cedilanid group(9.7 ± 3.5h), the difference was statisticaly significant. Conclusion: Intravenous bolus amiodarone in clinical efficacy to control rapid ventricular rate of AF significantly better than Cedilanid. Conclusion: Intravenous bolus amiodarone in clinical efficacy to control rapid ventricular rate of atrial fibrilation significantly better than Cedilanid.%  目的:观察胺碘酮与西地兰在控制快速心房颤动心室率上的临床疗效。方法:将70例快速房颤患者随机分组,每组35例,分别行胺碘酮和西地兰治疗。结果:胺碘酮组的房颤转复成功率(74.3%)显著高于西地兰组(48.6%),转复成功时间上,胺碘酮组(6.3±1.4h)明显短于西地兰组(9.7±3.5h),差异具有统计意义。结论:静脉推注胺碘酮在控制快速房颤心室率的临床疗效上显著优于西地兰。

  18. Liver cirrhosis induced by long-term administration of a daily low dose of amiodarone: A case report

    Institute of Scientific and Technical Information of China (English)

    Hiroki Oikawa; Kazuyuki Suzuki; Tomoyuki Masuda; Chihaya Maesawa; Ryo Sato; Kanta Oikawa; Hiroyuki Yamada; Seizo Oriso; Sadahide Ono; Akiko Yashima-Abo; Koji Kotani

    2005-01-01

    The anti-arrhythmic agent amiodarone (AD) is associated with numerous adverse effects, but serious liver disease is rare. The improved safety of administration of daily low doses of AD has already been established and this regimen is used for long-term medication. Nevertheless,asymptomatic continuous liver injury by AD may increase the risk of step-wise progression of non-alcoholic fatty liver disease. We present an autopsy case of AD-induced liver cirrhosis in a patient who had been treated with a low dose of AD (200 mg/d) daily for 84 mo. The patient was a 85-year-old male with a history of ischemic heart disease.Seven years after initiation of treatment with AD, he was admitted with cardiac congestion. The total dose of AD was 528 g. Mild elevation of serum aminotransferase and hepatomegaly were present. Liver biopsy specimens revealed cirrhosis, and under electron microscopy numerous lysosomes with electron-dense, whorled, lamellar inclusions characteristic of a secondary phospholipidosis were observed. Initially, withdrawal of AD led to a slight improvement of serum aminotransferase levels, but unfortunately his general condition deteriorated and he died from complications of pneumonia and renal failure.Long-term administration of daily low doses of AD carries the risk of progression to irreversible liver injury. Therefore,periodic examination of liver function and/or liver biopsy is required for the management of patients receiving long-term treatment with AD.

  19. In vitro kinetics of amiodarone and its major metabolite in two human liver cell models after acute and repeated treatments.

    Science.gov (United States)

    Pomponio, Giuliana; Savary, Camille C; Parmentier, Céline; Bois, Frederic; Guillouzo, André; Romanelli, Luca; Richert, Lysiane; Di Consiglio, Emma; Testai, Emanuela

    2015-12-25

    The limited value of in vitro toxicity data for the in vivo extrapolation has been often attributed to the lack of kinetic data. Here the in vitro kinetics of amiodarone (AMI) and its mono-N-desethyl (MDEA) metabolite was determined and modelled in primary human hepatocytes (PHH) and HepaRG cells, after single and repeated administration of clinically relevant concentrations. AMI bioavailability was influenced by adsorption to the plastic and the presence of protein in the medium (e.g. 10% serum protein reduced the uptake by half in HepaRG cells). The cell uptake was quick (within 3h), AMI metabolism was efficient and a dynamic equilibrium was reached in about a week after multiple dosing. In HepaRG cells the metabolic clearance was higher than in PHH and increased over time, as well as CYP3A4. The interindividual variability in MDEA production in PHHs was not proportional to the differences in CYP3A4 activities, suggesting the involvement of other CYPs and/or AMI-related CYP inhibition. After repeated treatment AMI showed a slight potential for bioaccumulation, whereas much higher intracellular MDEA levels accumulated over time, especially in the HepaRG cells, associated with occurrence of phospholipidosis. The knowledge of in vitro biokinetics is important to transform an actual in vitro concentration-effect into an in vivo dose-effect relationship by using appropriate modelling, thus improving the in vitro-to-in vivo extrapolation.

  20. Clinical observation of amiodarone in the treatment of atrial fibril ation%胺碘酮在心房颤动治疗中的疗效观察

    Institute of Scientific and Technical Information of China (English)

    陈思光

    2013-01-01

    Objective Comparative Study on efficacy of amiodarone and digitalis drug treatment of atrial fibril ation to control ventricular rate.Methods October 2009 to October 2011, 110 cases of hospitalization of patients with atrial fibril ation in hospital medicine as a research object,The patients were randomly divided into 2 groups,Amiodarone group 54 cases,Digitalis group of 56 cases, Intravenous administration.Results Amiodarone group the total effective rate was 85.2%(46/54),Digitalis group, the total effective rate was 57.1%(32/56),Two groups of patients with total efficiency,Statistical y significant difference(P<0.05).Conclusion Intravenous bolus of amiodarone in the treatment of atrial fibril ation effective than digitalis drugs,Superior to digitalis drugs in the control of ventricular rate.%目的对比研究胺碘酮与洋地黄类药物治疗房颤控制心室率的疗效。方法以2009年10月至2011年10月在本院内科住院110例房颤患者为研究对象,患者随机分成2组,胺碘酮组54例,洋地黄组56例,分别静脉给药胺碘酮和毛花苷C。结果胺碘酮组的总有效率为85.2%(46/54),洋地黄组的总有效率为57.1%(32/56),两组患者的总有效率比较,差异具有统计学意义(P<0.05)。结论静脉推注胺碘酮治疗房颤的疗效优于洋地黄类药物,在控制心室率方面也优于洋地黄类药物。

  1. Study on Transport Mechanism of Amiodarone and Effect of Atorvastatin on Transport of Amiodarone by Caco-2 Cell Monolayer Model%采用Caco-2细胞转运模型研究胺碘酮转运机制及阿托伐他汀对其转运的影响

    Institute of Scientific and Technical Information of China (English)

    孔令提; 刘冬; 宋春丽; 朱裕林

    2016-01-01

    OBJECTIVE:To probe into the intestinal absorption characteristics of amiodarone , and to evaluate the effects of combination of atorvastatin on intestinal absorption of amiodarone .METHODS: The apparent permeability coefficients(Papp) of amiodarone in both the apical-to-basolateral(AP→BL) and the basolateral-to-apical(BL→AP) direction were studied by using the Caco-2 cell monolayer model , the transport mechanism of membrane-disrupting were also evaluated .And the effects of verapamil and atorvastatin on the Papp value was determined .RESULTS:The bilateral transfer capacity of amiodarone increased with the ascent of concentration (10μmol/L, 20μmol/L, 40μmol/L) . There was no significant difference in Papp values of different concentrations ( P>0.05) , and the outside ratio were all less than 1.5.There was no obvious effects on Papp values with verapamil or atorvastatin (P>0.05), which indicated that the transport mechanism of intestinal absorption of amiodarone was passive diffusion .CONCLUSIONS:The passive diffusion is the main transport mechanism of intestinal absorption of amiodarone , and combination of atorvastatin does not affect the intestinal absorption of amiodarone .%目的:探讨胺碘酮的肠吸收特性,评价联合应用阿托伐他汀是否影响胺碘酮的肠吸收。方法:采用Caco-2细胞转运模型,研究胺碘酮在不同浓度下从绒毛面(apical,AP)侧到基底面(basolateral,BL)侧,以及从BL侧到AP侧2个方向的转运过程,计算表观渗透系数(apparent permeability coefficient ,Papp),考察其跨膜转运机制,同时考察维拉帕米、阿托伐他汀对其Papp值的影响。结果:不同浓度(10、20、40μmol/L)胺碘酮的双侧转运量均随浓度增高而相应增大;不同浓度胺碘酮双向转运Papp值的差异无统计学意义(P>0.05),且外排比率均<1.5;加入维拉帕米或阿托伐他汀对胺碘酮的 Papp值无显著影响(P>0.05);

  2. Microscopia confocal in vivo nos depósitos corneanos por amiodarona In vivo confocal microscopy in amiodarone corneal deposits

    Directory of Open Access Journals (Sweden)

    Gustavo Victor

    2007-02-01

    Full Text Available OBJETIVO: Descrever os achados da microscopia confocal in vivo em pacientes nos diversos estágios de ceratopatia induzida por amiodarona, e correlacionar o estadiamento biomicroscópico com o estadiamento confocal. MÉTODOS: Vinte olhos de 10 pacientes (6 homens e 4 mulheres em tratamento com amiodarona, que apresentavam ceratopatia induzida pela droga, foram selecionados para o estudo, com a microscopia confocal (MC. RESULTADOS: A média de idade foi 58 ± 6,2 anos (50-66 anos e o tempo de uso da droga foi de 6 ± 3,2 anos (2-11 anos. Todos pacientes tinham acuidade visual com correção melhor ou igual a 20/40. A biomicroscopia evidenciou ceratopatia por amiodarona: dois pacientes no estágio 1, quatro no estágio 2 e quatro no estágio 3. Todas as córneas apresentaram inclusões intracelulares brilhantes e de alta refletividade na camada epitelial basal. A partir dos estágios 2 e 3, foram encontrados microdepósitos em todas camadas corneanas. Foram observados afilamento e aumento da tortuosidade dos nervos corneanos nos estágios 2 e 3 da ceratopatia. A contagem endotelial média foi de 2.524 ± 150,3 células/mm². CONCLUSÃO: O epitélio basal foi o mais acometido nos diferentes estágios da ceratopatia. Nos pacientes do estágio 1 a biomicroscopia, os microdepósitos subepiteliais são restritos ao epitélio superficial e basal, ao passo que nos pacientes dos estágios 2 e 3, os microdepósitos afetam todas camadas corneanas. À medida que a ceratopatia avança, os nervos corneanos ficam mais afilados e tortuosos.PURPOSE: To describe in vivo confocal microscopy findings in patients with different stages of amiodarone-induced keratopathy, and correlate biomicroscopy stages with confocal stages. METHODS: Twenty eyes of 10 patients (6 men and 4 women, who receive treatment with amiodarone were selected for the study with confocal microscopy (MC. RESULTS: The average age was 58 ± 6.2 years (50-66 years and time of use of the drug was 6

  3. Validated HPLC and Ultra-HPLC Methods for Determination of Dronedarone and Amiodarone Application for Counterfeit Drug Analysis.

    Science.gov (United States)

    El-Bagary, Ramzia I; Elkady, Ehab F; Mowaka, Shereen; Attallah, Maria

    2015-01-01

    Two simple, accurate, and precise chromatographic methods have been developed and validated for the determination of dronedarone (DRO) HCl and amiodarone (AMI) HCl either alone or in binary mixtures due to the possibility of using AMI as a counterfeit of DRO because of its lower price. First, an RP-HPLC method is described for the simultaneous determination of DRO and AMI. Chromatographic separation was achieved on a BDS Hypersil C18 column (150×4.6 mm, 5 μm). Isocratic elution based on potassium dihydrogen phosphate buffer with 0.1% triethylamine pH 6-methanol (10+90, v/v) at a flow rate of 2 mL/min with UV detection at 254 nm was performed. The second method is RP ultra-HPLC in which the chromatographic separation was achieved on an AcclaimTM RSLC 120 C18 column (100×2.1 mm, 2.2 μm) using isocratic elution with potassium dihydrogen phosphate buffer with 0.1% triethylamine pH 6-methanol (5+95, v/v) at a flow rate of 1 mL/min with UV detection at 254 nm. Linearity, accuracy, and precision of the two methods were found to be acceptable over the concentration ranges of 5-80 μg/mL for both DRO and AMI. The results were statistically compared using one-way analysis of variance. The optimized methods were validated and proved to be specific, robust, precise, and accurate for the QC of the drugs in their pharmaceutical preparations.

  4. Real-time monitoring of oxygen uptake in hepatic bioreactor shows CYP450-independent mitochondrial toxicity of acetaminophen and amiodarone.

    Science.gov (United States)

    Prill, Sebastian; Bavli, Danny; Levy, Gahl; Ezra, Elishai; Schmälzlin, Elmar; Jaeger, Magnus S; Schwarz, Michael; Duschl, Claus; Cohen, Merav; Nahmias, Yaakov

    2016-05-01

    Prediction of drug-induced toxicity is complicated by the failure of animal models to extrapolate human response, especially during assessment of repeated dose toxicity for cosmetic or chronic drug treatments. In this work, we present a 3D microreactor capable of maintaining metabolically active HepG2/C3A spheroids for over 28 days in vitro under stable oxygen gradients mimicking the in vivo microenvironment. Mitochondrial respiration was monitored using two-frequency phase modulation of phosphorescent microprobes embedded in the tissue. Phase modulation is focus independent and unaffected by cell death or migration. This sensitive measurement of oxygen dynamics revealed important information on the drug mechanism of action and transient subthreshold effects. Specifically, exposure to antiarrhythmic agent, amiodarone, showed that both respiration and the time to onset of mitochondrial damage were dose dependent showing a TC50 of 425 μm. Analysis showed significant induction of both phospholipidosis and microvesicular steatosis during long-term exposure. Importantly, exposure to widely used analgesic, acetaminophen, caused an immediate, reversible, dose-dependent loss of oxygen uptake followed by a slow, irreversible, dose-independent death, with a TC50 of 12.3 mM. Transient loss of mitochondrial respiration was also detected below the threshold of acetaminophen toxicity. The phenomenon was repeated in HeLa cells that lack CYP2E1 and 3A4, and was blocked by preincubation with ascorbate and TMPD. These results mark the importance of tracing toxicity effects over time, suggesting a NAPQI-independent targeting of mitochondrial complex III might be responsible for acetaminophen toxicity in extrahepatic tissues.

  5. Rational design and synthesis of water-compatible molecularly imprinted polymers for selective solid phase extraction of amiodarone.

    Science.gov (United States)

    Muhammad, Turghun; Cui, Liu; Jide, Wang; Piletska, Elena V; Guerreiro, Antonio R; Piletsky, Sergey A

    2012-01-04

    Novel water-compatible molecularly imprinted polymers (MIPs) selective for amiodarone (AD) were designed via a new methodology which relies on screening library of non-imprinted polymers (NIPs). The NIP library consisted of eighteen cross-linked co-polymers synthesized from monomers commonly used in molecular imprinting. The binding capacity of each polymer in the library was analyzed in two different solvents. Binding in water was used to assess non-specific (hydrophobic) interactions and binding in an appropriate organic solvent was used to assess specific interactions. A good correlation was found between the screening tests and modeling of monomer-template interactions performed using computational approach. Additionally, analysis of template-monomer interactions was performed using UV-vis spectroscopy. As the result, 4-vinylpyridine (4-VP) was selected as the best monomer for developing MIP for AD. The 4-VP-based polymers demonstrated imprinting factor equal 3.9. The polymers performance in SPE was evaluated using AD and its structural analogues. The recovery of AD was as high as 96% when extracted from spiked phosphate buffer (pH 4.5) solution and 82.1% from spiked serum samples. The developed MIP shown as a material with specific binding to AD, comparing to its structural analogues, 1-(2-diethylaminoethoxy)-2,6-diiodo-4-nitrobenzene and lidocaine, which shown 9.9% and 25.4% of recovery from the buffer solution, correspondingly. We believe that the screening of NIP library could be proposed as an alternative to commonly used computational and combinatorial approaches.

  6. Treatment of 200 cases with atrial fibrillation by Shensong Yangxin capsules compared with amiodarone%参松养心胶囊对比胺碘酮治疗心房纤颤200例

    Institute of Scientific and Technical Information of China (English)

    马军

    2015-01-01

    目的:对比参松养心胶囊和胺碘酮治疗心房纤颤的疗效和安全性。方法:100例心房纤颤患者随机分为参松养心胶囊组和胺碘酮组。结果:参松养心胶囊组和胺碘酮组治疗心房纤颤总有效率分别为55%、60%,统计学处理无明显差异(P>0.05)。结论:参松养心胶囊和胺碘酮治疗心房纤颤疗效相当,但参松养心胶囊不良反应更少。%Objective:To compare the clinical effects and safety of Shensong Yangxin capsules and amiodarone in the treatment of atrial fibrillation.Methods:100 cases with atrial fibrillation were divided into Shensong Yangxin capsule group and amiodarone group. Results: Shensong Yangxin capsule group and amiodarone group the total effective rate was 55% and 60% respectively in the treatment of atrial fibrillation, statistically no significant difference (P> 0.05).Conclusion:The therapeutic effects of Shensong Yangxin capsule and amiodarone in the treatment of atrial fibrillation are equal,but Shensong Yangxin capsule with less adverse reactions.

  7. 冠心病快速心律失常应用胺碘酮治疗的临床效果分析%The Clinical Effect of Coronary Heart Disease Tachyarrhythmia Analysis Amiodarone Therapy

    Institute of Scientific and Technical Information of China (English)

    陈铸雄

    2014-01-01

    Objective Clinical efficacy in patients with coronary heart disease tachyarrhythmia amiodarone therapy. Methods In our hospital from January 2012 to January 2014 were treated 60 cases of coronary heart disease complicated by tachyarrhythmias in patients of all emergency patients were given amiodarone therapy, and efficacy determination. Results The group of 60 patients after amiodarone total effective rate of 90.0%, adverse reactions were mild and no serious adverse events. Conclusions Amiodarone in the treatment of coronary artery disease in patients with tachyarrhythmia safe and effective.%目的:冠心病快速心律失常患者应用胺碘酮治疗的临床疗效。方法选取我院在2012年1月至2014年1月收治的冠心病并发快速心律失常患者60例,对所有患者均急诊给予胺碘酮治疗,并对疗效进行判定。结果本组60例患者经过胺碘酮治疗总有效率达90.0%,不良反应均较轻微,无严重不良反应发生。结论胺碘酮在冠心病快速心律失常患者的治疗中安全、有效。

  8. 胺碘酮治疗心衰伴心律失常的临床分析%Therapeutic effects of amiodarone on chronic heart failure complicated by arrhythmia

    Institute of Scientific and Technical Information of China (English)

    周兰珠

    2010-01-01

    目的 评价胺碘酮治疗心力衰竭(HF)伴心律失常的疗效.方法 选择心力衰竭合并心律失常患者96例,在抗心衰治疗同时给予口服胺碘酮6周.结果 治疗6周后观察总有效率91.9%.结论 胺碘酮治疗HF伴心律失常安全、有效.%Objective To evaluate the the therapeutic effects of amiodarone on chronic heart failure complicated by arrhythmia. Methods From 2006 to 2008,96 chronic congestive heart failure patients with arrhythmia were enrolled. All patients were given standard medical treatment according to the current practice guidelines with a β-blocker, an angiotensin-converting enzyme(ACE) inhibitor, and diuretics. At the same time,they were also given oral amiodarone for six weeks. Results After 6 weeks' treatment with amiodarone,the total effective therapeutic effects was 91.9 percent. Conclusion For patients with chronic congestive heart failure complicated by with arrhythmia, amiodarone treatment for six weeks is safe and effective.

  9. Amiodarona causa vasodilatação dependente do endotélio em artérias coronárias caninas Amiodarone causes endothelium-dependent vasodilation in canine coronary arteries

    Directory of Open Access Journals (Sweden)

    Alfredo José Rodrigues

    2005-03-01

    Full Text Available OBJETIVO: Avaliar os efeitos vasodilatadores da amiodarona em artérias coronárias caninas empregando soluções de amiodarona dissolvida em polisorbato 80 ou em água. MÉTODOS: Anéis de artéria coronária, com e sem o endotélio íntegro, foram imersos em solução de krebs e conectadas a um transdutor para aferição de força isométrica promovida por contração vascular. As artérias foram expostas a concentrações crescentes de polisorbato 80, amiodarona dissolvida em água, amiodarona dissolvida em polisorbato 80 e uma apresentação comercial da amiodarona (Cordarone®. Os experimentos foram conduzidos na presença e na ausência dos seguintes bloqueadores enzimáticos: apenas indometacina, Nômega-nitro-L-arginina associada à indometacina e apenas Nômega-nitro-L-arginina. RESULTADOS: O polisorbato 80 causou pequeno relaxamento não dependente do endotélio. O Cordarone®, a amiodarona dissolvida em água e em polisorbato 80 promoveram relaxamento dependente do endotélio, que foi de maior magnitude para a amiodarona dissolvida em polisorbato e para o Cordarone®. Apenas a associação de indometacina com a Nômega-nitro-L-arginina foi capaz de abolir o relaxamento dependente do endotélio provocado pela amiodarona dissolvida em polisorbato 80. CONCLUSÃO: Os resultados obtidos indicam que a vasodilatação promovida pela amiodarona em artérias coronárias caninas é causada principalmente pela estimulação da liberação de óxido nítrico e fatores endoteliais relaxantes dependentes das ciclo-oxigenases.OBJECTIVE: To assess the vasodilating effects of amiodarone on canine coronary arteries by using solutions of amiodarone dissolved in polysorbate 80 or water. METHODS: Rings of coronary arteries, with or without intact endothelium, were immersed in Krebs solution and connected to a transducer for measuring the isometric force promoted by a vascular contraction. The arteries were exposed to increasing concentrations of

  10. 厄贝沙坦联合胺碘酮治疗阵发性房颤的临床疗效%Effects of the irbesartan combined with amiodarone in the treatment of paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    邹丽芳; 张光君; 陈士良

    2012-01-01

    目的 评价胺碘酮联合厄贝沙坦治疗阵发性房颤的临床疗效.方法 78例阵发性房颤的患者随机分为治疗组(胺碘酮+厄贝沙坦)和对照组(胺碘酮),口服给药,疗程均为1年.比较治疗后2组窦性心律维持率和左心房内径的变化.结果 治疗组窦性心率维持率明显高于对照组(P<0.05),左心房内径亦有显著性缩小(P<0.05).结论 胺碘酮联合厄贝沙坦治疗阵发性心房颤动维持窦性心率的疗效优于单用胺碘酮,且能抑制左心房扩大.%Objective To observe clinical efficacy of amiodarone and irbesartan in the treatment of paroxysmal atrial fibrillation. Methods Seventy - eight cases of paroxysmal atrial fibrillation were randomly divided into treatment group ( amiodarone + irbesartan ) and the control group ( single with amiodarone ) . Taking drugs were by orally and the course was a year. Compared the change of sinus rhythm maintenance rate and left atrial diameter after the treatment in two groups. Results Compared with control group, the sinus rhythm maintenance rate in the treatment group was significantly higher than the control group (P < 0. 05 ) , the left atrial diameter in the treatment group also significantly reduced than the control group ( P < 0. 05 ).Conclusion Effects of amiodarone and irbesartan in the treatment of paroxysmal atrial fibrillation to maintain sinus rhythm has better than single amiodarone , and it can inhibit left atrial enlargement.

  11. Clinical study on the efficacy and safety of Amiodarone for treating atrial fibrillation in old patients%胺碘酮治疗老年心房纤颤的疗效及安全性观察

    Institute of Scientific and Technical Information of China (English)

    曹丹阳; 曹晶晶; 周冬翠; 武云涛; 陈艳梅; 毕磊

    2011-01-01

    Objective To study the efficacy and safety of Amiodarone for treating atrial fibrillation in old patients. Methods We retrospectively reviewed 40 elderly cases of atrial fibrillation, amiodarone was administered 0.6 g/day initially, then gradually reduced to 0.2 g/day for maintainance, the curative effect and the side effects of amiodarone in treatment of atrial fibrillation was observed. Results The efficiency of amiodarone treatment was 55%, laseris 32.5%, inefficient to 12. 5%. Simultaneous hypothyroidism occurred in 7 cases, thyroid function in hyperthyroidism, pulmonary fibrosis, pigmentation did not happen in all cases. Conclusions Amiodarone for treating atrial fibrillation in old patients is effective and safe.%目的 探讨胺碘酮对老年阵发性房颤治疗的效果和安全性.方法 观察分析40例老年阵发性房颤患者胺碘酮治疗的效果和药物副作用.结果 胺碘酮治疗显效率为55 0%,有效率为32 5%,无效率为12 5%;发生甲状腺功能减退 7例,未发生甲状腺功能亢进、肺纤维化、色素沉着.结论 胺碘酮应用于老年人房颤有效、安全,但需密切观察甲状腺功能和对肺的毒性作用.

  12. Long-term efficacy and safety of very-low-dose amiodarone treatment for the maintenance of sinus rhythm in patients with chronic atrial fibrillation after successful direct-current cardioversion

    Institute of Scientific and Technical Information of China (English)

    JONG Gwo-ping; CHANG Mu-hsin; CHANG Ting-chuan; CHOU Pesus; FU Chong-yau; TIEN Li-yun; CHEN Chung-yin; MA Tso-chiang

    2006-01-01

    Background Long-term maintenance of sinus rhythm after successful conversion of chronic atrial fibrillation (CAF), often ameliorates patients' symptoms, reduces the risk of ischemic stroke and improves cardiovascular hemodynamics. This prospective study aims to evaluate the long-term efficacy and safety of very low-dose amiodarone (100 mg daily) for the maintenance of sinus rhythm after successful direct-current (DC)cardioversion in patients with CAF and rheumatic heart disease (RHD) post intervention.Methods This study was a randomized prospective trial. One day after successful DC cardioversion (remained normal sinus rhythm) in patients with CAF and RHD post intervention for more than six months and adequate anticoagulation, all were randomly administered either amiodarone 200 mg daily in group A or amiodarone 100mg daily in group B.Results A total of 76 patients (40 men and 36 women) were examined from February 1998 to December 1999.The mean age of the patients was (66±10) years, and the mean follow-up was (67±8) months (range 61 to 84months). Actuarial rates of the maintenance of sinus rhythm were similar in the two groups after 5 years of follow-up. Four patients (11%) in group A but none in group B experienced significant adverse effects that necessitated withdrawal of amiodarone. No death occurred during the study period.Conclusion A very low dose of amiodarone results in adequate long-term efficacy and is safe for maintaining sinus rhythm in patients with CAF and RHD post intervention after successful DC cardioversion.

  13. 胺碘酮急诊治疗快速性心律失常的疗效观察%THE EFFICACY OBSERVATION OF AMIODARONE IN EMERGENCY TREATMENT OF TACHYARRHYTHMIA

    Institute of Scientific and Technical Information of China (English)

    武彦秋; 王燕; 孙鹏; 胥冬梅

    2011-01-01

    [Objective]To discuss the curaliveeffect and the safety of amiodarone treatment of pediatric tachyarrhythmia (supraventricular SVT, ventricular VT).[Methods]Divided 60 infants into 2 groups according to SVT and VT.Each group was randomly divided into treatment group and control group.[Results]The converting rates in SVT group with amiodarone treatment was 94.4%, 40.9% in SVT group with rytmonorm treatment, the converting rates in VT group with amiodarone treatment was 88.2% , that in VT group with lidocaine treatment was 35% , and the adverse reaction rate due to amiodarone was 3.3%.[Conclusion]The successful converting rate of the amiodarone in treating pediatric tachyarrhythmia has high performance and the safety is high.It can be used in clinic preferentially.%[目的]探讨胺碘酮治疗小儿快速性心律失常(室上性SVT、室性VT)的疗效及安全性.[方法]将60例患儿按病种(SVT、VT)分为2组,每组再随机分为治疗组(胺碘酮)、对照组(心律平、利多卡因)治疗.[结果]SVT组胺碘酮转复率为94.4%,心律平组40.9%;对VT成功复律率为88.2%,利多卡因组35%,胺碘酮不良反应发生率3.3%.[结论]胺碘酮治疗小儿快速性心律失常转复成功率高,起效快,安全性高,在临床上可优先使用.

  14. The Clinical Analysis of 24 Cases of Patients with Amiodarone Ventricular Tachycardia%胺碘酮室性心动过速24例临床分析

    Institute of Scientific and Technical Information of China (English)

    宋雪莲

    2014-01-01

    目的:探讨静脉注射胺碘酮治疗室性心动过速疗效。方法自2012年2月~2013年12月对24例室性心动过速患者应用胺碘酮临床治疗资料进行分析。结果经治疗室性心动过速成功复律21例,占87.5%。结论室速发生较多者可用胺碘酮,胺碘酮应采取小剂量负荷,胺碘酮治疗较为安全,维持量亦可相应减少,可提高疗效,提高生活质量。%Objective The effect of intravenous amiodarone treatment of ventricular tachycardia to be investigated. Methods Analyzing clinical treatment data selected from 24 cases of patients with ventricular tachycardia who are given intravenous amiodarone treatment from February 2012 to December 2013. Results With intravenous amiodarone treatment, 21 cases of patients with ventricular tachycardia are cured which make up 87.5 percent of the whole. Conclusions The patients with ventricular tachycardia are suggested to take intravenous amiodarone, but with smal amount of dosage;since the intravenous amiodarone treatment is comparative safe, the dosage can be reduced gradual y with improving the effect and quality of life.

  15. Efficacy Observation of Amiodarone in the Treatment of Atrial Fibrillation Cardioversion with Intravenous Administration%静脉应用胺碘酮治疗心房颤动复律的疗效观察

    Institute of Scientific and Technical Information of China (English)

    张景富; 尹春元

    2011-01-01

    OBJECTIVE: To observe clinical efficacy of amiodarone in the treatment of atrial fibrillation cardioversion with intravenous administration. METHODS: 172 patients with atrial fibrillation were randomly divided into amiodarone group and placebo group. Amiodarone group (n=87) received amiodarone 5 mg·kg-1 intravenously, and then followed by continuous infusion of 0.9% Sodium chloride injection with amiodarone at 10~20 mg·kg-1· d-1 until sinus rhythm was restored. Placebo group (n=85)received0.9% Sodium chloride injection with intravenous push and intravenous infusion, and ventricular rate control treatment. Successful rate and time of rhythm control of 2 groups were observed. RESULTS: 74 patients (85.1%) in amiodarone group returned into sinus rhythm. 68 patients (80.0%) in placebo group also returned into sinus rhythm (P>0.05). The duration of atrial fibrillation in amiodarone group was shorter than in placebo group (P<0.01). One patient suffered from sinus bradycardia in amiodarone group. CONCLUSION: Intravenous administration of amiodarone can not improve the successful rate of rhythm control but can shorten the duration of atrial fibrillation.%目的:观察静脉应用胺碘酮对心房颤动复律的临床疗效.方法:将172例心房颤动患者随机分为胺碘酮组和安慰剂组.胺碘酮组(n=87)静脉推注胺碘酮5mg·kg-1,再以胺碘酮10~20mg·kg-1·d-1加入0.9%氯化钠注射液中持续静脉滴注,维持直至恢复为窦性节律;安慰剂组(n=85)静脉推注和静脉滴注0.9%氯化钠注射液,并给予控制心室率治疗.观察2组复律成功率和复律时间.结果:胺碘酮组有74例(85.1%)恢复为窦性节律,安慰剂组有68例(80.0%)恢复为窦性节律,2组比较差异无统计学意义(P>0.05).胺碘酮组心房颤动持续时间短于安慰剂组(P<0.01).胺碘酮组1例患者出现窦性心动过缓,停药后恢复.结论:胺碘酮静脉应用不能提高复律率,但能缩短心房颤动持续时间.

  16. 伊布利特和胺碘酮转复心房扑动及心房颤动的临床观察%Efficacy of ibutilide and amiodarone for termination of atrial fibrillation and flutter

    Institute of Scientific and Technical Information of China (English)

    王磊

    2011-01-01

    目的 观察新一代Ⅲ类抗心律失常药物伊布利特和经典Ⅲ类抗心律失常药物胺碘酮转复心房颤动(房颤)和心房扑动(房扑)的成功率及安全性.方法 选择40 ~ 75岁,持续时间≤90 d的房颤和房扑患者38例,按入院顺序随机分为伊布利特组19例和胺碘酮组19例,伊布利特组体质量≥60 kg者首剂1 mg、体质量<60 kg者首剂0.01 mg/kg,如无效10 min后再给予1 mg或0.01 mg/kg;胺碘酮组首剂150 mg,如无效10 min后再给予150 mg,观察转复率和转复时间,记录不良反应.结果 伊布利特和胺碘酮组4h内转复窦律分别为78.9%和31.5%,24 h内转复窦律分别为84.2%和52.6%,平均转复时间分别为(19±12)min和(48 ±17)min (P<0.01).两组均未发生致命性不良反应.结论 伊布利特与胺碘酮均能终止房颤和房扑,伊布利特转复房颤、房扑的疗效高于胺碘酮,转复时间短于胺碘酮,但须在严格监控下进行.%Objective To investigate the efficacy,safety and tolerance of intravenous ibutilide and amiodarone for conversion of atrial fibrillation( AF) and flutter( AFL) to normal sinus rhythm.Methods Thirty - eight consecutive patients aged 40 - 75 years with AF/AFL were included.The duration of arrhythmia were less than 90 days (ranged from 3 hours to 90 days),and ventricular rate(VR) were more than 60 beats/min.Two groups were assigned randomly.Patients in the ibutilide group( 19 cases) received ibutilide 1 mg if body weight ≥60 kg or 0.01 mg/kg if body weight < 60 kg; Treatment was repeated if atrial fibrillation or flutter was not converted after 10 min of the first dosage.Patients in the amiodarone group( 19 cases) received amiodarone 150 mg,followed by amiodarone 150 mg if atrial fibrillation or flutter persisted after 10 min of the first dosage.Results In 4 hours AF/AFL were converted in 15 of 19 patients(78.9% )in ibutilide group and in 6 of 19 patients(31.5% )in amiodarone group (P < 0.05),and in 24

  17. 急性心肌梗死急诊诊断与治疗分析%Clinical effect of intravenous injection of amiodarone in treatment of acute heart failure with rapid atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    许敏

    2013-01-01

    目的:分析研究AMI(急性心肌梗死)的临床诊断以及治疗效果。方法抽取近年来在我院收治的80例患有急性心肌梗塞的患者,随机分为实验组和对照组,每组各40例患者,其中实验组对患者采取尿激酶溶栓治疗,对照组对患者采取传统常规治疗。结果实验组患者的临床治疗效果明显优于对照组患者,两组间差异具有统计学意义(P<0.05)。结论采取及时有效的临床干预以及治疗对治疗急性心肌梗塞的患者起到至关重要的作用,具有临床推广价值应用。%Objective To investigate the clinical effect of intravenous injection of amiodarone in the treatment of acute heart failure with rapid atrial fibrillation.Methods A total of 172 patients with acute heart failure and rapid atrial fibrillation who were admitted to our hospital from October 2011 to July 2013 were randomly divided into heart failure and atrial fibrillation group and amiodarone group. The heart failure and atrial fibrillation group received conventional treatment, while the amiodarone group received conventional treatment plus injection of amiodarone. The treatment outcomes of the two groups were compared.Results After 7 d of treatment, the amiodarone group had a significant more improvement in cardiac function, a significantly better heart rate control, and a significantly lower mortality rate, as compared with the heart failure and atrial fibrillation group (P<0.05 for all comparisons). ConclusionConventional treatment plus injection of amiodarone can improve cardiac function and control heart rate in the treatment of heart failure.

  18. Influence of puncture site and methods for phlebitis caused by amiodarone%穿刺部位及方法对胺碘酮致静脉炎的影响

    Institute of Scientific and Technical Information of China (English)

    曹利芸

    2011-01-01

    Objective To study the correlation between the different puncture site and methods and of the incidence of phlebitis caused by amiodarone. Methods 90 patients treated with amiodarone were selected as research object. The incidence of phlebitis caused by amiodarone at different puncture site and methods, concentration of amiodarone, injection time were analyzed. Results The incidence of phlebitis of upper limbs vein was lower than that of the other position.The incidence of phlebitis of central venous was lower than that of peripheral vein. The incidence of phlebitis of micropump was higher than that of the other methods. The incidence of phlebitis injected with longer time was higher than that of the shorter. The incidence of phlebitis at high-concentration amiodarone was higher than that of lower-concentration amiodarone. Conclusion The different puncture site and methods are related to the incidence of phlebitis.%目的 探讨不同穿刺部位及方法与胺碘酮致静脉炎的发生率的相关性.方法 选取胺酮进行治疗的90例患者为研究对象,将穿刺部位、穿刺方法及胺碘酮浓度、注射时间不同时静脉炎的发生率进行统计和比较.结果 颈外静脉炎发生率较其他部位要低,微泵注药静脉炎发生率高于其他方式,注药时间长者静脉炎发生率高于短者,胺碘酮浓度高者静脉炎发生率高于低浓度者,经比较,差异均有显著性(均P<0.05).结论 不同穿刺部位及方法与胺碘酮致静脉炎的发生率相关性较大,应引起重视,以预防静脉炎的发生.

  19. Amiodarone-induced ADR reports in Anhui from 2005~2009%安徽省2005~2010年胺碘酮药品不良反应报告分析

    Institute of Scientific and Technical Information of China (English)

    张树强; 叶根深

    2012-01-01

    Objective To study the condition and analyze the related factors of amiodarone-induced adverse drug reactions( ADR ) in An-hui province. Methods Amiodarone-related ADR reports reported in Anhui province from Jan 1,2005 to Nov 31,2010 were searched, from which a total of 120 qualified amiodarone-induced ADR reports were screened out and analyzed statistically. Results Amiodarone-induced ADR occurred more in males, aged from 40 to 80, most of which were not serious. They were majorly induced by oral administration, and majorly occurred within 1 to 7 days. They might involve multi-organs or systems, and their clinical manifestations were chiefly nausea,vomiting or constipation. Most were relatively mild,and subsided after amiodarone withdrawal. Conclusion Medical staffs should pay much attention to amiodarone -induced ADR,and ADR monitoring should be more strengthened.%目的 调查安徽省胺碘酮致药品不良反应(ADR)情况并分析相关因素.方法 检索安徽省2005年1月1日~2010年11月31日呈报的与胺碘酮相关的ADR报告表,筛选合格报告表120例,进行统计分析.结果 ADR多发生在40~80岁,男性多于女性;以一般不良反应居多.主要由口服途径给药引起,多发生于给药后1~7 d内;可累及多个系统/器官,多为恶心、呕吐或便秘;多数较轻微,停药或/和对症处理后可好转、治愈.结论 医务人员应重视胺碘酮所致ADR,并进一步加强ADR监测.

  20. Clinical analysis of low-dose amiodarone therapy in the management of ventricular arrhythmias%小剂量胺碘酮治疗室性心律失常56例临床分析

    Institute of Scientific and Technical Information of China (English)

    王珍

    2001-01-01

    Objective:To evaluate the efficacy and safety of low-dose amiodarone therapy in the management of ventricular arrhythmias.Methods:56 patients with symptomatic drug refractory managed with low-dose oral amiodarone therapy over 5-year period was analyzed retrospec tively. Loading dose of amiodarone 800 mg daily for 1 week, 400 mg daily for anoth er week, then, 100-200 mg daily as maintenance daily.Mean treatment duration was 29±8 months.Results:The efficacy of amiodarone was 81% in the management of ventricular arrhymias. The cumulative incidence of amiodarone related adverse effects was 9%. 1 patient had thyroid dysfunction, and 1 developed pulmonary int erstitial fibrosis.Conclusion:The higer efficacy and acceptable side effect profile of low amiodarone therapy in the management of ventricular arrhythmias.%目的:观察小剂量胺碘酮长期治疗室性心律失常的疗效和安全性。方法:回顾性分析了我院5年来收治的经其它药物治疗无效的室性心律失常的患者56例,给以胺碘酮负荷量800 mg/日,一周后400 mg/日,一周后100~200 mg/日维持,平均给药时间29±8月。结果:胺碘酮治疗室性心律失常有效率81%。与胺碘酮有关的副作用累计发生率为9%,引起甲状腺功能异常和肺间质纤维化各1例。结论:小剂量胺碘酮治疗室性心律失常是安全有效的。

  1. Disfunção tireoidiana e conduta dos cardiologistas em pacientes usando amiodarona Thyroid dysfunction and cardiological management in patients receiving amiodarone

    Directory of Open Access Journals (Sweden)

    Anna Gabriela Fuks

    2004-06-01

    Full Text Available OBJETIVO: Determinar a prevalência de disfunção tireoidiana em pacientes usando amiodarona e os possíveis fatores associados. Verificar através de questionário aplicado a cardiologistas, a importância do fármaco causar alterações na função tireoidiana. MÉTODO: Avaliados 56 pacientes em uso crônico (> 3 meses de amiodarona com dosagens séricas de TSH, T4 livre, T3 total e Anti-TPO e definidos como portadores de disfunção tireoidiana (DT pacientes com TSH alterado. RESULTADOS: A prevalência de disfunção tireoidiana foi de 33,9%. Não houve diferença entre este grupo e os pacientes sem disfunção, exceto em relação à prevalência de anti-TPO positivo maior nos pacientes com DT (p=0,02. Hipotireoidismo subclínico foi diagnosticado em 10 (17,9% pacientes e hipotireoidismo clínico em 6 (10,7%. A prevalência de hipertireoidismo subclínico foi de 3,6% e de hipertireoidismo clínico de 1,8%. Anticorpos anti-TPO foram positivos em 5 (8% pacientes (dos quais 4 apresentavam disfunção. Quando comparados aos doentes sem anti-TPO positivo este grupo teve maior prevalência de disfunção (80% vs 29,4%; p=0,04. Verificado que apenas 49,2% dos cardiologistas faziam acompanhamento da função tireoidiana rotineiramente e a prevalência de disfunção referida na experiência da maioria era de 1 a 10%. CONCLUSÃO: A prevalência de disfunção tireoidiana na nossa população foi elevada, mostrando a necessidade de implementação de uma rotina laboratorial. Houve grande divergência entre os cardiologistas em relação ao tipo de acompanhamento utilizado nos pacientes em uso de amiodarona.OBJECTIVE: To determine the prevalence of thyroid dysfunction in patients receiving amiodarone, and the possible associated factors. The study also aimed at assessing the effect of amiodarone on thyroid function through the application of a questionnaire to cardiologists. METHOD: Fifty-six patients chronically (> 3 months receiving amiodarone were

  2. Use of Intravenous Amiodarone in the Treatment of Nifekalant-Resistant Arrhythmia: A Review of 11 Consecutive Cases with Severe Heart Failure

    Science.gov (United States)

    Nakagawa, Koji; Nakamura, Kazufumi; Kusano, Kengo Fukushima; Nagase, Satoshi; Tada, Takeshi; Murakami, Masato; Hata, Yoshiki; Morita, Hiroshi; Kohno, Kunihisa; Hina, Kazumasa; Ujihira, Tohru; Ohe, Tohru; Ito, Hiroshi

    2011-01-01

    Background: Both nifekalant hydrochloride (NIF), a selective IKr blocker, and intravenous amiodarone (AMD), a multi-channel (including IKr blocking) blocker, have been reported to be efficacious for refractory arrhythmias. However, the optimal use of those antiarrhythmic drugs for refractory arrhythmia with severe heart failure has not been established. Intravenous AMD might be effective for arrhythmias refractory to NIF in patients with severe heart failure. Here, we report that intravenous amiodarone was effective in the treatment of nifekalant-resistant in a group of arrhythmia patients with severe heart failure. Methods: Eleven severe heart failure patients who had received intravenous AMD for treatment of NIF-resistant arrhythmias were included in this study, and retrospective analysis was performed. Clinical efficacy (terminative and preventive effects on arrhythmia) of intravenous AMD was evaluated. Results: All cases were emergent cases and had depressed left ventricular ejection fraction (30 ± 13%). Clinical arrhythmias were ventricular fibrillation (VF) in four patients, ventricular tachycardia (VT) in six patients, and atrial fibrillation (AF) in one patient. NIF was administered to all patients by intravenous injection. After administration of NIF, VT/VF/AF was terminated in seven of the 10 patients, but a preventive effect was not obtained in any of the patients (NIF-resistance). Intravenous AMD (maintenance dose: 484 ± 166 mg/day) was effective both in termination (80%) and in prevention (80%) of VT/VF events in those patients. It was also effective in termination (80%) and prevention (60%) of AF events refractory to NIF. During continuous AMD administration, no significant adverse effects or proarrhythmic effects were observed in any of the patients. Five patients died within one month, but there was no arrhythmic deaths. Conclusions: Intravenous AMD was effective in NIF-resistant lethal arrhythmias and was relatively safe in emergent cases with

  3. 胺碘酮对急性心肌梗死并发室性心动过速的治疗分析%Clinical analysis on intravenous Amiodarone for continuous ventricular tachycardia in patients with acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    阎晋华; 齐守罡

    2012-01-01

      目的观察静脉注射胺碘酮治疗急性心肌梗死并发室性心动过速的疗效。方法将30例急性心肌梗死患者分为2组,每组15例,分别给予静脉注射利多卡因、胺碘酮治疗,观察2组临床疗效。结果胺碘酮组15例患者中,13例患者室性心动过速得到控制,对照组有8例患者室性心动过速得到控制,胺碘酮组有效率高于对照组。结论静脉注射胺碘酮治疗急性心肌梗死并发室性心动过速安全有效,可提高急性心肌梗死的抢救成功率。%  Objective To investigate the effect of amiodarone to continuous ventricular tachycardia in patients with acute myocardial infarction.Methods 30 cases of acute myocardial infarction patients were divided into 2 groups, 15 cases in each group, were given intravenous lidocaine, amiodarone treatment, observation of clinical curative effect of 2 sets.Results Among 15 cases in the observation group, 13 patients with ventricular tachycardia were under control, in the control group, 8 patients with ventricular tachycardia got controlled heartbeat, amiodarone group was higher than that of control group.Conclusion Intravenous amiodarone is more effective and safer than lidocaine in treating continuous ventricular tachycardia in patients with AMI.

  4. Clinical observation of amiodarone in treatment of pulmonary tachyarrhythmia complicated with respiratory failure%胺碘酮治疗呼吸衰竭并快速肺源性心律失常的临床观察

    Institute of Scientific and Technical Information of China (English)

    张淑立; 王毅

    2012-01-01

    Objective To observe the effect of amiodarone in the treatment of pulmonary tachyarrhythmia complicated with respiratory failure. Methods Multifocal atrial tachycardia, atrial fibrillation, atrial flutter and rapid ventricular arrhythmia were observed in 20 patients with acute exacerbation of chronic respiratory failure in our ICU receiving electrocardiography custody. Amiodarone was first injected intravenously followed by infusion pumps, and then orally. Results After amiodarone being administrated, all kinds of arrhythmia in the 19 patients were greatly reduced or disappeared, while only 1 patient with atrial flutter remained. Serious side effect was not detected during the therapy. Conclusions Amiodarone can be used in the patients with pulmonary tachyarrhythmia complicated with respiratory failure safely and effectively.%目的 观察胺碘酮对呼吸衰竭伴快速肺源性心律失常的疗效.方法 20例慢性呼吸衰竭病人,在监护病房持续心电监护,呼吸衰竭急性加重期出现紊乱性房性心律失常、房颤、房扑以及快速室性心律失常,予胺碘酮先静脉推注、静脉泵入,后序贯为口服.结果 用胺碘酮后19例病人各种心律失常明显减少或消失,1例房扑病人无转复.用药过程中未发现明显副作用.结论 胺碘酮对呼吸衰竭伴快速肺源性快速心律失常安全、有效.

  5. Discuss the Treatment of Amiodarone Combined With Metoprolol in Coronary Heart Disease in Elderly Patients%胺碘酮联合美托洛尔治疗老年冠心病

    Institute of Scientific and Technical Information of China (English)

    王勇; 李连鑫

    2015-01-01

    目的:探讨胺碘酮联合美托洛尔治疗老年冠心病的临床效果。方法将我院于2013年1月~2014年1月收治的156例老年冠心病患者列为研究对象,将其随机平分,观察组给予常规药物加胺碘酮联合美托洛尔口服;对照组给予常规药物加胺碘酮口服,6个月后对较分析其心绞痛、心律失常的改善情况。结果观察组室性心绞痛、心律失常的治疗有效率均明显大于对照组,差异显著(P<0.05),具有统计学意义。结论胺碘酮联合美托洛尔治疗老年冠心病效果比单用胺碘酮疗效好,差异显著。%ObjectiveDiscuss the clinical effect of Amiodarone combined with metoprolol in Coronary heart disease in elderly.Method Selected 156 cases of coronary heart disease in elderly admitted in our hospital, divided them into two groups. Observation group received conventional drugs and oral amiodarone combined with metoprolol, control group received conventional drugs and oral amiodarone, compared their improvement of angina and arrhythmias six months later.Results Observation group' room angina, arrhythmia treatment effective rate was signiifcantly greater than control group, the difference was signiifcant (P<0.05), with statistical significance.Conclusion Amiodarone combined with metoprolol have a better efifcacy in coronary heart disease in elderly patients..

  6. 利多卡因混合制剂湿敷治疗胺碘酮所致静脉炎%Lidocaine mixture wet compress therapy with amiodarone induced phlebitis

    Institute of Scientific and Technical Information of China (English)

    陈秀红

    2012-01-01

      Objective:To investigate the loss and treatment with amiodarone induced phlebitis method. Methods:Using 2%lidocaine, 75%ethanol, dexamethasone, vitamin B12 four kinds of drugs into the mixture wet compress therapy with amiodarone induced phlebitis. 60 patients with amiodarone induced phlebitis were randomly divided into the experimental group 32 cases, 28 cases of the control group. The experimental group used lidocaine mixture wet compress therapy, the control group with 75%alcohol wet compress therapy.Results:in the experimental group were significantly better than the control group, treatment effect.Conclusion:intravenous infusion of amiodarone induced peripheral phlebitis, application of lidocaine mixture wet compress remarkable curative effect, safety and Reliability, no adverse reaction.%  目的:探讨减轻及治疗胺碘酮所致静脉炎的方法。方法:采用2%利多卡因、75%乙醇、地塞米松、维生素B12等四种药物配伍成混合制剂湿敷治疗胺碘酮所致静脉炎。将60例盐酸胺碘酮所致静脉炎患者随机分为实验组32例,对照组28例。实验组用利多卡因混合制剂湿敷治疗,对照组用75%乙醇湿敷治疗。结果:实验组治疗效果显著优于对照组。结论:对于胺碘酮静脉滴注所致的外周静脉炎,应用利多卡因混合制剂湿敷疗效显著,安全可靠,无不良反应。

  7. 去乙基胺碘酮--容易被忽视的影响胺碘酮临床使用质量的因素%Desethylamiodarone-an Neglected Factor Affecting the Clinical Use of Amiodarone

    Institute of Scientific and Technical Information of China (English)

    谭蓉; 杨继红; 孙为民

    2014-01-01

    Drugs could affect the activity of CYP450 isoenzyme, which would influence drug safety and efficacy of the substrates of CYP450 isoenzyme. Desethylamiodarone, an in vivo metabolite of amiodarone, not only contributes to its therapeutic effect, at the same time, also plays great role in the side effects of amiodarone by influencing the CYP450 isoenzyme system. Therefore, neglecting the influence factors of desethylamiodarone will affect the safety and efficacy evaluation of amiodarone.%药物可通过CYP450同工酶途径影响其底物药物临床使用的安全性和有效性。胺碘酮体内代谢产物去乙基胺碘酮不仅对其治疗作用贡献较大,同时,对CYP450同工酶系的影响也较为广泛,作用也更强。因此,对胺碘酮临床使用的评估,忽视去乙基胺碘酮的影响因素,将影响胺碘酮临床使用的安全性和有效性。

  8. 胺碘酮治疗老年冠心病心律不齐的临床疗效观察%Clinical Efficacy of Amiodarone for Elderly Patients With Coronary Heart Disease Combined With Arrhythmia

    Institute of Scientific and Technical Information of China (English)

    张洪莲

    2016-01-01

    Objective To investigate the efficacy of amiodarone in the treatment of CHD combined with Arrhythmia for elderly patients.Methods We divided 80 patients into two groups,the control group used conventional therapy,and observation group used amiodarone treatment.Results The efficiency and incidence of adverse reactions of observation group were significantly better than control group(P<0.05).ConclusionThe effect of of amiodarone in the treatment of CHD combined with Arrhythmia is ideal.%目的:观察胺碘酮治疗老年冠心病心律不齐的效果。方法随机将我院收治的80例冠心病心律不齐老年患者平均分为两组,对照组行常规治疗,观察组行胺碘酮治疗。结果观察组总有效率、不良反应发生率等优于对照组(P<0.05)。结论胺碘酮治疗老年冠心病心律不齐效果理想。

  9. The Clinical Research of Amiodarone in the Treatment of Patients With Heart Failure Combined With Arrhythmia%胺碘酮治疗心衰合并心律失常患者的临床研究

    Institute of Scientific and Technical Information of China (English)

    许波

    2015-01-01

    目的:分析胺碘酮治疗心衰合并心律失常的效果。方法选取心衰合并心律失常患者42例,均给予胺碘酮治疗。结果42例患者总有效率95.2%,用药后心功能较用药前明显改善,无严重不良反应,仅2例胃肠道不适,经对症处理后好转。结论胺碘酮治疗心衰合并心律失常效果显著。%Objective To analysis the effect of amiodarone in the treatment of heart failure combined with arrhythmia. Methods 42 cases of patients with heart failure combined with arrhythmia were selected and all patients were given amiodarone treatment. Results After treatment,the total effective rate was 95.2%in 42 cases. The cardiac function of patients were significantly improved than before treatment. There was no serious adverse reaction. Only 2 patients had gastrointestinal discomfort and they were cured after symptomatic treatment. Conclusion The effect of amiodarone in treatment of heart failure combined with arrhythmia is significantly.

  10. 胺碘酮治疗心房颤动23例的临床体会%Clinical Experience of 23 Cases of Atrial Fibrillation Treated with Amiodarone

    Institute of Scientific and Technical Information of China (English)

    赵文霞; 刘成涛

    2015-01-01

    Objective To investigate the amiodarone treatment the clinical curative ef ect of new onset atrial fibril ation.Methods Our hospital from May 2011 to May 2015 were 23 cases of amiodarone treatment for atrial fibril ation patients as the research object. In the strong heart diuresis expansion blood vessel, etc on the basis of routine therapy and amiodarone treatment. Results 23 cases, 13 cases were markedly improved (57%), 7 cases (30%), ef ective invalid in 3 patients (22%), the total ef ective rate was 87%. The group were markedly improved in 1 case because of gastrointestinal symptoms and recur ence after the drug was stopped, take amiodarone after converting. Conclusion Amiodarone compared with other anti-arrhythmic drugs, can more safely and ef ectively control and prevent the occur ence of ventricular ar hythmias, atrial fibril ation and does not af ect heart function.%目的:探讨胺碘酮治疗新发心房纤颤的临床疗效。方法选取本院自2011年5月~2015年5月收治的23例胺碘酮治疗心房房颤动患者作为研究对象。在强心利尿扩血管等常规治疗的基础上采用胺碘酮治疗。结果23例中显效13例(57%),有效7例(30%),无效3例(22%),总有效率87%。其中的显效组中1例因出现胃肠道症状而自行停药后复发,续服胺碘酮后转复。结论胺碘酮与其他抗心律失常药相比,能更安全有效地防治房颤和预防室性心律失常的发生,且不影响心功能。

  11. 胺碘酮联合美托洛尔静注治疗快速心律失常的临床观察%Clinical observation of amiodarone combined with metoprolol injection in the treatment of rapid arrhythmia

    Institute of Scientific and Technical Information of China (English)

    戴志刚

    2014-01-01

    目的:探讨胺碘酮联合美托洛尔静脉注射治疗快速心律失常的临床疗效。方法:2009年1月-2013年8月收治快速心律失常患者60例,对照组给予胺碘酮治疗,研究组给予胺碘酮联合美托洛尔静注治疗。结果:研究组临床治疗效果明显优于对照组,两组差异具有统计学意义(P<0.05);研究组与对照组均未发生严重的不良反应,两组差异不具备统计学意义(P>0.05)。结论:研究胺碘酮联合美托洛尔静脉注射治疗快速心律失常的临床疗效好于单用胺碘酮治疗,安全性、有效性较高,值得在临床治疗中推广使用。%Objective:To investigate the clinical efficacy of amiodarone combined with metoprolol injection in the treatment of rapid arrhythmia.Methods:60 patients with rapid arrhythmia were selected from January 2009 to August 2013.The control group received the treatment of amiodarone,while the research group were treated with amiodarone combined with metoprolol injection therapy.Results:The clinical effect of the treatment group was better than that of the control group,and the difference was statistically significant between two groups(P0.05).Conclusion:The therapeutic effect of amiodarone combined with metoprolol injection is better than single amiodarone in the treatment of rapid arrhythmia.This treatment has high safety,and it also effective,so it worth to be popularized in clinical treatment.

  12. 胺碘酮在临床使用中如何预防静脉炎的发生%In clinical use of amiodarone on prevention of phlebitis

    Institute of Scientific and Technical Information of China (English)

    李小英

    2016-01-01

    objective:Study of infusion of amiodarone causing phlebitis main reason and prevention measures.Methods:the hospital treated 120 ca-ses of intravenous amiodarone in the treatment of arrhythmias in patients with clinical data analysis,detailed study amiodarone intravenous drip or phlebitis after peripheral intravenous injection causes and ways to prevent phlebitis.Results:78 cases of Ⅰ - Ⅱ stage nursing care of patients with phlebitis after 3-7d cured,12 cases of grade ⅲ local induration at the injection site for magnesium sulfate wet packing of 72h is not valid.Conclusion:proper use hydrochloric acid amiodarone and effective nursing intervention on prevention of phlebitis induced by amiodarone hydrochloride controlled and vesting has an extremely important role.%目的:研究输注胺碘酮导致静脉炎发生的主要原因及预防措施。方法:对我院收治的120例静脉应用胺碘酮治疗心律失常患者的临床资料进行分析,详细探讨盐酸胺碘酮静脉滴注或外周静脉推注后致静脉炎的原因和预防静脉炎发生的方法。结果:78例Ⅰ-Ⅱ级静脉炎患者经过3-7d 的护理治疗痊愈,12例Ⅲ级的注射部位局部硬结给予硫酸镁湿敷72h 无效。结论:正确合理的使用盐酸胺碘酮和积极有效的护理措施对盐酸胺碘酮所致静脉炎的预防控制及转归有极其重要的作用。

  13. 盐酸胺碘酮治疗儿童难治性持续性心动过速%Treatment of intractable incessant tachycardia in children with Amiodarone

    Institute of Scientific and Technical Information of China (English)

    李筠; 周爱卿; 杨健萍; 朱敏; 张海燕

    2009-01-01

    目的 提高对盐酸胺碘酮治疗儿童难治性持续性心动过速的认识.方法 对2006年1月-2007年12月80例应用盐酸胺碘酮治疗的难治性心动过速患儿的资料进行总结.其中男52例,女38例;年龄1个月~14岁(平均2.5岁).结果 盐酸胺碘酮具有良好的控制心室率的作用,总有效率为90%左右;同时它有不同程度转复窦性心律的作用,房性心动过速67%,阵发性室上性心动过速92%,交界逸搏性心动过速89%、室性心动过速56%;小剂量β受体阻滞剂具有协同盐酸胺碘酮抗心动过速的作用.治疗过程中7例出现低血压,4例出现心动过缓.结论 Ⅲ类抗心律失常药盐酸胺碘酮具有广泛的抗心律失常作用,它对治疗血流动力学相对稳定的小儿难治性持续性心动过速是安全有效的.%Objective To improve the understanding of Amiodarone in the treatment of intractable incessant tachycardia in children. Methods Data of 80 patients with intractable incessant tachycardia treated by Amiodarone were summarized. Among them 52 were male, 38 were female, and average age was 2.5 years old. Results Amiodarone reduced heart rate effectively, with about 90% effective. Simultaneously, it could convert tachycardia into sinus rhythm and succeeded 67% in atrial tachycardia, 92% in paroxysmal supraventricular tachycardia, 89% in junctional ectopic tachycardia, 56% in ventricular tachycardia respectively. Use of small dosage of β-receptor blocker together with Amiodarone showed synergy. Hypotension and bradycardia are the main side effects. Conclusions Too rapid and sustained tachycardia can lead, to hemodynamic disorders and cause heart failure, it requires urgent and adequate treatment. Amiodarone can be used to treat different kinds of intractable incessant tachycardia, and is safe and effective in patients with relatively stable hemodynamis.

  14. 胺碘酮联合肉毒素A治疗面肌痉挛的临床疗效观察%Clinical efficacy of amiodarone combined with botulinum toxin A in hemifacial spasm

    Institute of Scientific and Technical Information of China (English)

    冯建钦; 张鹏飞

    2016-01-01

    Objective To observe the clinical efficacy of amiodarone combined with botulinum toxin A in the treatment of hemifacial spasm.Methods Sixty-five patients with hemifacial spasm were randomly divided into amiodarone(n=33)and control(n=32)group.In the amiodarone group,oral amiodarone and local intramuscular injection of botulinum toxin A were administered.In the control group,only local intramuscular injections of botulinum toxin A was performed.The clinical efficacy was evaluated according to the Cohen rating on the 1st,4th,16th,32nd week.Results The Cohen rating in amiodarone group was significantly better than control group on 4th,16th,32nd week(P<0.05).The complete remission in amiodarone group was significantly higher than control group on 4th,16th,32nd week(75.8% vs.43.8%,81.8% vs.12.5%,81.8% vs.6.2%,all P <0.05).The total effective rate in amiodarone group was significantly higher than control group on 16th,32nd week(97.0%vs.75.0%,93.9% vs.65.6%,all P<0.05). There was one case of recurrence in control group on 4th week,while there was no recurrence in amiodarone group.The recurrence in control group on 16th,32nd week was higher than amiodarone group(56.3 % vs.0.0 %,65.6% vs.12.1%,all P<0.05).There was no signigicant difference in adverse reactions between amiodarone group and control group(24.2%vs.18.8%).Conclusion Combination of amiodarone and botulinum toxin A is more effective than botulinum toxin A alone in the treatment of hemifacial spasm.%目的:探讨胺碘酮( amiodarone)与肉毒素A( botulinum toxin A)联合治疗面肌痉挛的临床疗效。方法65例面肌痉挛患者,随机分为胺碘酮组(33例,胺碘酮联合肉毒素A治疗)和对照组(32例,单纯肉毒素A治疗)。2组治疗前及治疗1、4、16、32周时依据Cohen痉挛强度分级标准进行功能分级及疗效判定。结果治疗4、16、32周时,胺碘酮组Cohen分级明显优于对照组( P<0.05)。治疗4、16和32周时,胺碘酮组的完

  15. 静脉用胺碘酮致急性严重肝损害七例分析%Clinical analysis of seven cases of acute severe hepatic injury induced by intravenous infusion with amiodarone

    Institute of Scientific and Technical Information of China (English)

    衣桂燕; 张彩云; 张萱; 彦青

    2013-01-01

    目的 探讨短时(12 h内)静脉滴注胺碘酮致急性严重肝功能损害的临床特点.方法 收集我院2000年1月至2011年12月12 h内静脉用胺碘酮患者908例的临床表现进行回顾性分析.结果 908例患者中发生急性严重肝损害者7例,发生率为0.8%,病毒性肝炎指标均未见异常.静脉使用胺碘酮时间为1.0~10.0 h,平均使用时间(6±4)h;胺碘酮使用总剂量为210± 1150 mg,平均(733±312)mg.静脉使用胺碘酮前有5例患者肝功能正常,2例轻度升高,ALT为15 ~ 78 U/L,平均(39±21) U/L,AST为22~ 65 U/L,平均(37±15)U/L.用胺碘酮后次日ALT为820~ 4845 U/L,平均(2604±1295) U/L,AST为758~3962U/L,平均(2069±1091) U/L.肝功能恢复时间为7~15 d,平均(10±3)d.肝功能恢复后继续随访至少3个月,未再出现肝损害.结论 短时静脉滴注胺碘酮可导致急性严重肝损害,其发生较早,及时停用胺碘酮后可较快恢复.在静脉用胺碘酮过程中应监测肝功能,尽量避免或及时治疗肝损害.%Objective To analyze the clinical feature and possible mechanism of acute severe hepatic injury induced by intravenous infusion with amiodarone within 12 hours.Methods The clinical diagnoses,medication and characteristics of hepatic injury induced by intravenous infusion with amiodarone within 12 hours were analyzed in 908 cases from 2000 to 2011.Results There were 7 cases of acute severe hepatic injury in 908 cases of intravenous infusion with amiodarone(the rate of 0.8%).The average time of intravenous infusion with amiodarone was (6 ± 4) h.The average accumulated dosage of amiodarone was (733 ± 312) mg,ranging from 210 mg to 1150 mg.The peak of alanine aminotransferase(ALT) was (2604 ± 1295) U/L,ranging from 820 U/L to 4845 U/L,and the aspartate aminotransferase (AST) was (2069 ± 1091) U/L,ranging from 758 U/L to 3962 U/L.The liver enzyme levels returned to baseline values within (10 ± 3)d after hepatoprotection therapy,ranging from 7 d to

  16. Methanolic extract of Moringa oleifera leaf and low doses of gamma radiation alleviated amiodarone-induced lung toxicity in albino rats

    Directory of Open Access Journals (Sweden)

    Hasan Hesham F.

    2016-01-01

    Full Text Available This study aimed to evaluate the effects of methanolic extract of Moringa oleifera (MO and/or low doses of gamma radiation (LDR on amiodarone (AMD-induced lung toxicity in rats. AMD administered to female albino rats (100 mg/kg body weight for 10 consecutive days. Rats received methanolic extract of MO (250 mg/kg bwt for 15 successive days and/or were exposed to whole body LDR (0.25Gy on the 1st and 10th days, up to a total dose of 0.5Gy. MO administration induced a significant decrease in serum tumor necrosis factor-alpha (TNF-α and transforming growth factor-beta (TGF-β levels as well as lactate dehydrogenase (LDH activity. Also, the content of malondialdehyde (MDA and hydroxyproline (HYP was significantly decreased in lung tissue. Furthermore, MO significantly increased reduced glutathione (GSH content in lung tissue as compared with AMD. The histopathological investigation of lung tissue revealed the appearance of interstitial pneumonia in rats treated with AMD. The oral administration of MO and/or exposure to LDR reversed the biochemical and histopathological alterations induced by AMD. It can be posited that MO and LDR might have a considerable role in the prevention of lung toxicity induced by AMD.

  17. Comparison of the Frequency-dependent Effects of Amiodarone on Ventricular Electrophysiology in Congestive Heart Failure Canine Models and Normal Dogs

    Institute of Scientific and Technical Information of China (English)

    Zhou Shuxian; Zhang Yuling; Lei Juan; Wu Wei; Zhang Xuming

    2007-01-01

    Objectives To compare the frequency-dependent effects of amiodarone (Ami) on ventricular electrophysiology in right ventricular rapid pacing-induced congestive heart failure (CHF) canine models.Methods Thirty-two dogs were randomized into four groups: the control group, the Ami group in which the normal dogs were given Ami orally 300 mg a day for 4~5 weeks, the CHF group induced by right ventricular rapid pacing ( 240 pulses. min -1 for 4 ~ 5 weeks), and the group of CHF dogs fed with Ami orally 300 mg a day for 4 ~ 5 weeks. The techniques of electrical stimulation and monophasic action potential (MAP) recording were used in the electrophysiology studies. Results The effects of Ami on ventricular MAP duration(MAPD90) and effective refractory period (VERP)were not frequency-dependent in CHF dogs. There was also no frequency-dependent effect on the increase in the ratio of VERP to MAPD90 (VERP/MAPD90). The prolongation of ventricular conduction time was frequencydependent. Conclusions The frequency-dependent effects of Ami on ventricular electrophysiology in CHF dogs were similar to that in normal dogs.

  18. A transcriptomics-based hepatotoxicity comparison between the zebrafish embryo and established human and rodent in vitro and in vivo models using cyclosporine A, amiodarone and acetaminophen.

    Science.gov (United States)

    Driessen, Marja; Vitins, Alexa P; Pennings, Jeroen L A; Kienhuis, Anne S; Water, Bob van de; van der Ven, Leo T M

    2015-01-22

    The zebrafish embryo (ZFE) is a promising alternative, non-rodent model in toxicology, which has an advantage over the traditionally used models as it contains complete biological complexity and provides a medium to high-throughput setting. Here, we assess how the ZFE compares to the traditionally used models for liver toxicity testing, i.e., in vivo mouse and rat liver, in vitro mouse and rat hepatocytes, and primary human hepatocytes. For this comparison, we analyzed gene expression changes induced by three model compounds for cholestasis, steatosis, and necrosis. The three compounds, cyclosporine A, amiodarone, and acetaminophen, were chosen because of their relevance to human toxicity and these compounds displayed hepatotoxic-specific changes in the mouse in vivo data. Compound induced expression changes in the ZFE model shared similarity with both in vivo and in vitro. Comparison on single gene level revealed the presence of model specific changes and no clear concordance across models. However, concordance was identified on the pathway level. Specifically, the pathway "regulation of metabolism - bile acids regulation of glucose and lipid metabolism via FXR" was affected across all models and compounds. In conclusion, our study with three hepatotoxic model compounds shows that the ZFE model is at least as comparable to traditional models in identifying hepatotoxic activity and has the potential for use as a pre-screen to determine the hepatotoxic potential of compounds.

  19. 厄贝沙坦联合胺碘酮对阵发性房颤复律后维持窦性心律的效果%Maintenance of sinus rhythm by lrbesartan combined with amiodarone after cardioversion in patients with paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    闫晓英; 林小凤

    2012-01-01

    目的:观察厄贝沙坦联合胺碘酮对阵发性心房颤动复律后维持窦性心律的临床效果及其对左心房内径的影响.方法:选择阵发性心房颤动患者89例,分为胺碘酮治疗组(44例,单纯服用胺碘酮),联合治疗组(45例,服用胺碘酮及厄贝沙坦),随访12个月,观察两组患者治疗前后窦性心律维持率,左房内径的变化,并进行比较分析.结果:治疗12个月后,与胺碘酮组比较,联合治疗组窦性心律维持率明显提高(64.3%比81.4%),左房内径明显减小[ (40.12±10.6) mm比(34.10±10.11)mm],P均<0.05.结论:厄贝沙坦联合胺碘酮对阵发性心房颤动复律后维持窦性心律的作用明显优于单用胺碘酮,且明显抑制左房扩大,无明显不良反应.%Objective: To study maintenance of sinus rhythm by irbesartan combined with amiodarone after cardioversion in patients with paroxysmal atrial fibrillation (PAF) and its influence on left atrial diameter. Methods: A total of 89 PAF patients were divided into amiodarone treatment group (n = 44, only received amiodarone) and combination therapy group (n = 45. received amiodarone and irbesartan). All patients were followed up for 12 months. Changes of maintenance rate of sinus rhythm and left atrial diameter before and after treatment were observed and compared between the two groups. Results: Compared with amiodarone group after 12 months, there was significant increase in maintenance rate of sinus rhythm (64.3% vs. 81.4%) and significant decrease in left atrial diameter [ (40.12 ± 10.6) mm vs. (34.10 ± 10.11) mm] in combination therapy group, P<0.05 both. Conclusion: Maintenance of sinus rhythm by irbesartan combined with amiodarone after cardioversion in patients with paroxysmal atrial fibrillation is significantly better than that of single amiodarone treatment, and irbesartan combined with amiodarone significantly inhibits left atrial enlargement without significant adverse reactions.

  20. 胺碘酮治疗老年冠心病心律不齐的临床研究%Clinical Research on Amiodarone for the Treatment of Senile Coronary Heart Disease and Arrhythmia

    Institute of Scientific and Technical Information of China (English)

    程红伟

    2015-01-01

    目的:研究分析胺碘酮应用于老年冠心病心律不齐患者的临床治疗中所取得的效果。方法选择本院76例冠心病心律不齐老年患者,选择胺碘酮以及普罗帕酮对患者实施分组治疗,对比两组患者的临床疗效。结果采用胺碘酮的观察组总治疗有效率为95.6%,明显优于对照组(采用普罗帕酮)的76.5%,两组患者临床治疗有效率比较存在明显差异,具有统计学意义(P<0.05);观察组患者的不良反应发生率明显低于对照组患者(P<0.05)。结论针对老年冠心病心律不齐患者,采用胺碘酮进行治疗能够取得明显疗效,建议推广应用。%Objective To study the clinical application of amiodarone treatment in elderly patients with coronary heart disease arrhythmia in multi effect has been achieved. Methods 76 cases of elderly patients with coronary heart disease arrhythmia amiodarone and propafenone in our hospital, choice of implementation of grouping treatment of patients, the clinical efficacy were compared between two groups. Results The effective rate of observation group with amiodarone total treatment was 95.6%, significantly better than the control group (using propafenone) 76.5% (P<0.05). Conclusion In elderly coronary heart disease patients with amiodarone for the treatment of arrhythmia, can obtain obvious effect, application suggestions.

  1. Clinical Experience of Amiodarone Combined with Wenxinkeli in Treating New Atrial Fibrillation%胺碘酮联合稳心颗粒治疗新发心房纤颤的临床体会

    Institute of Scientific and Technical Information of China (English)

    李晓渝

    2014-01-01

    Objective To analyze the clinical efficacy of amiodarone combined with Wenxinkeli in treating new atrial fibrillation. Methods A total of 46 patients with new atrial fibrillation in our hospital from April 2O1O to March 2O14 were se-lected,and then they were divided into control group(23 cases)and observation group(23 cases). The control group was treated with amiodarone combined with verapamil,the observation group was treated with amiodarone combined with Wenxinkeli. Clinical efficacy of two groups were compared. Results The total effective rate of the observation group was higher than that of control group,the difference was statistically significant( PAmiodarone combined with Wenxinkeli has significant clinical efficacy in treating new atrial fibrillation,which,can improve patients'physical fitness and quality of life.%目的:探讨胺碘酮联合稳心颗粒治疗新发心房纤颤的临床疗效。方法选取2O1O年4月-2O14年3月于本院接受治疗的新发心房纤颤患者46例作为研究对象。将其分成对照组及观察组,各23例。对照组给予盐酸胺碘酮联合维拉帕米治疗;观察组给予胺碘酮及稳心颗粒的联合治疗。比较两组患者的临床疗效。结果观察组临床治疗的总有效率高于对照组,差异有统计学意义( P

  2. Efficacy and safety of small dose of amiodarone in treatment of arrhythmia%小剂量胺碘酮在心律失常治疗中的疗效及安全性

    Institute of Scientific and Technical Information of China (English)

    冯杰

    2015-01-01

    目的:探讨小剂量胺碘酮在心律失常治疗中的疗效和安全性。方法将该院2013年10月—2014年9月医治的54例心律失常患者随机分为常规组与观察组。两组患者在常规治疗基础上分别使用普鲁帕酮与小剂量的胺碘酮进行治疗。比较两组患者不同药物治疗后总有效率和不良反应情况。结果在治疗后,观察组、对照组总有效率分别为88.89%(24/27)、59.26%(16/27),观察组疗效优于对照组(P<0.05);观察组不良反应情况明显低于对照组(P<0.05)。结论使用小剂量胺碘酮治疗室性心律失常,治疗效果明显,安全、有效,值得推广。%Objective To investigate the efficacy and safety of small dose of amiodarone in treatment of arrhythmia. Methods 54 patients with arrhythmia were divided into control group and observation group randomly. Two groups of patients were given propafenone and small dose of amiodarone on the basis of conventional treatment. the clinical efficacy and adverse reactions of propafenone situation with a small dose of amiodarone. Results after treatment, the observation group, the control group total effectiveness respectively is 88.89% (24/27), 59.26% (16/27), the effect of observation group is better than control group (P <0.05); the adverse reactions observed was significantly lower than control group (P < 0.05). Conclusion the use of small dose amiodarone in therapeutic room, arrhythmia, obvious curative effect, safety, effective, worthy of promotion.

  3. Application Effect of Amiodarone on Patients With Congestive Heart Failure and Arrhythmias%心力衰竭并心律失常患者胺碘酮的应用效果观察

    Institute of Scientific and Technical Information of China (English)

    雷娜

    2015-01-01

    目的 研究探讨对心力衰竭合并心律失常患者应用胺碘酮的临床疗效.方法 选择我院心内科自2013年1月~2015年1月收治的80例心力衰竭合并心律失常的患者作为研究对象,所有患者均予以胺碘酮进行治疗,对其临床效果进行回顾性分析.结果 经胺碘酮治疗研究患者的总有效率为90.0%,不良反应发生率为8.7%,且心脏功能较治疗前改善(P<0.05),差异具有统计学意义.结论 在临床中应用胺碘酮治疗心力衰竭合并心律失常患者具有有效率高及不良反应率低等优点,并且可显著改善患者的心脏功能.%Objective To investigate the clinical efifcacy in patients with heart failure, arrhythmia amiodarone. Methods Hospital Cardiology from 80 cases of patients with heart failure with cardiac arrhythmia from January 2013 to January 2015 admitted to the study, all patients were to be treated with amiodarone were retrospectively analyzed clinical Results . Results Amiodarone therapy in patients with total effective rate was 90.0% incidence of adverse reactions was 8.7%, and heart function was significantly improved compared with before treatment (P < 0.05), a statistically significant difference. Conclusion The clinical application of amiodarone treatment of heart arrhythmia the patient has high efficiency and low adverse reaction rate, etc., and can significantly improve the patient's cardiac function.

  4. 普罗帕酮和胺碘酮治疗阵发性室上性心动过速的临床分析%Clinical analysis of propafenone and amiodarone in the treatment of paroxysmal suproventricular tachycardia

    Institute of Scientific and Technical Information of China (English)

    税小波; 高建军; 邹玉刚; 税朝东; 税朝莲

    2015-01-01

    目的:探讨分别运用普罗帕酮和胺碘酮治疗阵发性室上性心动过速的临床效果。方法:2010年11月-2014年7月收治阵发性室上性心动过速患者64例,随机分为观察组和对照组,各32例。对照组和观察组分别采用普罗帕酮和胺碘酮进行治疗,比较两组的治疗效果。结果:观察组转复时间明显长于对照组,不良反应率明显低于对照组,组间比较差异均具有统计学意义(P<0.05)。观察组临床总有效率(87.50%)同对照组(90.63%)相比差异无统计学意义(P>0.05)。结论:在阵发性室上性心动过速的临床治疗中,普罗帕酮和胺碘酮均有良好的治疗效果,但普罗帕酮起效更快,胺碘酮的安全性更高。%Objective:To explore the clinical effect of propafenone and amiodarone used respectively in the treatment of paroxysmal suproventricular tachycardia.Methods: 64 cases of paroxysmal suproventricular tachycardia were selected from November 2010 to July 2014.They were divided into the observation group and the control group with 32 cases in each.The control group and the observation group were treated with propafenone and amiodarone respectively.We compared the therapeutic effect of the two groups.Results:The converting time of the observation group was obviously higher than that of the control group,and the adverse reaction rate was significantly lower than that of the control group.The differences between the two groups were statistically significant(P0.05).Conclusion:Propafenone and amiodarone in the treatment of paroxysmal suproventricular tachycardia had good treatment effect,but amiodarone had faster effect and higher safety.

  5. 胺碘酮致飞行员甲状腺功能异常二例并文献复习%Two cases of pilots with amiodarone-induced thyroid dysfunction and literature review

    Institute of Scientific and Technical Information of China (English)

    杨彩哲; 于亚静; 徐先荣; 郑军; 刘红巾; 付兆君; 崔丽; 关小宏; 王建昌

    2015-01-01

    目的 总结飞行人员因心律失常服用胺碘酮而引起甲状腺功能异常的临床特征、诊断、分型、治疗及预后,为以后类似疾病的诊治及航空医学鉴定提供经验. 方法 通过回顾性分析2例飞行员因心房颤动服用胺碘酮而引起甲状腺功能异常的过程,结合文献复习,总结胺碘酮诱发甲状腺功能异常的临床特征、诊断、分型、治疗及转归. 结果 例1飞行员在服用胺碘酮7个月后停药,停药1个月后出现“低T3综合征”.停药2年后再次服用胺碘酮,1个月后出现碘诱导2型甲状腺毒症;停用胺碘酮3个月,甲状腺功能恢复正常.例2飞行员间断服用胺碘酮9年后诊断为碘诱导甲状腺功能减退,停用胺碘酮,并口服左甲状腺素钠75 μg,1次/d,补充治疗,5个月后甲状腺功能恢复正常.应用左甲状腺素钠2年后停药,甲状腺功能完全恢复正常.两例飞行员鉴定结论为暂时飞行不合格. 结论 飞行人员应用胺碘酮前,应完善相关检查.在治疗过程中、停药后6~9月甚至更长时间内,应定期检查甲状腺功能.对服用胺碘酮的飞行员要定期随访,尤其对既往存在甲状腺疾病和存在危险因素者.胺碘酮所引起的甲状腺功能异常有可能恢复正常.鉴定结论要结合心律失常和甲状腺功能情况综合判断.%Objective To summarize the clinic feature,diagnosis,treatment,and prognosis of amiodarone-induced thyroid dysfunction in the pilots with arrhythmia and gather the experiences on treatment and aviation medical assessment.Methods Retrospective analysis was done on the process of 2 cases with amiodarone induced abnormal thyroid function in pilots with atrial fibrillation and on the literatures to summary the clinic feature,diagnosis,treatment,and prognosis were reviewed.Results Case 1 had taken amiodarone for 7 months and low T3 syndrome was diagnosed 1 month later.Two years later,he took amiodarone again for 1 month and was

  6. Comparison of amiodarone plus irbesartan regimen versus amiodarone alone on maintaining sinus rhythm in rheumatic heart disease patients with persistent atrial fibrillation post valve replacement and cordioversion%厄贝沙坦与胺碘酮联合对风湿性心脏病持续性心房颤动转复患者的窦性心律维持作用

    Institute of Scientific and Technical Information of China (English)

    丁平; 李莉; 张浩; 陈良金; 邓学军; 袁义强

    2009-01-01

    Objective To compare the efficacy of combined amiodamne and irbesartan use versus amiodarone alone on maintaining sinus rhythm in rheumatic heart disease patients with persistent atrial fibrillation(AF)post valve replacement and cardioversion.nethods Patients were randomly divided into amiodarone group(A,n=31)and amiodarone plus irbesartan group(AI,n=32)and all patients received Warfarin(INR 2.0-3.0).For patients in group A,intravenous amiodarone(600 mg/d)was applied for 10 days and oral amiodarone(200 mg,b.I.d.)was given on the 7th day for 3 days.For patients in group AI,irhesartan(150 mg/d)was added on top of amiodarone at the study begin.Electric cardioversion was performed for patients still with AF on day 10.Amiodarone(200 mg,b.I.d.for 1 week,then 200 mg,q.d.till study end) with or without irbesartan(150 me/d)was continued thereafter.Patients were followed up for 12 months after sinus rhythm recovery.The primary end points are first recurrence of symptomatic and asymptomatic AF.Results Twelve months post therapy,number of patients on sinus rhythm was significantly higher(68.7%vs.41.9%,P<0.05)and left atrium diameter(LAD)was significantly smaller[(48.6±4.6)mm vs.(51.5±4.2)mm,P<0.05]in group AI than those in group A.LAD(OR 1.242)and use of irbesartan(OR 0.226)are associated with the AF recurrence.Conclusion Combined amiodarone and irbesartan use is superior to amiodarone alone for maintaining sinus rhythm in rheumatic heart disease patients with persistent AF post valve replacement and cardioversion.%目的 研究风湿性心脏病持续性心房颤动(房颤)应用厄贝沙坦联合胺碘酮的窦性心律(窦律)维持作用及复发的危险因素.方法 选择住院准备房颤复律且符合入选标准风湿性心脏病(风心病)瓣膜置换术后持续性房颤患者63例.随机分为对照组(31例)和试验组(32例).对照组给予胺碘酮,试验组用胺碘酮+厄贝沙坦.入选患者转复为窦律后即为试验起始

  7. Combinatorial release of dexamethasone and amiodarone from a nano-structured parylene-C film to reduce perioperative inflammation and atrial fibrillation

    Science.gov (United States)

    Robinson, Erik; Kaushal, Sunjay; Alaboson, Justice; Sharma, Sudhish; Belagodu, Amogh; Watkins, Claire; Walker, Brandon; Webster, Gregory; McCarthy, Patrick; Ho, Dean

    2016-02-01

    Suppressing perioperative inflammation and post-operative atrial fibrillation requires effective drug delivery platforms (DDP). Localized anti-inflammatory and anti-arrhythmic agent release may be more effective than intravenous treatment to improve patient outcomes. This study utilized a dexamethasone (DEX) and amiodarone (AMIO)-loaded Parylene-C (PPX) nano-structured film to inhibit inflammation and atrial fibrillation. The PPX film was tested in an established pericardial adhesion rabbit model. Following sternotomy, the anterior pericardium was resected and the epicardium was abraded. Rabbits were randomly assigned to five treatment groups: control, oxidized PPX (PPX-Oxd), PPX-Oxd infused with DEX (PPX-Oxd[DEX]), native PPX (PPX), and PPX infused with DEX and AMIO (PPX[AMIO, DEX]). 4 weeks post-sternotomy, pericardial adhesions were evaluated for gross adhesions using a 4-point grading system and histological evaluation for epicardial neotissue fibrosis (NTF). Atrial fibrillation duration and time per induction were measured. The PPX[AMIO, DEX] group had a significant reduction in mean adhesion score compared with the control group (control 2.75 +/- 0.42 vs. PPX[AMIO, DEX] 0.25 +/- 0.42, P films compared to control (9.5 +/- 6.8 s vs. 187.6 +/- 174.7 s, p = 0.003). Time of atrial fibrillation per successful induction decreased among PPX[AMIO, DEX] films compared to control (2.8 +/- 1.2 s vs. 103.2 +/- 178 s, p = 0.004). DEX/AMIO-loaded PPX films are associated with reduced perioperative inflammation and a diminished atrial fibrillation duration. Epicardial application of AMIO, DEX films is a promising strategy to prevent post-operative cardiac complications.Suppressing perioperative inflammation and post-operative atrial fibrillation requires effective drug delivery platforms (DDP). Localized anti-inflammatory and anti-arrhythmic agent release may be more effective than intravenous treatment to improve patient outcomes. This study utilized a dexamethasone (DEX

  8. Phospholipidosis in rats treated with amiodarone: serum biochemistry and whole genome micro-array analysis supporting the lipid traffic jam hypothesis and the subsequent rise of the biomarker BMP.

    Science.gov (United States)

    Mesens, Natalie; Desmidt, Miek; Verheyen, Geert R; Starckx, Sofie; Damsch, Siegrid; De Vries, Ronald; Verhemeldonck, Marc; Van Gompel, Jacky; Lampo, Ann; Lammens, Lieve

    2012-04-01

    To provide mechanistic insight in the induction of phospholipidosis and the appearance of the proposed biomarker di-docosahexaenoyl (C22:6)-bis(monoacylglycerol) phosphate (BMP), rats were treated with 150 mg/kg amiodarone for 12 consecutive days and analyzed at three different time points (day 4, 9, and 12). Biochemical analysis of the serum revealed a significant increase in cholesterol and phospholipids at the three time points. Bio-analysis on the serum and urine detected a time-dependent increase in BMP, as high as 10-fold compared to vehicle-treated animals on day 12. Paralleling these increases, micro-array analysis on the liver of treated rats identified cholesterol biosynthesis and glycerophospholipid metabolism as highly modulated pathways. This modulation indicates that during phospholipidosis-induction interactions take place between the cationic amphiphilic drug and phospholipids at the level of BMP-rich internal membranes of endosomes, impeding cholesterol sorting and leading to an accumulation of internal membranes, converting into multilamellar bodies. This process shows analogy to Niemann-Pick disease type C (NPC). Whereas the NPC-induced lipid traffic jam is situated at the cholesterol sorting proteins NPC1 and NPC2, the amiodarone-induced traffic jam is thought to be located at the BMP level, demonstrating its role in the mechanism of phospholipidosis-induction and its significance for use as a biomarker.

  9. Die zukünftige Rolle von Amiodaron bei Hochrisikopatienten. Aktuelle Schlußfolgerungen aus den Ergebnissen früherer und jüngst veröffentlichter Studien zur Problematik des plötzlichen Herztodes.

    Directory of Open Access Journals (Sweden)

    Pürerfellner H

    2004-01-01

    Full Text Available Der plötzliche Herztod (PHT stellt heute nach wie vor ein epidemiologisch bedeutendes und medizinisch ungelöstes Problem in der westlichen Welt dar. Die häufigsten Grunderkrankungen finden sich dabei in der ischämischen und nichtischämischen Kardiomyopathie. Hochrisikopatienten sind im besonderen durch eine eingeschränkte Pumpfunktion und die symptomatische Herzinsuffizienz charakterisiert. Noch vor wenigen Jahren war der Nutzen implantierbarer Geräte (implantierbarer Kardioverter-Defibrillator, ICD zur Behandlung von lebensbedrohlichen ventrikulären Arrhythmien im Vergleich zur Standardtherapie mit antiarrhythmisch wirksamen Medikamenten (im besonderen mit Amiodaron unklar. Der folgende Artikel gibt einen Überblick über die Entwicklung der Rhythmustherapie in der Primär- und Sekundärprophylaxe zur Verhinderung des PHT anhand von Ergebnissen der in den letzten 15 Jahren erschienen großen randomisierten, kontrollierten Studien. Zusätzlich wird der zukünftige Stellenwert von Amiodaron bei Hochrisikopatienten beleuchtet.

  10. The treatment effect and relapse prevention of cardioversion of atrial fibrillation with Wenxin granules and amiodarone%稳心颗粒与胺碘酮联合转复心房颤动及预防复发的疗效观察

    Institute of Scientific and Technical Information of China (English)

    张玉榕; 史继利; 贾荣波

    2011-01-01

    目的 观察稳心颗粒联合胺碘酮转复及预防心房颤动复发的疗效.方法 选择慢性心房颤动患者共60例,随机分为稳心颗粒联合胺碘酮组(A组)及单纯胺碘酮组(B组)各30例,所有患者入院后静脉应用胺碘酮24 h同时口服胺碘酮由600 mg/d逐渐减量至200 mg/d维持,另外A组同时给予口服步长稳心颗粒(9 g,3次/d)共4周.观察2组患者4周内转复窦性心律情况及半年内复发情况.结果 第2、3、4周内累积转复窦性心律例数A组显著高于B组(分别是73.3%与43.3%,x2=5.55:83.3%与63.3%,x2=3.07;90.0%与66.7%,x2=4.81;P均<0.05),半年内复发B组有高于A组的趋势.结论 稳心颗粒联合应用胺碘酮转复心房颤动疗效优于单纯应用胺碘酮,并且半年内复发率可能更低.%Objective To observe the treatment effect and relapse prevention of cardioversion of atrial fibrillation with Wenxin granules and amiodarone. Methods Sixty patients of chronic atrial fibrillation were divided randomly into treatment of Wenxin granules and amiodarone group (group A) and treatment of simple amiodarone gorup(group B),Thirty cases in each group. All cases were treated with amiodarone by intravenous drip along with oral amiodarone. Thirty cases in group A were treated with Wenxin granules (9 grams,per day) additionally for 4 weeks. Results Patients in group A resumed normal sinus rhythm significantly higher than that in group B. The increasing relapse tendency of atrial fibrillation was higher in group B within 6 months. Conclusion Drug combination with Wenxin granules and amiodarone has better effect than simple amiodarone in the relapse prevention of cardioversion of atrial fibrillation.

  11. 胺碘酮联合β受体阻断药治疗冠脉搭桥术后早期新发房颤%The Effect of Amiodarone and β Blockers on 102 Cases of the Early Arrhythmia after Coronary Artery Bypass Grafting

    Institute of Scientific and Technical Information of China (English)

    陈雪; 唐泓波; 胡大清; 曾宁

    2012-01-01

    [目的]:观察胺碘酮联合β受体阻断药治疗冠状动脉搭桥(CABG)术后早期新发房颤(AF)的效果和不良反应.[方法]:102例CABG术后早期发生快室率房颤患者随机分为对照组48例和治疗组54例,对照组给予胺碘酮注射液静脉泵入,治疗组在对照组基础上加用艾司洛尔注射液或美托洛尔注射液.观察心电监护、心电图及24h动态心电图心率变化,比较两组1周内转复为窦性心律的有效率和不良反应发生率.[结果]:两组有效率分别为79.1%和94.4%,差异有统计学意义(P<0.05).两组不良反应发生率比较,差异无统计学意义(P>0.05).[结论]:胺碘酮联合艾司洛尔或美托洛尔转复CABG术后早期新发房颤效果优于单用胺碘酮.不良反应少,安全性高,值得临床推荐.%Objective:To investigate the effect and side effect of Amiodarone and β blockers on the arrhythmia after Coronary artery bypass grafting( CABG). Methods; 102 AF patients after CABG were randomly divided into two groups; Amiodarone group and Amiodarone and β blockers combined group. There were 48 cases with Amiodarone alone, 54 cases with Amiodarone and β blockers. The heart rale of ambulatory Holter monitor,electrocardiogram ( ECG) and dynamic electrocardiogram were recorded. The effective rate and complication rate of the two groups whose heart rate turned to sinus rhythm in one week were recorded. Results:The effective rate of combined group was superior to the Amiodarone group, 94.4% to 79.1 % (P 0.05). Conclusion: Using combined group on AF patients after CABG can achieve better results comparing to the Amiodarone group. Side effect is low and the combination drug therapy is worth to clinical recommenclation.

  12. Analysis on curative effect of metoprolol combined with amiodarone in patients with congestive heart failure and taehyarrhythmia%胺碘酮联合美托洛尔治疗充血性心力衰竭患者快速型室性心律失常的临床效果分析

    Institute of Scientific and Technical Information of China (English)

    邓志元

    2014-01-01

    目的:观察美托洛尔联合胺碘酮治疗充血性心力衰竭并快速性心律失常的治疗效果。方法:选择慢性心功能不全合并室性心律失常43例。心功能按NYHA分级为Ⅱ~Ⅳ级,随机分为胺碘酮治疗组、胺碘酮+美托洛尔治疗组。结果:胺碘酮+美托洛尔治疗组临床有效率90%(18/20),胺碘酮治疗组的总有效率60.87%(14/23)。2组差异有统计学意义(P<0.05)。结论:联合应用胺碘酮及美托洛尔治疗慢性心功能不全合并室性心律失常疗效明显优于单用胺碘酮或美托洛尔,不良反应无增加。%Objective:To investigate the curative effect of metoprolol combined with amiodarone in patients with congestive heart failure and taehyarrhythmia .Methods:A total of 43 NYHA classⅡ-Ⅳpatients with CHF complicated by ventricular arrhythmia were randomly divided into amiodarone group and amiodarone +metoprolol group .The therapeutic effects were evaluated .Results:The clinical effective rate was 90%(18/20)in amiodarone+metoprolol group,while that was 60.87%(14/23)in amiodarone group,the difference was statisti-cally significant(P<0.05).Conclusion:The combination of amiodarone and metoprolol could produce better effect than amiodarone alone in the treatment of CHF complicated by ventricular arrhythmia .

  13. Attenuation of amiodarone induced lung fibrosis and phospholipidosis in hamsters, by treatment with the platelet activating factor receptor antagonist, WEB 2086

    Directory of Open Access Journals (Sweden)

    S. N. Giri

    1993-01-01

    Full Text Available Therapeutic use of amiodarone (AMD, a Class III antiarrhythmic drug is complicated by the development of lung fibrosis (LF and phospholipidosis (PL. In the present study, the effectiveness of a PAF antagonist, WEB 2086, against AMD induced LF and PL has been tested in hamsters. The animals were randomly divided into four groups: (1 saline + H2O; (2 WEB + H2O; (3 saline + AMD; and (4 WEB + AMD. Saline or WEB (10 mg/kg i.p. was given 2 days prior to intratracheal instillation of water or AMD (1.5 μmol/0.25 ml/100 g BW and thereafter daily throughout the study. Twenty-eight days after intratracheal instillation, the animals were killed and the lungs processed for various assays. The amount of lung hydroxyproline, an index of LF, in saline + H2O, WEB + H2O, saline + AMD, and WEB + AMD groups were 959 ± 46, 1035 ± 51, 1605 ± 85 and 1374 ± 69 μg/lung, respectively. Total lung PL, an index of phospholipidosis, in the corresponding groups were 8.4 ± 0.4, 8.3 ± 0.3, 11.7 ± 0.3 and 9.9 μg/lung. Lung malondialdehyde, an index of lipid peroxidation and superoxide dismutase activity in saline + H2O WEB + H2O, saline + AMD, and WEB + AMD were 93.0 ± 4.3, 93.0 ± 2.7, 138.9 ± 6.0 and 109.0 ± 3.8 nmol/lung and 359.7 ± 13.9, 394.0 ± 22.8, 497.5 ± 19.7 and 425.5 ± 4.9 units/lung, respectively. Administration of AMD alone caused significant increases in all the above indexes of lung toxicity, and treatment with WEB 2086 minimized the AMD induced toxicity as reflected by significant decreases in these indexes. Histopathological studies revealed a marked reduction in the extent and severity of lung lesions in the WEB + AMD group compared with the saline + AMD group. Treatment with WEB 2086 also reduced the acute mortality from 35% in saline + AMD group to 22% in WEB + AMD group. It was concluded that PAF is involved in the AMD induced lung fibrosis and phospholipidosis and that the PAF receptor antagonist may, therefore, be potentially useful in

  14. Comparison of the efficacy and safety of propafenone and amiodarone in the treatment of paroxysmal supraventricular tachycardia%普罗帕酮和胺碘酮治疗阵发性室上性心动过速疗效与安全性比较

    Institute of Scientific and Technical Information of China (English)

    曾益华; 张世杰; 胡爱民

    2011-01-01

    Objective To evaluate the efficacy and safety of propafenone and amiodarone in the treatment of paroxysmal supraventricular tachycardia(PSVT). Methods Total 86 cases of PSVT were randomly divided into propafenone group and amiodarone group. Propafenone group had intravenously injected 70 mg propafenone. The intravenous injections lasted 5 minutes. Amiodarone group were intravenously infused amiodarone(5-7 mg/kg) (the intravenous infusion lasted 30 minutes). Results The termination rate of PSVT was 93.2% in propafenone group and 88.1% in amiodarone group respectively. Cardioversion time showed as follows: propafenone group(12.4 ±7.8 min) was significantly shorter than amiodarone group (30.7 ± 10.3) min (P < 0.01). Side reaction showed that propafenone group(29.5%) was significantly higher than amiodarone group (11.9%) (P < 0.05). Conclusions The effective cardioversion rates of propafenone and amiodarone in treating PSVT are high in emergency department.Propafenone shows faster effect and higher side effects but better outcome for patients without serious organic heart diseases than Amiodarone which is better for patients with serious organic heart diseases.%目的 比较普罗帕酮和胺碘酮静脉用于急诊转复阵发性室上性心动过速的疗效及不良反应.方法 将急诊阵发性室上性心动过速患者86例完全随机分成普罗帕酮组(44例)和胺碘酮组(42例),普罗帕酮组给予普罗帕酮70 mg静脉注射(5 min注完),若无效,20min后重复1次;胺碘酮组给予胺碘酮5~7 mg/kg加入100 ml 5%葡萄糖或0.9%氯化钠注射液中静脉滴注,30 min滴完,继之以1 mg/min的速度持续静脉滴注.观察2组的治疗效果和不良反应发生情况.结果 普罗帕酮组和胺碘酮组转复有效率分别为93.2%(41/44)和88.1%(37/42)(P>0.05);平均转复时间普罗帕酮组[(12.4±7.8)min]明显短于胺碘酮组[(30.7±10.3)min](P<0.01);不良反应发生率普罗帕酮组为[29.5%(13/44)]明显高

  15. 雷米普利和替米沙坦与胺碘酮联用治疗阵发性心房颤动的临床观察%Clinical observations of ramipril and telmisartan combined with amiodarone in patients with paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    赵美丽; 刘大钧

    2010-01-01

    目的 探讨雷米普利和替米沙坦与小剂量胺碘酮联用对心功能正常的阵发性心房颤动(房颤)维持窦性心律的长期疗效.方法 将180例阵发性房颤患者完全随机分为胺碘酮组(A组,61例)、胺碘酮+雷米普利组(B组,59例)、胺碘酮+替米沙坦组(C组,60例),随访2年,比较3组治疗后6、12、18、24个月的窦性心律维持率以及治疗前、后的左心房内径.结果 治疗12个月后,A组左心房内径大于B、C组(P<0.05),A组窦性心律维持率明显低于B、C组(P<0.05).试验终点时,A组的窦性心律维持率为58.62%,B组为77.78%,C组为78.57%(P<0.05).结论 胺碘酮分别与雷米普利和替米沙坦配伍治疗阵发性房颤维持窦性心律具有相同的疗效,但优于单用胺碘酮,并能抑制左心房的扩大.%Objective To evaluate the clinical efficacy of ramipril and telmisartan combined with amioda-rone on maintenance of sinus rhythm in patients with idiopathic paroxysmal atrial fibrillation(PAF). Methods One hundred and eighty patients with idiopathic PAF were included in the study and randomly divided into three groups: group A (Amiodarone group, n=61) was treated with amiodarone alone; group B (Amiodarone plus Ramipril, n=59) was treated with amiodarone combined with Ramipril;group C(Amiodarone plus telmisartan group,n=60)was trea-ted with amiodarone combined with telmisartan. The left atrial diameter(LAD) was measured with transthoracic echo-cardiogram before and 6,12,18 and 24 month after treatment. The follow-up was up to 2 years and the primary end point of the study was the first recurrence of AF. Results During the 6 months follow-up, there was no difference in LAD among three groups. After 12 months, LAD in group A was significantly larger than that in group B and group C(P<0.05). At the end of 12 months, the sinus rhythm maintenance of group A was lower significantly than that of group B and group C. At the end of the study, the maintenance of sinus rhythm in

  16. Estudo prospectivo dos efeitos da amiodarona na função tiroidiana de pacientes chagásicos em área de deficiência de iodo Prospective study of amiodarone effects on thyroid function of chagasic patients in an iodine deficient area

    Directory of Open Access Journals (Sweden)

    Maria Aparecida Enes de Barros

    1994-09-01

    Full Text Available Com o objetivo de avaliar a junção tiroidiana após uso crônico da amiodarona, em área de deficiência de iodo e endemia chagásica, 24 pacientes foram analisados antes e após três e nove meses de uso da droga. A avaliação constou de exame clínico, dosagem sérica de T4, T3, rT3, TSH, anticorpo antitiroglobulina e TSH 30 minutos após infusão venosa de uma ampola de 200µg de TRH. A captação do iodo radioativo 131 e a cintilografia datiróide foram realizadas antes e aos 9 meses após tratamento. Disfunção tiroidiana ocorreu em 20,8% dos pacientes sendo 12,5% de hipertiroidismo e 8,3% de hipotiroidismo, com anticorpos antitiroglobulina negativos. Captação do iodo radioativo 131 foi positiva em um paciente hipertiroideo com bócio. O diagnóstico de hipertiroidismo foi melhor evidenciado pela resposta reduzida ou bloqueada do TSH ao TRH e não pela concentração do T3 no soro e o de hipotiroidismo pela concentração elevada do TSH. O TSH elevado desde o início do tratamento pode predispor ao aparecimento de bócio. Concluímos que o uso da amiodarona em nossa região deve serjudiciosamente analisado, sendo a função tiroidiana cuidadosamente monitorizada antes e durante o tratamento.In order to evaluate the development of thyroid dysfunction during chronic amiodarone treatment in an area deficient in iodine and endemic for Chagas 'disease, a group of 24patients wasprospectively studied. Clinical examination and measurement of serum T4, T3, rT3, TSH and antithyroglobulin antibodies were performed before and at 3 and 9 months of use of amiodarone. A TSH response 30 minutes after IV injection of 200µg of TRH was also compared to TSH basal levels before and during amiodarone treatment. Thyroid radioative uptake and scan were obtained before and nine months after amiodarone was started. Elevated rT3 concentrations were unexpectedly found in two thirds of the patients before treatment. Thyroid dysfunction developed during

  17. 胺碘酮联合磷酸肌酸钠对心肺复苏后心肌的保护作用%Protective effects of amiodarone combined with creatine phosphate sodium on myocardium after cardiopulmonary resuscitation in rabbits

    Institute of Scientific and Technical Information of China (English)

    王芳; 周雨; 许铁

    2013-01-01

    目的 研究胺碘酮联合磷酸肌酸钠对兔心肺复苏(CPR)后心肌的保护作用.方法 用窒息法制作CPR模型.选取健康日本长耳大白兔40只,随机分为A组(假手术组)、B组(生理盐水组)、C组(胺碘酮组)、D组(磷酸肌酸钠组)、E组(胺碘酮联合磷酸肌酸钠组),每组8只,动态监测HR、MAP及血浆CK、CK-MB含量.复苏后6 h处死兔,光镜下观察心肌组织病理学变化.结果 B组、C组、D组和E组兔的HR、MAP比较差异无统计学意义(P>0.05).与A组比较,CPR后B组、C组、D组和E组兔血浆CK、CK-MB含量均增高,差异有统计学意义(P 0.05). Compared with group A, the levels of plasma CK, CK - MB were significantly higher in group B, group C, group D and group E after CPR (P 0.05). In group B, group C, group D and group E, the levels of plasma CK, CK - MB increased gradually after CPR( P < 0. 05 ). Correlation analysis showed that there was significantly postitive relation between the levels of plasma CK, CK - MB and the time after CPR in group B, group C, group D and group E (P < 0. 05 ) . Results of pathology showed that myocardial injury were more seriously in group B than in group C and group D, and myocardial injury were more seriously in group C and group D than in group E. Conclusion Treatment with amiodarone, creatine phosphate sodium, amiodarone combined with creatine phosphate sodium can alleviate myocardial injury after CPR in rabbits, the protective effects of amiodarone combined with creatine phosphate sodium were the best.

  18. A tomografia computadorizada de alta resolução na avaliação da toxicidade pulmonar por amiodarona High-resolution computed tomography of amiodarone pulmonary toxicity

    Directory of Open Access Journals (Sweden)

    Daniela Peixoto Consídera

    2006-04-01

    Full Text Available OBJETIVO: Avaliar as principais alterações identificadas na tomografia computadorizada de alta resolução do tórax em pacientes com toxicidade pulmonar pela amiodarona. MATERIAIS E MÉTODOS: Foram avaliadas dez tomografias computadorizadas de alta resolução de tórax de pacientes com pneumonite pela amiodarona, seis desses pacientes do sexo masculino e quatro do sexo feminino, com idade média de 73,5 anos. RESULTADOS: Os achados tomográficos mais relevantes foram opacidades lineares ou reticulares em seis casos (60%, pequenos nódulos com densidade elevada em seis casos (60%, consolidações densas em três casos (30% e aumento da densidade do parênquima hepático em cinco de oito casos em que havia estudo tomográfico do abdome superior (62,5%. CONCLUSÃO: A tomografia computadorizada de alta resolução é um exame importante na avaliação de pacientes com toxicidade pulmonar pela amiodarona, devendo ser realizada sempre que houver suspeita deste diagnóstico. O achado de espessamento de septos interlobulares associado a lesões com aumento de densidade é altamente sugestivo deste diagnóstico.OBJECTIVE: To evaluate the main findings of chest high-resolution computed tomography in patients with amiodarone pulmonary toxicity. MATERIALS AND METHODS: Ten patients - six male and four female, average age of 73.5 years - with amiodarone-induced pneumonitis have undergone chest high-resolution computed tomography. RESULTS: The most relevant tomographic findings were linear or reticular opacities in six cases (60%, small high density nodules in six cases (60%, dense consolidations in three cases (30% and increased density in the hepatic parenchyma in five of eight cases in which there was a superior abdomen CT scan (62.5%. CONCLUSION: The high-resolution computed tomography is a valuable non-invasive test for evaluating patients with amiodarone pulmonary toxicity and should always be performed when one suspects of the presence of this

  19. 文献对胺碘酮、利多卡因治疗阵发性室性心动过速预后差异的Meta分析%Research Document of Amiodarone, Lidocaine Treatment of Paroxysmal Supraventricular Tachycardia Meta-analysis of Differences in Prognosis

    Institute of Scientific and Technical Information of China (English)

    陈阵; 刘亚凤; 胡念丹; 苏薇薇; 李文强

    2012-01-01

    目的 评价相关文献中关于使用胺碘酮和利多卡因治疗阵发性室性心动过速(paroxysmal ventricular tachycardia,PVT)的预后差异.方法 检索Cochrane图书馆、EMbase、Pubmed及Medline 1996~ 2011年中采用随机对照试验(RCT)中关于使用胺碘酮、利多卡因治疗PVT预后差异的文献,对纳入文献质量进行评价和资料提取,并进行Meta分析.结果 本研究共纳入5篇文献,均表明使用胺碘酮治疗PVT较利多卡因预后好,差异有统计学意义(P<0.05);两药治疗PVT在复律失败人数、死亡人数、药物不良反应等方面比较差异均有统计学意义(P<0.05).结论 使用胺碘酮治疗PVT可降低患者住院次数,且未增加不良反应,故当PVT症状不严重时,胺碘酮可作为治疗的首选.%Objective To evaluate the pertinent literature of amiodarone, lidocaine treatment in the prognosis of paroxysmal ventricular tachycardia ( PVT). Methods The papers from Cochrane Library, EM base, Pubmed were searched, Medline for RCT of paroxysmal ventricular tachycardia treatment using amiodarone or lidocaine was randomly evalvated, an assessment for the methodology after screening and selecting all the papers with the help of the software of Review manager 5.0 was made, and Meta analysis was conducted. Results A total of 5 literatures were included, all of which results showed that amiodarone had a better prognosis than lidocaine, and the difference was significant (P < 0.05 ) ; the number of successful cardio version, adverse reactions and the number of deaths related to the RCT docamented significant differences between the Amiodarone and Lidocaine treatment of PVT (P <0.05). Conclusion The use of PVT Amiodarone treatment can reduce the rate of hospitalization, without increasing the incidence rate of other adverse reactions. Therefore, in minor cases of PVT, Amiodarone can be the preferred treatment method.

  20. Comparison on Effect of Amiodarone and Propafenone Treating Paroxysmal Supraventricular Tachycardia%胺碘酮和普罗帕酮治疗阵发性室上性心动过速的效果比较

    Institute of Scientific and Technical Information of China (English)

    赵敏

    2014-01-01

    目的:比较胺碘酮和普罗帕酮治疗阵发性室上性心动过速的疗效。方法将88例阵发性室上性心动过速患者随机分为两组,A 组44例患者给予胺碘酮治疗,B 组44例患者给予普罗帕酮治疗。结果两组复律成功率比较,差异无统计学意义(P >0.05);A 组复律时间长于 B 组,复律时间分布较 B 组差,不良反应发生率低于 B 组,差异均有统计学意义(P <0.05)。结论胺碘酮和普罗帕酮对阵发性室上性心动过速的治疗各有利弊,普罗帕酮见效快、患者耐受差,适用于无严重器质性心脏病及心功能正常者;而胺碘酮见效较慢、不良反应少、适应证广,适用于器质性心脏病及心功能不全患者。%Objective To compare the efficacy of amiodarone and propafenone treating paroxysmal supraventricular tachycardia. Methods 88 cases with paroxysmal supraventricular tachycardia were selected and divided into two groups randomly. The A group for 44 cases were treated with amiodarone, and the B group for 44 cases were treated with propafenone. Results The difference for the successful rate of cardioversion between two groups had no statistical significance(P>0.05). The cardioversion time of A group was longer than that of B group, and the cardioversion time distribution of A group was worse than that of B group, the incidence rate of adverse reactions in A group was lower than that of B group ,which had statistical significance (P<0.05). Conclusion Propafenone and propafenone treating paroxysmal supraventricular tachycardia has advantages and disadvantages. Amiodarone has the advantages that the effect is fast, the patients have poor tolerance and it is applied to the patients with normal cardiac function and without organic heart disease, and amiodarone has the advantages that the effect is slow, there are few adverse reactions, there are wide range of indications, and it is applied to patients with organic heart disease

  1. 胺碘酮对冠心病心律失常心率变异性的影响%Influnce of amiodarone on coronary heart arrhythmia heart rate variability

    Institute of Scientific and Technical Information of China (English)

    贺桂彬

    2012-01-01

    Objective To observe the effect of amiodarone on clinical treatment of coronary heart disease,analysis of the drug on arrhythmia heart rate variability. Methods From May 2009 to October 2010 our hospital 80 patients with coronary heart arrhythmia patients were randomly divided into treatment group (40 cases) and control group (40 cases) ,the expansion of the control group with conventional coronary artery and anti - arrhythmic drugs,while the experimental group was given amiodarone weekly decline. The two groups were compared the efficiency of treatment and related indicators of the efficacy of amiodarone in the treatment of coronary heart disease arrhythmias. Results The treatment rate was 80% ,higher than 65% ,respectively,compared with a statistically significant difference ( P < 0.01). Two groups of patients did not occur during treatment reduced heart function,liver function abnormalities,interstitial pneumonia,thyroid dysfunction and nerve,cornea and other adverse reactions. Conclusions Amiodarone in patients with coronary heart arrhythmia efficacy,low cost,convenient route of administration,security,it is worth promoting and applications.%目的 观察胺碘酮对冠心病的临床治疗作用,分析该药对心律失常心率变异性的影响.方法 收取2009年5月至2010年10月本院治疗的80例冠心病心率失常患者,按照随机原则分为治疗组(40例)和对照组(40例),对照组采用常规扩张冠状动脉和抗心律失常药物,而实验组则每周递减给予胺碘酮治疗.比较两组患者的治疗有效率及相关指标,探讨胺碘酮治疗冠心病心律失常的疗效.结果 治疗组的治疗有效率为80%,高于对照组的65%,两组相比具有明显统计学差异(P<0.01).两组患者在治疗过程中未发生心功能减低、肝功能异常、间质性肺炎、甲状腺功能异常及神经、眼角膜等不良反应.结论 胺碘酮对冠心病心律失常的患者疗效明显,价格低廉,用药途径方便

  2. Clinical Analysis of Emergency Application of Amiodarone in Acute Myocardial Infarction Patients with Malignant Ventricular Arrhythmia%急性心肌梗死伴恶性室性心律失常急诊胺碘酮的应用

    Institute of Scientific and Technical Information of China (English)

    杨华; 王月权; 李宁

    2015-01-01

    39 cases of acute myocardial infarction (AMI) with malignant ventricular ar hythmia, frequent ventricular premature beat (hereinafter refer ed to as premature ventricular) in 16 cases, 17 cases of ventricular tachycardia (vt), ventricular fibril ation (ventricular fibril ation) 6 cases. Give room early and ventricular tachycardia patients after intravenous amiodarone, rectified ventricular ar hythmia, ventricular fibril ation, 6 cases of patients with first give cardioerter, success in 4 cases, 2 cases after fails to give amiodarone, defibril ation success again. 38 cases of successful rescue, 1 case died of brain death. Rescue winners are transfer ed to medical ward for treatment.%39例急性心肌梗死(AMI)伴恶性室性心律失常,频发室性早搏(简称室早)16例,室性心动过速(简称室速)17例,心室颤动(简称室颤)6例。对室早及室速的患者给予静脉胺碘酮后,室性心律失常得以纠正,对室颤6例患者先给予电复律,4例除颤成功,2例不成功者给予胺碘酮后,再次除颤成功。抢救成功38例,1例死于脑死亡。抢救成功者均转入内科病房治疗。

  3. Clinical observation of amiodarone combined with metoprolol intravenous injection in the treatment of tachyarrhythmia%胺碘酮联合美托洛尔静脉注射治疗快速心律失常的临床观察

    Institute of Scientific and Technical Information of China (English)

    周斌

    2016-01-01

    目的:探讨胺碘酮联合美托洛尔治疗快速心律失常的临床效果。方法:收治快速心律失常患者62例,随机分为对照组和试验组,对照组采用胺碘酮治疗,试验组采用胺碘酮联合美托洛尔治疗,比较两组治疗效果。结果:治疗后,试验组的有效率、心率和收缩压均明显优于对照组(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论:胺碘酮联合美托洛尔治疗快速心律失常的临床效果显著。%Objective:To explore the clinical effect of amiodarone combined with metoprolol intravenous injection in the treatment of tachyarrhythmia.Methods:62 patients with tachyarrhythmia were selected.They were randomly divided into the control group and the experimental group.The control group was treated with amiodarone,and the experimental group was treated with amiodarone combined with metoprolol.We compared the treatment effect of two groups.Results:After treatment,the effective rate, heart rate and systolic blood pressure of the experimental group were significantly better than those of the control group(P0.05).Conclusion:The clinical effect of amiodarone combined with metoprolol intravenous injection in the treatment of tachyarrhythmia was significant.

  4. Clinical Observation of Amiodarone Combined With Wenxin Granule in the Treatment of Heart Failure Complicated With Arrhythmia%胺碘酮联合稳心颗粒治疗心衰合并心律失常的临床观察

    Institute of Scientific and Technical Information of China (English)

    高尚

    2015-01-01

    Objective To explore the clinical effect of amiodarone combined with Wenxin Granule in the treatment of heart failure complicated with arrhythmia. Methods 80 cases of patients with heart failure combined with arrhythmia were randomly divided into observation group and control group, respectively treated with amiodarone and amiodarone combined with Wenxin Granule treatment. Results Observation of curative effect, the patient's heart rate, QT interval, LVEF improvement was superior to the control group, the incidence of adverse reaction was lower than the control group (P<0.05). Conclusion Amiodarone combined with Wenxin Granule in the treatment of heart failure complicated with arrythmia curative effect, worthy of clinical application.%目的:探讨胺碘酮联合稳心颗粒治疗心衰合并心律失常的临床效果。方法将80例心衰合并心律失常患者随机分为观察组和对照组,分别给予胺碘酮治疗和胺碘酮联合稳心颗粒治疗。结果观察组疗效、患者心率、QT间期、LVEF改善情况均优于对照组,不良反应发生率明显低于对照组(P<0.05)。结论胺碘酮联合稳心颗粒治疗心衰合并心律失常疗效确切,值得临床应用推广。

  5. Clinical Analysis of the Treatment of Arrhythmia in Patients with Coronary Heart Disease Combined with the Stability of the Core Particles and Amiodarone%稳心颗粒联合胺碘酮治疗冠心病心律失常疗效分析

    Institute of Scientific and Technical Information of China (English)

    冯宝连

    2016-01-01

    Objective To observe the metacentre grain joint amiodarone treatment of arrhythmia in coronary heart disease clinical curative effect. Methods From October 2009 to October 2009 treatment of 90 cases of patients with arrhythmia in coronary heart disease, were randomly divided into two groups, treatment group 45 cases, on the basis of conventional treatment of oral metacentric particles and amiodarone; Control group 45 cases, on the basis of conventional treatment taking amiodarone, course of six weeks. Look before and after using patients electrocardiogram (ecg) and the improvement of clinical symptoms. Results The curative effect of treatment group is better than that of control group ( < 0.05). Conclusion metacentric particles joint amiodarone has good curative effect of treatment of coronary heart disease (CHD).%目的观察稳心颗粒联合胺碘酮治疗冠心病心律失常的临床疗效.方法选取我院2009年10月~2015年10月治疗的冠心病心律失常患者90例,随机分为两组,治疗组45例,在常规治疗基础上口服稳心颗粒和胺碘酮;对照组45例,在常规治疗基础上服用胺碘酮,疗程6w.观察用药前/后患者心电图及临床症状的改善程度.结果治疗组疗效优于对照组(<0.05).结论稳心颗粒联合胺碘酮治疗冠心病心律失常具有良好的疗效.

  6. The Clinic Alapplication Value of Amiodarone in the Treatment of Chronic Heart Failure Complicated With Arrhythmia%胺碘酮治疗慢性心力衰竭并发心律失常的临床应用价值

    Institute of Scientific and Technical Information of China (English)

    姜桂菊

    2015-01-01

    目的:讨论胺碘酮治疗慢性心力衰竭衰并发心律失常的临床应用价值。方法对照组采用抗心衰的治疗,研讨组在此基础上联合应用胺碘酮进行治疗。结果研讨组治疗效果、并发症等方面均优于对照组。结论在常规抗心衰的治疗基础上采用胺碘酮治疗心衰并发心律失常安全、有效。%ObjectiveTo investigate the clinic application value of amiodarone in the treatment of chronic heart failure complicated with arrhythmia. Methods The research group was treated with anti heart failure. The research group based on the combined application of amiodarone for the treatment.Results Research group of the treatment effect, complications were better than those of control group. ConclusionOn the basis of routine anti heart failure treatment on the use of amiodarone in the treatment of heart failure complicated with arrhythmia safe, effective.

  7. Comparison of short-term efficacy and safety between amiodarone and esmolol treatment in elderly patients with acute myocardial infarction complicated with ventricular arrhythmia%胺碘酮与艾司洛尔治疗老年患者急性心肌梗死合并室性心律失常的短期疗效与安全性比较

    Institute of Scientific and Technical Information of China (English)

    邹德玲; 刘兴利; 方悦; 陈艳丽; 耿宁; 庞文跃

    2014-01-01

    目的 比较老年急性心肌梗死(AMI)合并严重室性心律失常患者静脉应用胺碘酮或艾司洛尔48 h内疗效及不良反应,为临床安全用药提供依据. 方法 2009年1月至2013年6月在中国医科大学附属盛京医院心脏内科连续住院治疗的老年AMI合并严重室性心律失常患者纳入研究,分为胺碘酮组与艾司洛尔组.胺碘酮组患者在10 min内静脉注射胺碘酮150 mg+ 5%葡萄糖注射液20 ml后经微量注射泵静脉输注胺碘酮1 mg/min共6h,减量至0.5 mg/min静脉输注24~48 h,之后口服胺碘酮0.2g,3次/d,共7d.艾司洛尔组患者在1 min内静脉注射艾司洛尔注射液0.5 mg/kg后经微量注射泵静脉输注艾司洛尔0.1 mg/(kg·min)共6h,减量至0.05 mg/(kg·min)静脉输注24 ~ 48 h,之后口服美托洛尔25 mg,2次/d,共7d.胺碘酮组和艾司洛尔组静脉应用胺碘酮或艾司洛尔6h后仍有室速发作者,分别加用上述艾司洛尔或胺碘酮治疗方案.比较2组患者治疗48 h内有效率和不良反应发生率. 结果 胺碘酮组和艾司洛尔组48 h内有效率分别为92.1%(35/38)和75.0%(27/36),组间差异有统计学意义(P=0.046);不良反应发生率分别为39.5%(15/38)和19.4%(7/36),组间差异无统计学意义(P =0.060).胺碘酮组2例伴有心力衰竭患者静脉用药24 h后出现急性肝损伤,停药并对症治疗2周后肝功能恢复正常. 结论 静脉应用胺碘酮治疗老年患者AMI合并严重室性心律失常有效率优于艾司洛尔.胺碘酮与艾司洛尔均较安全.高龄AMI且伴心力衰竭者静脉应用胺碘酮时需密切监测肝功能,出现肝损伤需立即停药并给予对症治疗.%Objective To compare the efficacy and safety of intravenous application of amiodarone or esmolol in elderly patients with ventricular arrhythmia following acute myocardial infarction (AMI) within 48 hours,and provide reference for safe use of medication in clinical practice.Methods Elderly hospitalized

  8. 炙甘草汤加减配合胺碘酮治疗慢性心力衰竭312例疗效观察%Curative effect observation of Zhi Gan Cao decoction adjusted with amiodarone in the treatment of 312 cases of chronic cardiac failure

    Institute of Scientific and Technical Information of China (English)

    李玉红; 王立娜; 崔骞

    2014-01-01

    目的:观察炙甘草汤加减配合胺碘酮治疗慢性心力衰竭情况。方法:将慢性心力衰竭患者312例按随机数字表法分为观察组160例(炙甘草汤加减配合胺碘酮组)与对照组152例(胺碘酮组)。随访6个月,观察两组总有效率和复发率情况。结果:观察组总有效率98%,复发率10.22%;对照组总有效率82%,复发率32.9%。两者差异有统计学意义(P<0.05)。结论:在预防慢性心力衰竭的复发方面,炙甘草汤加减配合胺碘酮优于单纯应用胺碘酮,值得在临床中推广应用。%Objective:To observe Zhi Gan Cao decoction adjusted with amiodarone in the preventment of recurrence of chronic cardiac failure.Methods:According to random number table method,312 patients with chronic cardiac failure were divided into the observation group in 160 cases(Zhi Gan Cao decoction adjusted with amiodarone group)and the control group in 152 cases(amiodarone group).After 6 months of follow up,the recurrence rates of premature beat in the two groups were observed. Results:In the observation group,the total effective rate was 98%,and the recurrence rate was 10.22%.In the control group, the total effective rate was 82%, and the recurrence rate was 32.9%.The difference was statistically significant(P<0.05).Conclusion:In the preventment of recurrence of chronic cardiac failure,Zhi Gan Cao decoction adjusted with amiodarone is better than the simple application of amiodarone.It is worth of popularization and application in clinical.

  9. 盐酸胺碘酮联合步长稳心颗粒治疗阵发性快速房颤疗效观察%The Clinical Observation of amiodarone with Wenxinkeli in Treatment of rapid atrial fibrillation in patients with paroxysmal efficacy

    Institute of Scientific and Technical Information of China (English)

    严新美

    2013-01-01

    目的:评价胺碘酮联合步长稳心颗粒治疗阵发性快速房颤的疗效。方法将80例阵发性快速房颤患者随机分为治疗组和对照组,两组均予以吸氧、心电监护、胺碘酮治疗,治疗组加服步长稳心颗粒,共观察6个月。结果观察6个月后,治疗组在有效改善症状、复律时间、及胺碘酮用量方面明显优于对照组,差异有统计学意义(P<0.01)。结论胺碘酮与步长稳心颗粒合用治疗阵发性房颤,能有效改善症状,提高治疗效果且可减少胺碘酮用量,缩短复律时间,有一定的临床应用价值。%Objective Evaluation of amiodarone the joint step Wenxinkeli rapid atrial fibrillation in patients with paroxysmal efficacy. Methods 80 patients with paroxysmal rapid atrial fibrillation were randomly divided into a treatment group and a control group, and both groups are oxygen, ECG, amiodarone,The treatment group took Buchangwenxin particles were observed 6 months. Results Observed after 6 months, the treatment group was effective in improving symptoms, time of cardioversion and amiodarone dosage was significantly better than the control group, the difference was statistically significant (P <0.01). Conclusion the particle combination therapy of paroxysmal atrial fibrillation, amiodarone and Buchangwenxin improve symptoms, improve treatment and reduce amiodarone dosage and shorten the time of cardioversion clinical application value.

  10. 胺碘酮配合中药对慢性心力衰竭并室性早搏的临床干预%Clinical intervention of amiodarone with Traditional Chinese Medicine on chronic heart failure and premature ventricular contractions

    Institute of Scientific and Technical Information of China (English)

    于瑞玲; 宗燕

    2014-01-01

    Objective:T o observe the effect of amiodarone with Traditional Chinese Medicine on prev enting the re currence of chronic h eart failure and p remature ventr icular contractions. Me thods:78 cases with ch ronic heart failur e were randomized into a group given amiodarone with Traditional Chinese Medicine( the treatment group with 40 cases) and a group given amiodarone( the control group with 38 cases) .Followed up for six months, the recurrence r ates of premature w ere observ ed . Results:Th e treatment groups:the t otal effective r ate was 98%, th e re currence ra te w as 10.22%; the control group: the to tal effective rat e was 82%, the re currence rate was 32.9%. The dif ference was st atistically sign ificant ( P<0 .05). C onclusions:In the aspect of prevention of chronic h eart fa ilure and premature ventricular contractions, amiodarone with Traditional Chinese Medicine is better than amiodarone and it is worth y of promotion in clinical applications.%目的:观察中药联合胺碘酮预防慢性心力衰竭并室性早搏复发情况。方法:慢性心力衰竭室性早搏病人78例,随机分为中药联合胺碘酮组(治疗组40例)与胺碘酮组(对照组38例)。随访6个月,观察两组早搏复发率情况。结果:治疗组:总有效率分别为98%,复发率10.22%;对照组:总有效率82%,复发率32.9%。两者有显著性差异(P<0.05)。结论:在预防慢性心力衰竭并室性早搏的复发方面中药联合胺碘酮优于单纯应用胺碘酮,值得在临床中推广应用。

  11. Comparison of clinical effect between amiodarone and propafenone in prehospital treatment of paroxysmal supraventricular tachycardia%胺碘酮与盐酸普罗帕酮在院前急救中治疗阵发性室上性心动过速的疗效比较

    Institute of Scientific and Technical Information of China (English)

    胡远扬; 洪建芳; 赫英春; 林志华

    2016-01-01

    目的:研究院前急救中选择胺碘酮与盐酸普罗帕酮治疗阵发性室上性心动过速(paroxysmal supraventricular tachycardia,PSVT)的临床疗效。方法选取2008-01至2016-02福建省某急救指挥中心院前急救PSVT患者78例,随机分成胺碘酮组(n=39)和盐酸普罗帕酮组(n=39),给予相应药物治疗,观察两组患者治疗后PSVT转复有效率、转复时间及药物不良反应。结果经胺碘酮治疗组的转复有效率略优于盐酸普罗帕酮组,但差异无统计学意义;盐酸普罗帕酮组转复所用时间明显短于胺碘酮组[(13.1±3.2)vs(24.8±5.3) h],差异有统计学意义(t=2.07,P=0.003);胺碘酮组不良反应发生率(5.13%)低于盐酸普罗帕酮组(20.51%),差异有统计学意义(P<0.05)。结论院前急救选择胺碘酮与盐酸普罗帕酮转复PSVT均可获得明显疗效,胺碘酮的治疗效果略优于盐酸普罗帕酮,且不良反应较少,但转复时间较长。%Objective To compare clinical efficacy between amiodarone and propafenone in prehospital treatment of paroxysmal supraventricular tachycardia.Methods 78 cases of an emergency command center in PSVT prehospital emergency patients from 2008, January to 2016, February in Fujian province were selected and randomly divided into amiodarone group (n=39) and propafenone group (n=39) treated by corresponding methods, PSVT cardioversion rate, cardioversion time and adverse drug reaction after treatment ,of the two groups were observed.Results The effective cardioversion rate of amiodarone group is slightly higher than that of propafenone hydrochloride group, but there was no significant difference; cardioversion time of the patients in the hydrochloride group was significantly shorter than that in the amiodarone group [(13.1±3.2)vs(24.8±5.3)h ], and the difference was statistically significant (t=2.07,P=0.003); the incidence of adverse reaction in the amiodarone group (5

  12. The clinical effect of amiodarone versus lidocaine on the myocardial infarction patients complicated with ventricular tachycardia: A Meta-analysis%胺碘酮与利多卡因治疗急性心肌梗死并室性心动过速疗效及安全性的Meta分析

    Institute of Scientific and Technical Information of China (English)

    党松; 王晞; 胡娟; 王鑫

    2012-01-01

    Objective To retrospectively compare the therapeutic effectiveness of amiodarone and lidocaine in the treatment of ventricular arrhythmia after acute myocardial infarction. Methods PubMed, Cochrane, EMBASE, MEDLINE, CNKI, Wanfang data were searched from the time of self-build library to December 2011 for randomized clinical trials( RCT ) of amiodarone vs. Lidocaine on the myocardial infarction patients complicated with ventricular tachycardia. Two investigators independently screened these data. Pooled estimates were calculate with usage of RevMan 5. 0 software. Results Ten trials were included in the analysis ( 1381 patients ). ( 1 )The effective rate in amiodarone group was higher than that in lidocaine group ( RR = 1. 27 , 95% CI 1. 12 ~ 1.44, P =0.0002 ). ( 2 ) Regardless of the effect of other medicines, the side effects of amiodarone was similar as lidocaine ( RR = 0. 79, 95% CI 0. 42 ~ 1. 48, P = 0. 46 ). ( 3 )The mortality rate in amiodarone group was higher than that in lidocaine group ( RR = 0.48, 95% CI 0. 27 ~ 0. 85, P =0.01). Conclusion The results of this Meta-analysis provide strong evidence that preferable effective of amiodarone therapy on the myocardial infarction patients complicated with ventricular arrhythmia, amiodarone can significantly decrease the incidence of ventricular tachycardia without increase the side effects, and decrease the mortality rate.%目的 运用Meta 分析比较胺碘酮和利多卡因对急性心肌梗死合并室性心动过速的疗效.方法 计算机检索PubMed、Cochrane、EMBASE、MEDLINE、中国知网(CNKI)数据库、万方数据库,查找自建库以来至2011年12月公开发表的比较胺碘酮和利多卡因治疗心肌梗死合并室性心动过速临床随机对照试验(RCT),按纳入排除标准进行RCT 的筛选、资料提取和质量评价,使用RevMan 5.0软件进行数据统计学分析.结果 共纳入10项研究、1381例患者.(1)胺碘酮组治疗有效率显著高于利多卡因组(RR=1

  13. Alta dose de amiodarona em curto período reduz incidência de fibrilação atrial e flutter atrial no pós-operatório de cirurgia de revascularização miocárdica High dose of amiodarone in a short-term period reduces the incidence of postoperative atrial fibrillation and atrial flutter

    Directory of Open Access Journals (Sweden)

    Rafael Vieira Alcalde

    2006-09-01

    Full Text Available OBJETIVOS: Avaliar se a administração de amiodarona, em doses altas e curso rápido, reduz a incidência de fibrilação ou flutter atrial, após cirurgia de revascularização miocárdica e se reduz, também, o tempo de internação hospitalar. MÉTODOS: A amostra se constituiu de 93 pacientes randomizados, em estudo duplo-cego, para receberem amiodarona (46 pacientes ou placebo (47 pacientes. A terapia consistia na aplicação de 600mg de amiodarona, três vezes ao dia, iniciada no mínimo 30 horas e no máximo 56 horas antes da cirurgia. RESULTADOS: Fibrilação ou flutter atrial no pós-operatório ocorreu em 8 dos 46 pacientes no grupo amiodarona (17,4% e em 19 dos 47 pacientes no grupo placebo (40,4% (p=0,027. A dose média de amiodarona foi de 2,8g. Os pacientes do grupo amiodarona ficaram hospitalizados por 8,9±3,1 dias, enquanto a internação dos pacientes do grupo placebo foi de 11,4± 8,7 dias (p=0,07. O tempo de internação foi significativamente prolongado nos pacientes que desenvolveram fibrilação ou flutter atrial após a cirurgia, independente do grupo randomizado. CONCLUSÃO: Esta nova alternativa de administração de amiodarona em alta dose e por um curto período, antes da cirurgia de revascularização miocárdica, reduz a incidência de fibrilação ou flutter atrial no pós-operatório desta cirurgia.OBJECTIVE: To investigate wheter oral amiodarone administered before surgery for a short period in high dose would reduce the incidence of postoperative atrial fibrillation or atrial flutter and reduces the lenght of hospital stay. METHODS: In the double-blind, randomized study, 93 patients were given either oral amiodarone (46 patients or placebo (47 patients. Therapy consisted of 600mg of amiodarone three times a day, started at mininum 30 hours and at maximum 56 hours before surgery. RESULTS: Postoperative atrial fibrillation or atrial flutter occurred in 8 of 46 patients in the amiodarone group (17.4% and 19 of the

  14. Effects of undiluted and diluted amiodarone on defibrillation and haemodynamics in a ventricular fibrillation pig model%胺碘酮原液和稀释液对心室颤动转复作用及血流动力学的影响

    Institute of Scientific and Technical Information of China (English)

    武军元; 李春盛; 王胜奇

    2010-01-01

    Objective Amiodarone was diluted to release the side effect of hypotension in clinic, but this maybe unsuitable during cardiopulmonary resuscitation (CPR). This study was designed to observe the effects of undiluted amiodarone, diluted amiodarone, and CPR alone on ventricular fibrillation (VF) in a pig model. Methods VF was induced in 21 pigs. The animals were randomly (random mumber) divided into 3 groups after VF 3 min.① CPR group ( n= 7): standard CPR; ② undiluted amiodarone group ( n= 7): undiluted amiodarone (5 mg/kg)bolus within 3 s, then 20 mL saline flush into the peripheral vein, CPR was started after observed 30 s; ③ diluted amiodarone group ( n = 7): amiodarone was dissolved in 20 mL saline and bolus with 30 s. Defibrillation was attempted at VF 5 min. Results The restoration of spontaneous circulation (ROSC) of CPR and undiluted amiodarone groups were higher than diluted group (85.7% vs. 71.4% vs. 42.9%), but the differences were not significant (all P >0.05). The defibrillation energy and times of CPR group were higher than that of undiluted amiodarone (P= 0.009) and diluted group ( P = 0. 170). The mean arterial pressure of undiluted amiodarone were lower than diluted and CPR groups at ROSC 10 min (all P <0.05), but the differences of undiluted and diluted groups were not significant after ROSC 0.5 h. Conclusions In this study, undiluted amiodaronecan effectively reduced the defibrillation times and energy. Although diluted amiodaronecan release the side effect of hypotension which was transient, it didn't significantly improved cardiac electric activity and delayed to start CPR.%目的 通过猪心室颤动(VF)模型,观察胺碘酮原液、稀释液以及单纯标准CPR对心肺复苏效果的影响.方法 21头北京长白猪,应用程控刺激仪诱导VF,VF 3 min后,将动物随机(随机数字法)分为3组.①单纯CPR组:只进行单纯标准CPR;②胺碘酮原液组:予胺碘酮原液5 mg/kg快速(<3 s)静推,生理盐水20 m

  15. 乙胺碘肤酮用作甲亢术前准备的临床观察%Clinical Observation of Amiodarone Used in the Preoperative Preperation in Grave's Disease

    Institute of Scientific and Technical Information of China (English)

    曾毅克; 黎绍基; 吕诗寿

    2000-01-01

    目的:初步探讨乙胺碘肤酮(Amiodarone)用于甲亢术前准备的可行性.方法:12名患者非随机分为两组,以使其平均年龄、甲亢的严重程度和甲状腺肿大程度相匹配,分别使用Lugol液和Amiodarone作术前准备,比较两组患者切除的腺体质量(m),术中出血量(V),甲状腺组织的碘含量(mI).结果:Amiodarone组m=(89.81±51.41)g,V=(128.16±30.92)ml,mI=(0.033±0.017)%;Lugol液组m=(81.28±39.81)g,V=(194.97±57.77)ml,mI=(0.034±0.013)%;两组对比在切除腺体质量相当时,Amiodarone组的术中出血量较少(t检验P0.05).结论:乙胺碘肤酮用于甲亢术前准备对甲亢控制良好,能达到常规Lugol液的准备效果,而且口服无刺激,较Lugol液优越.

  16. Manuseio peri-operatório do paciente em uso de amiodarona Manoseo peri-operatorio del paciente en uso de amiodarona Peri-operative management of amiodarone patients

    Directory of Open Access Journals (Sweden)

    Gilson Ramos

    2004-08-01

    principales efectos de la amiodarona y asociarlos a la práctica clínica del anestesista. CONTENIDO: Se trató de las principales propiedades de la amiodarona, su uso clínico, bien como los más importantes efectos adversos que pueden aumentar el riesgo quirúrgico de los pacientes en uso de este antidisrítmico. CONCLUSIONES: La amiodarona, a pesar de habitualmente segura y eficiente, puede presentar efectos adversos exacerbados, especialmente para el aparato cardiovascular, durante procedimientos anestésico-cirúgicos. Esto se debe posiblemente a las interacciones entre ese fármaco y agentes anestésicos, asociados principalmente a la anestesia general. Hay relatos de bradicárdias graves y resistentes a la terapéutica, bien como bloqueo atrioventricular (BAV en grados variados. El paciente debe ser rigurosamente monitorizado, especialmente en los procedimientos de grande porte, y el anestesista debe estar amparado en el peri-operatorio con drogas vasoactivas (isoproterenol y marcapaso cardíaco artificial temporario, que pueden ser fundamentales durante el procedimiento.BACKGROUND AND OBJECTIVES: Amiodarone is quite an effective anti-arrhythmic drug indicated for controlling ventricular and supra-ventricular arrhythmias, and it is being widely administered in clinical practice. However, its chronic use may be associated to severe side effects which may be worsened by anesthetic-surgical acts, thus increasing the risk of such procedures. This study aimed at reviewing major amiodarone effects and relating them to anesthetic procedures. CONTENTS: The study covers major amiodarone properties, its clinical use, as well as major adverse effects, which may increase patient's surgical risk. CONCLUSIONS: Amiodarone, although normally safe and effective, may present adverse effects, especially on cardiovascular system, during anesthetic-surgical procedures. This is possibly due to interactions between this drug and anesthetic agents mainly related to general anesthesia. There

  17. 静脉注射胺碘酮与普罗帕酮治疗阵发性室上性心动过速疗效的Meta分析%A meta-analysis of amiodarone and propafenone treatment of supraventricular tachycardia

    Institute of Scientific and Technical Information of China (English)

    王少波; 梁锦军; 黄从新

    2013-01-01

    Objective To evaluate the efficacy and safety of intravenous amiodarone and propafenone in treating par-oxysmal supraventricular tachycardia with the meta analysis. Methods Randomized controlled trials ( RCT ) included written in Chinese and English concerned using amiodarone and propafenone in treatment of paroxysmal supraventricular tachycardia were collected from 1999 to 2012 in a meta-analysis. The RevMan 5. 1 software of Cochrane Coordination Net was used for sta-tistical analysis. Results The therapy of amiodarone group and propafenone group in the treatment of paroxysmal supraventric-ular tachycardia effect analysis were: integrated test results was( OR = 1.45, 95% CIO.83 -2.51, P > 0. 05 ). The funnel plot analysis showed no significant bias. The adverse reaction analysis of amiodarone group and propafenone group therapy in the treatment of paroxysmal supraventricular tachycardia as follows: integrated test results was( OR =0.47, 95% CI 0. 29~ 0.77, P >0. 05 ). The funnel plot analysis showed no significant bias. Conclusion The amiodarone group and propafenone group therapy in the treatment of paroxysmal supraventricular tachycardia were showed no obvious differences. The incidence of adverse reactions of the amiodarone were lower than the propafenone.%目的 系统评价静脉注射胺碘酮与普罗帕酮治疗阵发性室上性心动过速的疗效与安全性.方法 计算机检索1999-2012年中英文电子文献数据库,收集有关胺碘酮和普罗帕酮治疗阵发性室上性心动过速的随机对照试验(RCT),应用Cochrane协作网提供的RevMan 5.1软件进行系统评价.结果 最终纳入5篇文献,(1)静脉注射胺碘酮组与普罗帕酮组治疗阵发性室上性心动过速疗效:两药差异无统计学意义(OR=1.45,95%CI 0.83~2.51,P>0.05);漏斗图分析结果未发现显著偏倚.(2)静脉注射胺碘酮组与普罗帕酮组治疗阵发性室上性心动过速不良反应:胺碘酮组不良反应发

  18. Analysis on efficacy and safety of amiodarone combined with dabigatran etexilate in treatment of non-valvular atrial fi-brillation%胺碘酮联合达比加群酯治疗非瓣膜性心房颤动的疗效和安全性分析

    Institute of Scientific and Technical Information of China (English)

    李玲; 罗晓丽; 王红勇

    2015-01-01

    Objective To investigate the efficacy and safety of amiodarone combined with dabigatran etexilate in the treatment of non-valvular atrial fibrillation.Methods 76 cases of non-valvular atrial fibrillation in our hospital from January to July 2014 were randomly divided into the treatment group and the control group.The treatment group was treated with amiodarone combined with dabigatran etexilate,while the control group was treated with ami-odarone combined with warfarin.The changes of electrocardiogram(EKG),blood coagulation indexes and biochemical indexes,and adverse reactions were observed in the two groups.Results Compared with before treatment,PT, APTT,INR and TT after treatment in the two groups were increased (P 0.05),the heart rate in the two groups was signif-icantly decreased (P 0.05).9 cases (23.7%) of gastrointestinal reactions occurred in the treatment group,which were higher than 5.3% in the control group (P 0.05),两组患者心率明显降低(P 0.05)。治疗组发生消化道反应9例(23.7%),高于对照组的5.3%(P <0.05)。而治疗组栓塞或血栓以及出血的发生率均低于对照组(P <0.05)。结论胺碘酮联合达比加群酯治疗非瓣膜性心房颤动安全有效,值得在临床推广。

  19. 胺碘酮治疗应用于冠心病急性心肌梗死伴高危快速型心律失常的临床疗效观察%Clinical effect of amiodarone in the treatment of acute myocardial infarction with high risk and rapid arrhythmia

    Institute of Scientific and Technical Information of China (English)

    许雪

    2015-01-01

    目的:研究分析胺碘酮应用于冠心病急性心肌梗死伴高危快速型心律失常的临床疗效.方法:收集我院2013年1月至2014年12月收治的80例冠心病急性心肌梗死伴高危快速型心律失常的患者,将80例患者平均分为观察组与对照组,两组患者均为40例,观察组采用胺碘酮对患者进行治疗,对照组采用利多卡因进行治疗,对两组患者的临床疗效进行对照分析.结果:观察组患者总有效率明显高于对照组(P<0.05).结论:对急性心肌梗死伴高危快速型心律失常的患者静脉注射胺碘酮能有效控制患者病情,胺碘酮治疗急性心肌梗死伴高危快速性心律失常具有良好的疗效,值得在临床上进行推广.%Objective: To study the clinical effect of amiodarone used in coronary heart disease (CHD) with high risk and rapid arrhythmia acute myocardial infarction. Methods: 80 cases of patients with acute myocardial infarction, coronary heart disease associated with high risk of fast arrhythmia patients were collected in our hospital during January 2013 to December 2013. The 80 patients were divided into an observation group and a control group with 40 cases in each group. The observation group was treated with amiodarone and the control group was treated with lidocaine. Analysis on comparison of the clinical curative effect of two groups of patients was conducted. Results: The total effective rate in the observation group was significantly higher than that of the control group (P< 0.05). Conclusion: For the acute myocardial infarction patients with high risk and rapid arrhythmia intravenous, amiodarone is effective to control the patient's condition. Amiodarone in treatment of acute myocardial infarction with high risk and rapid arrhythmia has good curative effect and it is worthy of application in clinical treatment.

  20. Influence of amiodarone on cardiac function in patients with arrhythmia%探讨胺碘酮对冠心病心律不齐患者心功能的影响

    Institute of Scientific and Technical Information of China (English)

    张春茹; 吕健; 郝丹

    2016-01-01

    Objective To investigate the influence of amiodarone on cardiac function and adverse events in elderly patients with arrhythmia. Methods A total of 78 elderly patients with arrhythmia who were diagnosed and treated in our hospital from March 2015 to March 2016 were enrolled and randomly divided into control group with 40 patients and observation group with 38 patients. Both groups were given conventional drugs for the treatment of coronary heart disease. The patients in the control group were given oral mexiletine treatment in addition, and those in the observation group were given oral amiodarone and long-term maintenance treatment in addition. The clinical effect and adverse events were compared between the two groups after one course of the treatment (14 days). Results The observation group had a significantly higher overall response rate than the control group (89.47% vs 65.0%, P0.05); after treatment, the observation group had significantly lower serum levels of hs-CRP and NT-proBNP and a significantly longer 6-minute walking distance compared with the control group (P<0.05). Six patients in the control group (15.0%) and 2 in the observation group (5.26%) experienced adverse events such as vomiting and nausea. The patients in both group achieved remission of symptoms after drug withdrawal. Among the patients in the control group, 3 (7.89%) experienced sinus bradycardia and a normal cardiac rhythm after the dose was reduced. Conclusion As for elderly patients with arrhythmia, amiodarone treatment has a significant clinical effect and few adverse effects and can significantly improve patients' cardiac function and relieve their signs. Clinical practice shows that this drug has a long half-life and needs few times of administration,which helps to guarantee safety. Therefore, it holds promise for clinical application.%目的:探讨胺碘酮对老年冠心病心律不齐患者心功能与不良反应的影响。方法选取2015年3月-2016年3

  1. Effects of Propafenone, Amiodarone and Dilthiazem on the potassium channel of c-Type Kv1.4△N%普罗帕酮、胺碘酮、地尔硫卓对Kv1.4△N钾通道的作用

    Institute of Scientific and Technical Information of China (English)

    王智泉; 蒋学俊; 王世敏; 徐林; 王能; 张冬

    2011-01-01

    目的 探讨不同类别抗心律失常药物普罗帕酮、胺碘酮和地尔硫卓对去N端Kv1.4通道(Kv1.4△N)的作用方式,以及这些作用的差异性.方法 将Kv1.4△N的mRNA注射入非洲爪蟾卵母细胞并使用双电极钳制法(two electrodes voltage clamp,TEV),运用Clampfit 9.0软件分别观察三种药物对KV1..4△N电生理特性的影响.结果 三种药物对ELvl.4△N通道的作用都具有浓度、频率和电压依赖性.在亲和力方面,propafenone的IC50最小,dilthiazem次之,amiodarone的IC50最大(P=0.031);在频率抑制性方面,propafenone组达到稳态时为对照组的41%,amiodarone为32%左右,dilthiazem为21%左右(P=0.045);在电压抑制性方面,100μMpropafenone,500μM amiodarone、350μM dilthjazem在+50 mV电压下分别能使fKv1.4△N通道电流抑制到对照组的(54.6±1.9)%,(46.3±3.5)%和(52.8±2.8)%(P=0.046).结论 三者都是fKv1.4△N通道的开放通道阻滞剂,对fKv1.4△N通道的作用和机制既有相同之处,又有不同特点,这可能是三者抗心律失常的机制之一.%Objective To study the effects of the antiarrhythmic drugs of propafenone, amiodarone and dilthiazem on c-type Kv1. 4 channels in Xenopus laevis oocytes with two-electrode voltage-clamp technique. Methods Defolliculated oocytes ( stage Ⅴ - Ⅵ) had transcribed cRNAs of ferret Kv1. 4△N channels injected. The oocytes were continuously perfused with control solution or propafenone, amiodarone and dilthiazem under monitoring of software of Clampfit v 9. 0. Results All of the three drugs blocked ferret Kv1. 4△N channel in voltage-, frequency- and concentration-dependent manners. The values of IC50 (50%inhibiting concentration ) of propafenone, amiodarone and dilthiazem were ( 103.4± 2. 2 ) μ mol/L,(501.22 +5.9) μmol/L and (353.62 +9.9) μmol/L, respectively. The currents under the actions of propafenone , amiodarone and dilthiazem were decreased to 41%, 32% and 21% of control group, respectively. Propafenone

  2. 异搏定和胺碘酮治疗阵发性室上性心动过速患者48例效果观察%Effect observation of the application of verapamil and amiodarone in 48 cases with paroxysmal supraventricular tachycardia

    Institute of Scientific and Technical Information of China (English)

    兰银花

    2014-01-01

    Objective:To observe the clinical effect of verapamil and amiodarone in the treatment of paroxysmal supraventricular tachycardia.Methods:48 cases with paroxysmal supraventricular tachycardia were selected from February 2010 to August 2013. They were randomly divided into the amiodarone group and the verapamil group with 24 cases in each.They were respectively given intravenous amiodarone and verapamil treatment.The treatment effective rate and cardiovascular adverse reactions of patients in two groups were observed.Results:In the amiodarone group,22 cases were effective;2 cases were invalid;the effective rate was 91.7%.In the verapamil group,21 cases were effective;3 cases were invalid;the effective rate was 87.5%.The effective rates of two groups were no significant difference(χ 2=0.2233,P>0.05).The cardiovascular adverse reactions in the amiodarone group included 1 case of sinus bradycardia,1 case of sinus arrest,2 cases of hypotension,and the incidence rate of adverse reaction was 16.67%.The cardiovascular adverse reactions in the verapamil group included 3 cases of sinus bradycardia,2 cases of sinus arrest,2 cases of complete atrioventricular block,4 cases of hypotension,1 case of shock,2 cases of cardiac function deterioration, and the incidence rate of adverse reaction was 58.33%.The incidence rate of cardiovascular adverse reaction in the amiodarone group was significantly lower than that of the verapamil group(χ 2=8.8889,P<0.01).Conclusion:Amiodarone in the treatment of paroxysmal supraventricular tachycardia has exact curative effect.It is safe and reliable.%目的:观察异搏定和胺碘酮治疗阵发性室上性心动过速的临床效果。方法:2010年2月-2013年8月收治阵发性室上性心动过速患者48例,随机分为胺碘酮组和异搏定组,各24例,分别给予静注胺碘酮、异搏定进行治疗,观察两组治疗的有效率及心血管不良反应。结果:胺碘酮组治疗有效22例,无效2例,有效率91

  3. The amiodarone derivative 2-methyl-3-(3,5-diiodo-4-carboxymethoxybenzyl)benzofuran (KB130015) opens large-conductance Ca2+-activated K+ channels and relaxes vascular smooth muscle.

    Science.gov (United States)

    Gessner, Guido; Heller, Regine; Hoshi, Toshinori; Heinemann, Stefan H

    2007-01-26

    2-methyl-3-(3,5-diiodo-4-carboxymethoxybenzyl)benzofuran (KB130015) has been developed to retain the antiarrhythmic properties of the parent molecule amiodarone but to eliminate its undesired side effects. In patch-clamp experiments, KB130015 activated large-conductance, Ca2+-activated BK(Ca) channels formed by hSlo1 (alpha) subunits in HEK 293 cells. Channels were reversibly activated by shifting the open-probability/voltage (P(o)/V) relationship by about -60 mV in 3 muM intracellular free Ca2+ ([Ca2+]in). No effect on the single-channel conductance was observed. KB130015-mediated activation of BK(Ca) channels was half-maximal at 20 microM with a Hill coefficient of 2.8. BK(Ca) activation by KB130015 did not require the presence of Ca2+ and still occurred with saturating (100 microM) [Ca2+]in. Effects of the prototypic BK(Ca) activator NS1619 (1,3-dihydro-1-[2-hydroxy-5-(trifluoromethyl)phenyl]-5-(trifluoromethyl)-2H-benzimidazol-2-one) and those of KB130015 were not additive suggesting that both activators may at least partially share a common mechanism of action. KB130015-mediated activation was observed also for BK(Ca) channels from insects and for human BK(Ca) channels with already profoundly left-shifted voltage-dependence. In contrast, human intermediate conductance Ca2+-activated channels were inhibited by KB130015. Using segments of porcine pulmonary arteries, KB130015 induced endothelium-independent vasorelaxation, half-maximal at 43 microM KB130015. Relaxation was inhibited by 1 mM tetraethylammonium, suggesting that KB130015 can activate vascular smooth muscle type BK(Ca) channels under physiological conditions. Interestingly, the shift in the P(o)/V relationship was considerably stronger (-90 mV in 3 microM [Ca2+]in) for BK(Ca) channels containing Slo-beta1 subunits. Thus, KB130015 belongs to a novel class of BK(Ca) channel openers that exert an effect depending on the subunit composition of the channel complex.

  4. 稳心颗粒联合胺碘酮治疗房颤合并频发室性心律失常临床效果研究%Clinical study on the effect of Wenxin Granule Combined with amiodarone in the treatment of atrial fibrillation and frequent ventricular arrhythmias

    Institute of Scientific and Technical Information of China (English)

    孟立立

    2014-01-01

    目的:探讨稳心颗粒联合胺碘酮治疗房颤合并频发室性心律失常患者的临床疗效。方法:2012年1月-2014年1月收治房颤合并频发室性心律失常患者60例,随机分为观察组和对照组,对照组单用胺碘酮治疗,观察组加用稳心颗粒治疗,并比较两组疗效。结果:观察组的总有效率(90.0%)明显大于对照组(76.7%),长间期发生率(6.67%)明显小于对照组(26.7%),且 P<0.05。结论:稳心颗粒联合胺碘酮治疗房颤合并频发室性心律失常患者可明显提高疗效,并降低长RR间期的发生率,值得临床推广。%Objective:To explore the clinical curative effect of Wenxin Granule Combined with amiodarone in the treatment of atrial fibrillation and frequent ventricular arrhythmias.Methods:We selected 60 cases of atrial fibrillation and ventricular arrhythmia patients in January 2012 to January 2014.These patients were randomly divided into observation group and control group.Control group was treated with amiodarone,while observation group added Wenxin Granule.The treatment effect of the two groups were compared.Results:In the observation group,the total efficiency(90.0% ) was obviously higher than that of control group(76.7%),and long interval incidence(6.67%) was significantly lower than that of control group(26.7%), P<0.05.Conclusion:The effect of Wenxin Granule Combined with amiodarone in the treatment of atrial fibrillation and frequent ventricular arrhythmias is significant.It can reduce the incidence of long RR interval.So it is worth the clinical promotion.

  5. 静脉滴注胺碘酮与普罗帕酮治疗阵发性室上性心动过速疗效分析%Analysis of the effect of intravenous amiodarone and propafenone on paroxysmal supraventricular tachycardia

    Institute of Scientific and Technical Information of China (English)

    黄萍

    2015-01-01

    目的:分析对阵发性室上性心动过速行静脉滴注胺碘酮与普罗帕酮治疗的效果。方法:收治阵发性室上性心动过速患者90例,随机分为研究组和对照组,每组45例。对照组行胺碘酮治疗,研究组行普罗帕酮治疗,观察两组疗效。结果:治疗后研究组总有效率95.56%显著高于对照组的71.11%,且转复时间(24.18±18.53)min显著少于对照组的(40.52±18.60)min(P<0.05)。结论:阵发性室上性心动过速患者行静脉滴注普罗帕酮治疗的效果显著。%Objective:To discuss the effect of intravenous amiodarone and propafenone on paroxysmal supraventricular tachycardia.Methods:90 patients with paroxysmal supraventricular tachycardia were selected.They were randomly divided into the study group and the control group with 45 cases in each.The control group received amiodarone treatment,and the study group underwent propafenone treatment.We observed the curative effect of two groups.Results:The study group after treatment the total efficiency of 95.56% was significantly higher than the control group of 71.11%,and the reversal time (24.18±18.53)min was less than the control group of(40.52 ± 18.60)min(P<0.05).Conclusion:The effect of intravenous amiodarone and propafenone on paroxysmal supraventricular tachycardia is outstanding.

  6. Impact of Wenxin Grannle Combined with Low - dose Amiodarone on Ventricular Remodeling of Valvular Heart Disease Patients Complicated with Paroxysmal Atrial Fibrillation%稳心颗粒联合小剂量胺碘酮对心脏瓣膜病并阵发性心房颤动患者心室重构的影响

    Institute of Scientific and Technical Information of China (English)

    刘国斌

    2016-01-01

    Objective To investigate the impact of wenxin grannle combined with low - dose amiodarone on ventricular remodeling of valvular heart disease patients complicated with paroxysmal atrial fibrillation. Methods From April 2013 to December 2015,a total of 106 valvular heart disease patients complicated with paroxysmal atrial fibrillation were selected in the Department of Cardiology,the Traditional Chinese Medicine Hospital of Neijiang,and they were divided into control group and treatment group according to random number table,each of 53 cases. Patients of both groups received mechanical heart valve replacement and radiofrequency ablation;patients of control group were given low - dose amiodarone after surgery,while patients of treatment group were given wenxin grannle combined with low - dose amiodarone. Clinical effect,index of ventricular remodeling(including LVEF,LVEDD and LVSV)before treatment and after 3 months of treatment were compared between the two groups,and incidence of adverse reactions during the treatment was observed. Results The clinical effect of treatment group was statistically significantly better than that of control group(P 0. 05);after 3 months of treatment,LVEF of treatment group was statistically significantly higher than that of control group,while LVEDD and LVSV of treatment group were statistically significantly lower than those of control group( P 0.05)。治疗后3个月,治疗组患者 LVEF 高于对照组,LVEDD 和 LVSV 低于对照组(P <0.05);且两组患者治疗后3个月 LVEF 高于治疗前,LVEDD 和 LVSV 低于治疗前(P <0.05)。治疗组患者治疗期间不良反应发生率低于对照组(P <0.05)。结论稳心颗粒联合小剂量胺碘酮治疗心脏瓣膜病并阵发性心房颤动的临床疗效确切,可有效逆转或延缓心室重构,且安全性较高。

  7. 胺碘酮和普罗帕酮治疗阵发性室上性心动过速的疗效对照研究%Controlled study on effect of amiodarone and hydrochloric acid propafenone on paroxysmal supraventricular tachycardia

    Institute of Scientific and Technical Information of China (English)

    霍秋玉

    2012-01-01

    Objective To observe the clinical efficacy and safety of intravenous amiodarone and hydrochloric acid propafenone in treating paroxysmal supraventricular tachycardia. Methods Eighty patients with paroxysmal supraventricular tachycardia were divieded into group A and B randomly (40 cases in each group). Group A received amiodarone, while group B received hydrochloric acid propafenone. The effective rate of cardioversion, cardioversion time, adverse reactions and the heart rate change were compared. Results The effective rate in group A was higher than that in group B, but the difference was not statistically significant. The cardioversion time in group A was obviously longer than that in group B (P<0. 01). The heart rates in the two groups after treatment decreased obviously (P<0.01), while the heart rate in group A was obviously lower than that in group B (P<0. 01). The incidence of adverse reactions in group A was lower than that in group B, but the difference was not statistically significant. Conclusion There are advantages of both amiodarone and propafenone in the treatment of paroxysmal supraventricular tachycardia. Propafenone is applicable to acute tachycardia, but adverse reactions should be taken into consideration. The amiodarone is effective in the treatment of paroxysmal supraventricular tachycardia in spite of the slow onset.%目的 比较静脉注射胺碘酮和普罗帕酮治疗阵发性室上心动过速的临床疗效及安全性.方法 将80例室上心动过速患者随机分为A、B 2组,各40例,A组给予胺碘酮注射液治疗,B组给予普岁帕酮注射液治疗,比较2组复律成功率、复律时间、不良反应及用药前后心率的变化.结果 A组复律成功率高于B组,但差异无统计学意义(P>0.05),而复律时间显著长于B组(P<0.01);2组治疗后心率均较治疗前显著下降(P<0.01),但治疗后A组心率显著低于B组(P<0.01).A组不良反应发生率低于B组,但差异无统计学意义.结论

  8. 静脉注射胺碘酮治疗心衰并心律失常的临床效果及护理干预%Clinical effect and nursing intervention of intravenous amiodarone in the treatment of heart failure and arrhythmia

    Institute of Scientific and Technical Information of China (English)

    马艾

    2015-01-01

    目的:对静脉注射胺碘酮治疗心衰并心律失常的临床效果及护理干预进行探讨。方法以我院心内科接收的40例心衰并心律失常患者作为研究对象,在治疗方式上采取胺碘酮静脉注射,并在此治疗基础上给予患者相关的护理干预,对患者治疗及护理干预的临床效果进行分析。结果患者在静脉注射胺碘酮治疗及精心地护理干预后恢复为窦性心律的为95%;余下2例患者治疗及护理干预效果不明显,实施电除颤治疗后转为窦性心律。40例患者均未发生心衰症状加重、休克等情况;患者无论在心率还是在舒张压及收缩压上均明显改善。结论通过静脉注射胺碘酮并实施针对性护理干预,能够使患者有效恢复窦性心律,促进患者并发症发生率的降低,改善患者心率、收缩压及舒张压,具有显著的救治疗效。%ObjectiveIntravenous amiodarone treatment of heart failure and arrhythmia clinical effect and nursing intervention were discussed. MethodIn my hospital Cardiology received 40 cases of patients with heart failure and arrhythmia as the research object, take on intravenous amiodarone treatment, and administered to patients in this treatment based on the relevant nursing intervention, treatment and care interventions for patients clinical results were analyzed.ResultsPatients in the intravenous amiodarone therapy and nursing intervention carefully restored to sinus rhythm was 95%; the remaining 2 patients after treatment and care interventions ineffective implementation defibrillation therapy sinus rhythm. 40 cases occurred in patients with no symptoms of heart failure worse, shock, etc; whether patients were significantly improved in the heart or in the diastolic and systolic blood pressure.ConclusionIntravenous amiodarone and implement specific nursing interventions, so that patients can effectively restore sinus rhythm, promote reduced patient morbidity and

  9. 碳纳米管存在下盐酸胺碘酮与 BSA 的相互作用%Interaction of amiodarone hydrochloride with BSA in the presence of carbon nanotubes

    Institute of Scientific and Technical Information of China (English)

    马红燕; 辛建伟; 张越诚

    2013-01-01

    Under the pH 7.40 Tris-HCl buffer system , fluorescence spectroscopy was used to investigate the influences of carbon nanotubes(CNTs)on the fluorescence of amiodarone hydrochloride (AD)on bovine serum albumin(BSA)and the influences of AD on that of BSA without CNTs.The experimental results demonstrated that AD could quench the intrinsic fluorescence of BSA ,and the quenching mechanism was dynamic quenching.The fluorescence quenching action of AD on BSA was strengthened in the pres-ence of CNTs.The binding constants KA,binding sites n and the corresponding thermodynamic parameters ΔH,ΔG andΔS at differ-ent temperatures were calculated.Based on the thermodynamic parameters ,it was proved that the major roles of binding force of AD-BSA was the electrostatic.The distance r of AD-BSA was evaluated according to the theory of Föster energy transfer.Moreover,the effect of AD on the conformation of BSA was also analyzed by using synchronous fluorescence spectroscopy .The results showed that AD changed the conformation of BSA during the reaction.But the CNTs could not change the conformation of BSA.The binding con-stants KA ,binding sites n of AD on BSA was increased in the presence of CNTs .The discussion offer a reference study on the action mechanism of CNTs and AD with albumin in vivo .%在pH 7.40的Tris-HCl缓冲体系下,用荧光光谱法研究了碳纳米管( MCNTs)对盐酸胺碘酮( AD)和牛血清白蛋白( BSA)荧光光谱特性的影响以及无碳纳米管共存时盐酸胺碘酮与BSA之间的相互作用。结果表明,AD对BSA的荧光有较强的猝灭作用,其猝灭机理为动态猝灭。碳纳米管的存在使AD对BSA的猝灭作用增强。计算了不同温度下AD与BSA之间的表观结合常数KA ,结合位点数n。相应的热力学参数ΔH、ΔG和ΔS表明,AD与BSA之间主要以静电作用力结合。根据Förster非辐射能量转移理论,确定了AD与BSA之间的结合距离r=3.99 nm。此外,利用同

  10. 氯沙坦联合胺碘酮在阵发性房颤复律及维持复律后窦性心率中的应用效果分析%Application Effect of Losartan Combined with Amiodarone in Patients with Paroxysmal Atrial Fibrillation ;Cardioversion and Maintenance of Sinus Heart Rate after Cardioversion

    Institute of Scientific and Technical Information of China (English)

    姜涛; 王曼; 武孟宇

    2015-01-01

    目的:探讨阵发性房颤患者应用氯沙坦联合胺碘酮的临床复律效果及对患者维持复律后窦性心率的意义。方法:2010年1月-2013年3月将72例非瓣膜病阵发性房颤患者按随机数字表法分为对照组36例和观察组36例,对照组给予胺碘酮治疗,观察组给予氯沙坦+胺碘酮治疗,比较治疗24 h、3 d和7 d时房颤的转复情况。在房颤复律后,继续药物治疗并随访观察1年,评价两组窦性心率的维持效果。结果:对照组治疗24 h、3 d和7 d房颤的转复率分别为72.2%(26/36)、83.3%(30/36)和91.7%(33/36),观察组的转复率分别为69.4%(25/36)、88.9%(32/36)和97.2%(35/36),观察组在7 d时房颤转复率较对照组明显升高(P<0.05)。两组窦性心率在治疗12个月时维持率分别为69.7%(23/33)和88.6%(31/35)(P<0.05),两组左房内径分别为(38.3±1.9)mm和(34.2±2.0)mm(P<0.05)。结论:阵发性房颤患者应用氯沙坦联合胺碘酮复律效果及维持复律后的窦性心率均优于单用胺碘酮治疗,可能与氯沙坦抑制肾素-血管紧张素系统,降低心脏负荷,抑制心房电及结构重构有关。%Objective:To investigate the clinical effect of losartan combined with amiodarone in patients with paroxysmal atrial fibrillation cardioversion and maintenance of sinus heart rate after cardioversion.Method:From January 2010 to March 2013,72 patients with nonvalvular paroxysmal atrial fibrillation randomly were given amiodarone therapy (control group 36 cases)and losartan combined with amiodarone therapy(observation group 36 cases),cardioversion of atrial fibrillation was compared after treatment for 24 h,3 d and 7 d. After cardioversion of atrial fibrillation,patients were continued to give drug treatment and followed up for 1 year,the maintenance effect of sinus heart rate was evaluated of the two groups.Result:The atrial fibrillation cardioversion rate in

  11. Clinical observation on treating CHD plus arrhythmia with beta-blocker and amiodarone plus the Shensong Yangxin granules%受体阻滞剂、胺碘酮等药物联合参松养心胶囊治疗冠心病合并心律失常的疗效观察

    Institute of Scientific and Technical Information of China (English)

    付振强

    2016-01-01

    Objective: To explore clinical efficacy of beta-blocker and amiodarone plus the Shensong Yangxin granules on coronary heart disease plus arrhythmia. Methods: 100 cases were randomly divided into the normal group and observed group, 50 cases in each group. The normal group received amiodarone; the other group took the Shensong Yangxin granules more, for 3 weeks. Results: In the observed group, recovery of symptoms was 92%, and was better than 80% in the normal group (P﹤0.05); improvement of electrocardiogram was 94%, and better than 74% in the normal group (P﹤0.05); Cases of suffering from adverse reactions were significantly lower than those in the normal group (P﹤0.05). Conclusion: Amiodarone plus the Shensong Yangxin granules was obviously effective on CHD, with little adverse reactions.%目的::探讨受体阻滞剂、胺碘酮等药物与参松养心胶囊对冠心病合并心律失常患者的临床治疗效果以及可行性分析。方法:把所收集到的100例冠心病合并心律失常患者在正常规范诊疗的基础上随机分成正常组与观察组各50例。正常组使用胺碘酮,观察组使用胺碘酮联合参松养心胶囊,疗程为3周,观察分析治疗后临床的效果及其可行性。结果:观察组的病情恢复改善率高达92%,明显比正常组的80%高(P﹤0.05),观察组心率失常症状改善率为92%,高出正常组的82%(P﹤0.05),观察组正常心电图改善率为94%,高出正常组(74%)(P﹤0.05),观察组出现不良反应的患者人数及所占的比例都显著低于正常组(P﹤0.05)。结论:药物胺碘酮与参松养心胶囊具有协同互补作用,二种药物联合使用可明显提高疗效,有极少数不良反应。

  12. 鲜芦荟外敷联合局部封闭治疗胺碘酮致静脉炎的效果观察%The observation of the clinical effect of using the fresh aloe vera which was for external application and uniting local block to treat the phlebitis which was by used amiodarone

    Institute of Scientific and Technical Information of China (English)

    龚兰娟; 叶春燕; 周小敏; 罗桂平; 关雪红; 黄丹

    2014-01-01

    Objective:It was to discuss the observation of the clinical effect of using the fresh aloe vera which was for external application and uniting local block to treat the phlebitis which was by used amiodarone with lidocaine. Method It happened to peripheral venous injection amiodarone from May 2011 to May 2013 in our hospital, which led to 50 patients had the phlebitis of grade 1 or more. And they were divided into observation and control group, each group had 25 cases. In the observation group, they used the fresh aloe vera which was for external application and someone united local block in the treatment of lidocaine with the phlebitis of grade 3 or more. In the control group, they were used by 50%magnesium sulfate wet. And it was to assess pain and contrast the clinical effect after giving drugs 4 or 8 hours. Result the clinical and analgesic effects of the observation group was better than that of the control group. Conclusion the clinical and analgesic effects of using the fresh aloe vera which was for external application and uniting local block to treat the phlebitis which was by used amiodarone with lidocaine was much better than that of using 50%magnesium sulfate wet.%目的:探讨鲜芦荟外敷联合利多卡因局部封闭治疗胺碘酮致静脉炎的临床疗效。方法:将2011年5月至2013年5月高州市人民医院收治的外周静脉输注胺碘酮致静脉炎Ⅰ级以上患者50例作为研究对象,分为观察组和对照组各25例,观察组给予鲜芦荟外敷,静脉炎Ⅲ级以上联合利多卡因局部封闭治疗,对照组给予50%硫酸镁湿敷,分别于给药后4、8 h 进行疼痛评估和对比临床疗效。结果:治疗4、8 h 后,观察组止痛效果优于对照组(P<0.05),治疗48 h 后,观察组临床疗效均优于对照组(P<0.05)。结论:采用鲜芦荟外敷联合利多卡因局部封闭治疗胺碘酮所致的静脉炎止痛效果及临床疗效明显优于50%硫酸镁湿敷。

  13. 胺碘酮治疗慢性心力衰竭并发室性心律失常56例临床分析%Chronic Heart Failure Complicated by Ventricular Arrhythmias Amiodarone Therapy Clinical Analysis of 56 Cases

    Institute of Scientific and Technical Information of China (English)

    金迪

    2015-01-01

    目的:探究胺碘酮治疗慢性心力衰竭并发室性心律失常的疗效,分析其优势。方法将2014年1月~2014年5月到我院诊治的56例慢性心力衰竭并发室性心律失常的患者随机分为对照组(实施常规抗心力衰竭治疗)和实验组(常规抗心力衰竭治疗+胺碘酮治疗)每组28例,观察两组的左心室射血分数(LVEF%)和二尖瓣口舒张早期和舒张晚期血流峰值计算E峰/A峰(E/A),心律失常,心功能改善情况,比较其差异。结果观察组内的治疗前后LVE、E/A资料分析后P0.05;在心功能改善方面差异显著(P 0.05; heart function improvement were significantly different (P <0.05).ConclusionAmiodarone can reduce pain and complications for patients with chronic heart failure complicated by ventricular arrhythmias, but should continue to study the long-term effectiveness.

  14. Terapia de resgate com amiodarona em crianças com grave disfunção ventricular esquerda causada por veneno de escorpião Terapia de rescate con amiodarona en niños con severa disfunción ventricular izquierda ocasionada por veneno de escorpión Antiadrenergic rescue therapy with amiodarone in children with severe left ventricular dysfunction secondary to scorpion envenomation

    Directory of Open Access Journals (Sweden)

    Justo J. Santiago

    2010-01-01

    ón endotraqueal y soporte respiratorio, electrocardiograma, radiografía de tórax, ecocardiograma y determinación sérica de la norepinefrina y troponina I. Los análisis se repitieron tras 12, 24 y 48 horas. Las siguientes medicaciones intravenosas se administraron: dobutamina 4-6 mcg/kg/min; amiodarona 3 mg/kg durante dos horas, con dosis de mantenimiento de 5 mg/kg/día; y furosemida 0.5 mg/kg. Amiodarona, dobutamina y furosemida se administraron durante las primeras 48 horas. Bloqueante betaadrenergicos e inhibidores de la enzima convertidora de la angiotensina se administraron hasta 48 tras la internación, una vez que el estado clínico había mejorado y la fracción de eyección ventricular izquierda se hallaba superior a un 0,35%. RESULTADOS: Al ingreso, la dosificación de la norepinefrina fue 1727,50± 794,96 pg/ml, la de troponina I 24,53 ± 14,09 ng/ml y la fracción de eyección del ventrículo izquierdo fue 0,20 ± 0,056. Tras 12 horas, los niveles séricos de norepinefrina y de troponina I disminuyeron para la mitad de los valores iniciales y la fracción de eyección aumentó para 0,32 ± 0,059. Durante las 24 y 48 horas subsiguientes, la fracción de eyección se elevó para 0,46 ± 0,045 (pBACKGROUND: Children with scorpion envenomation have massive sympathetic activation and variable degrees of left ventricular systolic dysfunction. OBJECTIVE: To evaluate a rescue protocol for children with severe left ventricular dysfunction secondary to scorpion envenomation. METHODS: Four children, after scorpion envenomation, were subjected to a rescue protocol for acute left ventricular dysfunction: Endotracheal intubation and respiratory assistance, electrocardiograms, chest x-Ray, echocardiograms and blood samples for norepinephrine and troponin I serum levels. Samples and echocardiograms were repeated at 12, 24 and 48 hours. Intravenous medications: Dobutamine: 4-6 μg/kg/min. Amiodarone: 3 mg/kg during a 2 hour period. Maintenance: 5 mg/kg/day. Furosemide: 0.5 mg

  15. Inhibitory effects of amiodarone on simvastatin metabolism in human liver microsomes

    Institute of Scientific and Technical Information of China (English)

    Chao Wan; Jiang wei Zhang; Ning Zhu; Ling Yang

    2009-01-01

    Objective To investigate the effects ofamiodarone (AMD) on simvastatin (SV) in human liver microsomes and the possible underlying mechanisms. Methods Time-, NADPH- and concentration-dependent inhibitions were tested in HLM. The logarithm of relative inhibition values was plotted versus preincubation time (0, 5, 10, 15, 20min) for a series concentration of AMD used (0, 2, 5,25, 50 μ mol/L), and the slopes determined by linear regression. These slope values represente the observed inactivation rate constants (kobs). A double-reciprocal plot was then constructed using the reciprocal of the ko~ (y-axis) and the reciprocal of the associated inhibitor concentration (x-axis) to estimate the values ofkinact and K, which were two principal kinetic constants that were specific for mechanism-based inhibition (MBI).drug-drug interactions (DDI) potential was predicted based on in vitro data and by using the in vitro-in vivo extrapolation. Results The time-, concentration- and NADPH-dependent charactga'istics confirmed that when SV was the substrate of CYP3A4, the inhibition of AMD to CYP3A4 is MBI. Kj and kinact value were calculated to be 5.1 μ mol/L and 0.018min-1 The Clint of SV was reduced 2.96-5.63 fold when it was administrated with AMD. Conclusion Based on the results, AMD would inhibit SV metabolism via the mechanism-based manner, which would lead to DDI when they are taken together. Careful clinical observation is recommended when AMD and SV have to be simultaneously prescribed.

  16. Atrial fibrillation and rheumatic valvular heart disease: usefulness of very-low-dose amiodarone

    Institute of Scientific and Technical Information of China (English)

    Tsuyoshi Shiga

    2006-01-01

    @@ Atrial fibrillation (AF) is frequently associated with rheumatic valvular heart disease (RVHD). AF leads to systemic thromboembolic complications,reduced quality of life (QOL), impaired ventricular function and also increased mortality. Multivariate analysis of results from a population-based study has shown that valvular heart disease is one of risk factors for development of AF.1 The frequency of RVHD has decreased in developed countries in recent years, but RVHD now constitutes a significant population for the cardiology services in developing countries.2

  17. Impact of dronedarone in atrial fibrillation and flutter on stroke reduction

    DEFF Research Database (Denmark)

    Christiansen, Christine Benn; Torp-Pedersen, Christian; Køber, Lars

    2010-01-01

    Dronedarone has been developed for treatment of atrial fibrillation (AF) or atrial flutter (AFL). It is an amiodarone analogue but noniodinized and without the same adverse effects as amiodarone.......Dronedarone has been developed for treatment of atrial fibrillation (AF) or atrial flutter (AFL). It is an amiodarone analogue but noniodinized and without the same adverse effects as amiodarone....

  18. 心室颤动的时-频分析和胺碘酮的作用%Time-frequency Analysis of Ventricular Fibrillation And the Effects of Amiodarone

    Institute of Scientific and Technical Information of China (English)

    王珂; 邓小燕; 徐在品; 李树刚; 刘岩; 郭然; Patwardhan Abhijit; Leonelli Fabio

    2007-01-01

    研究心室颤动时主导频率的动态性空间时间变化.在19只犬中建立正交心电图和心脏电除颤系统;诱发心室颤动持续10~30 s;使用时-频分析法分析心室颤动时频率的时频变化.另有4只犬在诱发心室颤动后静注胺碘酮100 mg以观察主导频率的改变.结果显示:在427个10 s VF和335个30 s VF的试验中,主导频率的变化与平均频率相差12%~18%;79个使用胺碘酮的试验中,主导频率的均值和变异性均降低.表明:在10~30 s心室颤动时心电图主导频率有明显和持续性的变异,胺碘酮可减小心室颤动时的频率和变异.

  19. 胺碘酮对美托洛尔药代动力学的影响%Effect of amiodarone on pharmacokinetics of metoprolol

    Institute of Scientific and Technical Information of China (English)

    詹少卿; 张冬梅; 黄建飞; 何振伟

    2009-01-01

    目的 考察胺碘酮对美托洛尔药代动力学的影响.方法 将符合入选条件的病例分为2组,每组10例,分别口服美托洛尔、芙托洛尔+胺碘酮,采用HPLC法测定美托洛尔血药浓度,经DAS软件处理,计算美托洛尔的主要药代动力学参数.结果 合用胺碘酮后,美托洛尔的血药浓度和药时曲线下面积(Area Under the Curve,AUC)显著升高.结论 胺碘酮可升高芙托洛尔在人体内的血药浓度,导致发生不良反应的风险增加.

  20. Mechanisms of amiodarone and valproic acid induced liver steatosis in mouse in vivo act as a template for other hepatotoxicity models

    NARCIS (Netherlands)

    Vitins, A.P.; Kienhuis, A.S.; Speksnijder, E.N.; Roodbergen, M.; Luijten, M.; Ven, van der L.T.M.

    2014-01-01

    Liver injury is the leading cause of drug-induced toxicity. For the evaluation of a chemical compound to induce toxicity, in this case steatosis or fatty liver, it is imperative to identify markers reflective of mechanisms and processes induced upon exposure, as these will be the earliest changes re

  1. Clinical Analysis of Propafenone and Amiodarone Emergency Cardioversion of Pparoxysmal Supraventricular Tachycardia%普罗帕酮和胺碘酮急诊转复阵发性室上性心动过速的临床分析

    Institute of Scientific and Technical Information of China (English)

    廉秀华

    2015-01-01

    目的:对普罗帕酮和胺碘酮治疗转复阵发性室上性心动过速(PSVT)患者的临床疗效进行分析。方法分析80例PSVT患者的临床资料。结果两组总有效率、不良反应率对比(P>0.05);治疗组转复时间短于对照组(P 0.05). The treatment group was significantly shorter than the control group (P < 0.05). Conclusion The clinical efficacy of the treatment of the patients with paroxysmal ventricular tachycardia with the drug treatment of the patients with the treatment of the patients with paroxysmal tachycardia is equivalent to that of Proba.

  2. The therapeutic effect of amiodarone on the elderly with sinus bradycardia and premature ventricular complexes%胺碘酮对老年心动过缓伴室性早搏临床疗效的观察

    Institute of Scientific and Technical Information of China (English)

    邵迴龙; 张红明; 高燕; 卫亚

    2004-01-01

    目的观察胺碘酮对老年心动过缓伴室性早搏的临床疗效.方法选择老年心动过缓伴室性早搏患者29例,入选者均为其它抗心律失常药物治疗效果欠佳或出现明显不良反应,口服胺碘酮4周并复查动态心电图、甲状腺功能、肝功、胸片等.结果显示口服胺碘酮后总有效率86.20%,用药后平均心率减慢,QTc延长,不良反应发生率为20.69%.结论胺碘酮治疗老年心动过缓伴室性早搏相对较安全、有效.

  3. 阿魏酸钠与胺碘酮对家兔心室肌电生理作用的对比研究%Comparison of the cardiac electrophysiological effects of sodium ferulateto amiodarone on rabbit right ventricular myocardium

    Institute of Scientific and Technical Information of China (English)

    周彤; 曾秋棠; 张桂清; 刘锦华; 李屏; 毛奕

    2002-01-01

    目的:研究阿魏酸钠对家兔心室肌复极及有效不应期(ERP) 的影响,探讨其抗心律失常的可能机制.方法:16只家兔随机分为阿魏酸钠组与胺碘酮组,各组同步记录体表心电图(ECG)及右室心内膜单相动作电位(MAP),比较在窦性心律下,用药前及用药后窦性心动周长(SCL)、QRS时限(QRSD)、MAP振幅(MAPA)、ERP及复极90%时程(MAPD90)的变化.结果:阿魏酸钠发挥与胺碘酮一致的时间依赖性延长MAPD90与ERP作用,但不改变ERP/MAPD90比值, 胺碘酮用药15 min,ERP及MAPD90分别由用药前的( 125.00± 16.26)ms、( 143.12± 15.80)ms延长为( 199.00± 21.62)ms、( 216.88± 23.14)ms(P< 0.01);阿魏酸钠用药25 min,ERP及MAPD90分别由用药前的( 122.50± 8.13)ms、( 140.00± 6.25)ms延长为( 143.75± 6.87)ms、( 164.38± 7.19)ms(P< 0.01).结论:经与胺碘酮比较,推测阿魏酸钠具有Ⅲ类抗心律失常药物的抗心律失常特性.

  4. Tiagabine

    Science.gov (United States)

    ... Tiagabine is in a class of medications called anticonvulsants. It is not known exactly how tiagabine works, ... mention any of the following: amiodarone (Cordarone, Pacerone);anticonvulsants such as carbamazepine (Tegretol), ethosuximide (Zarontin), gabapentin (Neurontin), ...

  5. Nimodipine

    Science.gov (United States)

    ... to mention any of the following: aprepitant (Emend); armodafinil (Nuvigil); alprazolam (Niravam, Xanax); amiodarone (Cordarone, Pacerone, Nexterone); ... Carbatrol, Equetro, Tegretol), phenobarbital (Luminal), and phenytoin ... (Provigil); nafcillin (Nallpen); oral contraceptives (birth control pills); ...

  6. Nebivolol

    Science.gov (United States)

    ... Nebivolol is in a class of medications called beta blockers. It works by relaxing blood vessels and slowing ... mention any of the following: amiodarone (Cordarone, Pacerone); beta blockers such as acebutolol (Sectral), atenolol (Tenormin, in Tenoretic), ...

  7. Betaxolol

    Science.gov (United States)

    ... Betaxolol is in a class of medications called beta blockers. It works by relaxing blood vessels and slowing ... mention any of the following: amiodarone (Cordarone, Pacerone); beta blocker eye drops such as betaxolol (Betoptic), carteolol (Ocupress), ...

  8. Potent synergistic in vitro interaction between nonantimicrobial membrane-active compounds and itraconazole against clinical isolates of Aspergillus fumigatus resistant to itraconazole.

    NARCIS (Netherlands)

    Afeltra, J.; Vitale, R.G.; Mouton, J.W.; Verweij, P.E.

    2004-01-01

    To develop new approaches for the treatment of invasive infections caused by Aspergillus fumigatus, the in vitro interactions between itraconazole (ITZ) and seven different nonantimicrobial membrane-active compounds--amiodarone (AMD), amiloride, lidocaine, lansoprazole (LAN), nifedipine (NIF), verap

  9. Drug: D02910 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available ic, ventricular] [DS:H00293] Same as: C06823 ATC code: C01BD01 Class III antiarrhythmic...A4 [HSA:1576], CYP1A2 [HSA:1544] Transporter inhibition: ABCB1 [HSA:5243] map07037 Antiarrhythmic drugs map0...C THERAPY C01B ANTIARRHYTHMICS, CLASS I AND III C01BD Antiarrhythmics, class III C01BD01 Amiodarone D02910 A...miodarone (USAN/INN) USP drug classification [BR:br08302] Cardiovascular Agents Antiarrhythmics Amiodarone D...D02910 Drug Amiodarone (USAN/INN) C25H29I2NO3 645.0237 645.3116 D02910.gif Cardiac depressant [anti-arrhythm

  10. Clinical studies on thyroid diseases

    NARCIS (Netherlands)

    Eskes, S.A.

    2014-01-01

    This thesis focuses on some aspects of thyroid disease: prevention of autoimmune thyroid disease (AITD), diagnosis of related conditions as autoimmune hypophysitis in autoimmune hypothyroidism (Hashimoto’s disease), and treatment of amiodarone-induced thyrotoxicosis (AIT).

  11. CARDIOVASCULAR SYSTEM

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    6.1 Cardiac Arrhythmias2007037 Angiotensin converting enzyme inhibitor improves the effect of amiodarone on maintaining sinus rhythm of patients with persistent atrial fibrillation. JIA Xinwei(贾新未), et al. Dept Cardiol, Affili Hosp, Hebei Univ Baoding 071000. Chin Cir J 2006; 21(57):379-381. Objective To investigate whether angiotensin converting enzyme inhibitor (ACEI) can improve the effect of amiodarone on maintaining sinus rhythm of patients with persistent atrial fibrillation and to elucidate its mechanism.

  12. Acceleration of ventricular rate by fibrillation associated with the Wolff-Parkinson-White syndrome.

    Science.gov (United States)

    Sheinman, B D; Evans, T

    1982-10-09

    Amiodarone has proved to be a valuable drug in atrial fibrillation associated with the Wolff-Parkinson-White syndrome. When it was administered to a patient with this syndrome in atrial fibrillation, who had previously suffered an inferior myocardial infarction, the ventricular rate accelerated from 170 to 230 beats/minute.This unusual case emphasises the need for full electrophysiological assessment of patients with the Wolff-Parkinson-White syndrome for whom amiodarone treatment is being considered.

  13. The effect of drug combination on patients with paroxysmal atrial fibrillation%联合用药对阵发性心房颤动患者疗效观察

    Institute of Scientific and Technical Information of China (English)

    程晓静; 付蓉; 郭丽丽; 潘华; 高悦顺

    2011-01-01

    Objective To observe the effect and safety of amiodarone, spironolactone and irbesartan on sinus rhythm, left atrial internal diameter and brain natruretic peptide(BNP) for patients with nonvalvular paroxysmal atrial fibrillation(AF). Methods One hundred and forty-two patients with nonvalvular paroxysmal atrial fibrillation were divided into amiodarone group(n=47), amiodarone plus spironolactone group (n = 47 ) and amiodarone spironolactone plus irbesartan group ( Combined treatment group, n = 48 ). Three groups were treated with amiodarone.Amiodarone plus spironolactone group was treated with spironolactone in addition. Combined treatment group was treated with irbesartan based on amiodarone and spironolactone. Left atrial internal diameter and BNP were observed after 6 months, 12 months, 18 months respectively and the rate of maintenance of sinus rhythm was observed after 3months, 6 months, 12 months, 18 months, 24 months respectively. The safety of drugs was observed during this study. Results After 6 months treatments, left atrial internal diameter and BNP of three groups was no difference but left atrial internal diameter and BNP of amiodarone plus spironolactone group and Combined treatment group was less than that of amiodarone group after 12 months ( P < 0.05 ). left atrial internal diameter and BNP of combined treatment group was less than those of amiodarone plus spironolactone group after 12 months ( P < 0.05 ). After 3and 6 months treatments, the rate of maintenance of sinus rhythm of amiodarone group was lower than that in amiodarone plus spironolactone group and combined treatment group, but there was no statistically significance difference between amiodarone group and amiodarone plus spironolactone group, amiodarone plus spironolactone group andCombined treatment group. The rate of maintenance of sinus rhythmia of amiodarone group was statistically lower than that in combined treatment group (P<0.05). After 12 months, The rate of mainterance

  14. Use and Outcomes of Antiarrhythmic Therapy in Patients with Atrial Fibrillation Receiving Oral Anticoagulation: Results from the ROCKET AF Trial

    Science.gov (United States)

    Steinberg, Benjamin A.; Hellkamp, Anne S.; Lokhnygina, Yuliya; Halperin, Jonathan L.; Breithardt, Günter; Passman, Rod; Hankey, Graeme J.; Patel, Manesh R.; Becker, Richard C.; Singer, Daniel E.; Hacke, Werner; Berkowitz, Scott D.; Nessel, Christopher C.; Mahaffey, Kenneth W.; Fox, Keith A.A.; Califf, Robert M.; Piccini, Jonathan P.

    2014-01-01

    Background Antiarrhythmic drugs (AAD) and anticoagulation are mainstays of atrial fibrillation (AF) treatment. Objective We aimed to study the use and outcomes of AAD therapy in anticoagulated AF patients. Methods Patients in the ROCKET AF trial (n=14,264) were grouped by AAD use at baseline: amiodarone, other AAD, or no AAD. Multivariable adjustment was performed to compare stroke, bleeding, and death across groups, as well as across treatment assignment (rivaroxaban or warfarin). Results Of 14,264 patients randomized, 1681 (11.8%) were treated with an AAD (1144 [8%] with amiodarone, 537 [3.8%] with other AADs). Amiodarone-treated patients were less-often female (38% vs. 48%), had more persistent AF (64% vs. 40%), and more concomitant heart failure (71% vs. 41%) than patients receiving other AADs. Patients receiving no AAD more closely-resembled amiodarone-treated patients. Time in therapeutic range was significantly lower in warfarin-treated patients receiving amiodarone versus no AAD (50% vs. 58%, p<0.0001). Compared with no AAD, neither amiodarone (adjusted HR 0.98, 95% CI 0.74–1.31, p=0.9) nor other AADs (adjusted HR 0.66, 95% CI 0.37–1.17, p=0.15) were associated with increased mortality. Similar results were observed for embolic and bleeding outcomes. Rivaroxaban treatment effects in patients not on an AAD were consistent with the overall trial (primary endpoint adjusted HR 0.82, 95% CI 0.68–0.98, pinteraction=0.06; safety endpoint adjusted HR 1.12, 95% CI 0.90–1.24, pinteraction=0.33). Conclusion Treatment with AADs was not associated with increased morbidity or mortality in anticoagulated patients with AF. The influence of amiodarone on outcomes in patients receiving rivaroxaban requires further study. PMID:24833235

  15. Effect Observation and Nursing Care OnFar Infrared ray Radiation Combined with External use of Hirudoid Creamin Prevention and Treatment of Phlebitis Caused by Amiodarone Hydrochloride%远红外线照射联合喜疗妥外敷防治胺碘酮相关静脉炎的疗效观察与护理

    Institute of Scientific and Technical Information of China (English)

    秦燕; 刘文秀; 耿炳超

    2016-01-01

    探讨远红外线照射结合喜疗妥外敷及护理防治胺碘酮相关静脉炎的临床效果.选取50例外周静脉输注盐酸胺碘酮患者,采取随机数字法将患者分为对照组和治疗组,每组各25例.对照组给予远红外线照射,采用一般护理措施;治疗组采取远红外线照射结合喜疗妥外敷治疗和护理干预措施,比较两组静脉炎及疼痛发生情况.两组静脉炎和疼痛程度比较差异(P<0.05)有统计学意义.远红外线照射结合喜疗妥外敷和护理干预可降低胺碘酮相关静脉炎的发生率,减轻炎症局部疼痛,提高患者舒适度.

  16. Effects of sodium ferulate and amiodarone on L-type calcium channel current in isolated rabbit ventricular myocytes%阿魏酸钠与胺碘酮对家兔心室肌细胞L型钙通道电流的影响

    Institute of Scientific and Technical Information of China (English)

    周彤; 曾秋棠

    2008-01-01

    目的 探讨阿魏酸钠对家兔心室肌细胞膜L型钙通道电流(ICa-L)的影响.方法 酶解法急性分离兔单个心室肌细胞,以经典的Ⅲ类抗心律失常药物胺碘酮为对照,应用膜片钳全细胞记录技术观察3,10,30,100μmol/L的阿魏酸钠对心室肌细胞膜ICa-L的作用.结果 阿魏酸钠及胺碘酮均呈浓度依赖性抑制L型钙电流.3,10,30,100 μmol/L 的阿魏酸钠对ICa-L的抑制率分别为11.1%±2.4%,26.9%±6.2%,40.5%±5.0%,61.9%±5.5%(P<0.05);1,3,10,30 μmol/L的胺碘酬对ICa-L的抑制率分别为21.1%±3.8%,32.6%±2.6%,52.6%±4.6%,71.4%±7%(P<0.05);半数抑制浓度分别为32.6及9.5μmol/L,阿魏酸钠的抑制作用弱于胺碘酮(P<0.05).阿魏酸钠及胺碘酮均能使ICa-L电流-电压曲线上移,稳态激活曲线右移,失活曲线左移,并可减慢钙通道灭活后的恢复过程.结论 阿魏酸钠对ICa-L具有浓度依赖性阻滞作用,使ICa-L的激活减慢,失活加快,并且失活后的恢复时间延长,可能是其抗心律失常作用的电生理机制之一.

  17. 充血性心力衰竭患者外周单核细胞分泌TNF-α水平变化及胺碘酮对其影响的研究%Change of TNF-α secretion from peripheral blood mononuclear cells in patients with congestive heart filure and effect of amiodarone on the production of TNF-α

    Institute of Scientific and Technical Information of China (English)

    姚恒臣; 冯桂芹; 孔祥泉; 张颖新; 王英丽; 高航; 侯岩芳; 侯新华

    2002-01-01

    目的:探讨充血性心力衰竭(CHF)患者血清TNF-α水平变化,以及胺碘酮对培养的正常人及CHF患者外周血单个核细胞(PBMC)分泌TNF-α的影响.方法: 取20例正常人和20例Ⅱ°-Ⅲ° CHF患者静脉血:(1)测其血清TNF-α含量;(2)离心取单个核细胞(PBMC),分别加入胺碘酮和LPS等,使胺碘酮的终浓度为0 mmol/L、0.1 mmol/L、1 mmol/L和 10 mmol/L进行培养,经24 h孵化后,取培养上清液,用ELISA法测血清和培养上清TNF-α含量.结果:CHF患者血清TNF-α含量明显高于对照组(P<0.01),并随心衰程度的加重而增加(P<0.01),胺碘酮对两组PBMC分泌TNF-α均有抑制作用,并呈剂量依赖性. 结论: (1)TNF-α可能参与CHF过程;(2)胺碘酮可能抑制TNF-α的产生.

  18. 胺碘酮联合美托洛尔治疗急性心肌梗死伴快速房颤的临床疗效%Amiodarone combined metoprolol in the treatment of acute myocardial infarction Atrial fibrillation with rapid clinical efficacy

    Institute of Scientific and Technical Information of China (English)

    雷玉梅; 胡小平; 马继东; 兰为群

    2009-01-01

    目的:观察胺碘酮联合美托洛尔(倍他乐克)治疗急性心肌梗死(AMI)伴快速房颤的临床疗效.方法:60例AMI患者伴快速房颤,给予胺碘酮首剂150 mg静脉推注,15 min后未转复窦性心律,可再给以150 mg静推,继之0.5~1.0 mg·min-1持续静滴1~3 d,静脉用药同时给予口服胺碘酮(第1周200 mg,tid,第2周200 mg,bid,第3周200 mg,qd,24 h总量<1 200 mg)和倍他乐克(25~50 mg,bid),观察用药前后房颤转复、心率、血压变化情况.结果:55例房颤转复,所有患者心室率得到控制,用药前后血压平稳.结论:胺碘酮联合美托洛尔治疗急性心肌梗死伴快速房颤安全有效.

  19. Electrophysiological effects of amiodarone on pacemaker cells in guinea-pig left ventricular outflow tract under conditions of hypoxia, acidosis and treatment with epinephrine%胺碘酮对低O2、酸中毒及肾上腺素条件下豚鼠左心室流出道自律细胞电活动的影响

    Institute of Scientific and Technical Information of China (English)

    赵兰平; 王雪芳; 陈彦静; 杜会博; 胡兴光; 季振慧

    2010-01-01

    目的:研究胺碘酮对豚鼠左心室流出道自律细胞电活动的影响以及胺碘酮对低O2、酸中毒和肾上腺素(EPI)所致该部位自律性改变的影响.方法:采用标准玻璃微电极细胞内电位记录技术,分别观测胺碘酮对豚鼠左心室流出道自发慢反应电位的影响,以及胺碘酮对无糖低氧、pH6.8和EPI导致的该电位改变的影响.结果:(1)0.1 μmol/L胺碘酮可使左心室流出道自发慢反应电位自发放电频率(RPF)减慢,最大舒张电位(MDP)绝对值减小,复极80%时间(APD80)延长(P<0.05);1 μmol/L胺碘酮可引起4相自动除极速度(VDD)和0相最大除极速度(Vmax)减慢,动作电位幅度(APA)减小,复极50%时间(APD50)延长(P<0.05),RPF减慢,MDP减小和APD80延长(P<0.01);10μmol/L胺碘酮可使VDD进一步减慢,APA进一步减小(P<0.01),其它指标的改变维持1 μmol/L胺碘酮灌流时的水平.(2)低O2可使VDD、RPF和Vmax减慢,MDP和APA减小,APD50缩短(P<0.05);和低O2组相比,1 μmol/L胺碘酮+低O2可使RPF和Vmax进一步减慢,MDP增大,APD80延长(P<0.05),VDD进一步减慢,APD50延长(P<0.01).(3)pH6.8的灌流液可使VDD和RPF减慢,APD80缩短(P<0.05),Vmax减慢,APA减小(P<0.01);与pH6.8组相比,pH6.8的1 μmol/L胺碘酮可使RPF进一步减慢,MDP和APA进一步减小,APD80延长(P<0.05),VDD进一步减慢,APD50延长(P<0.01).(4)10 μmol/L EPI可使VDD、RPF和Vmax加快,MDP增大,APD50和APD80缩短(P<0.05),APA增大(P<0.01);μmol/L胺碘酮+10 μmol/L EPI可使VDD和RPF减慢,MDP和APA减小,Vmax减慢,APD50和APD80延长(P<0.05,P<0.01).结论:胺碘酮可降低豚鼠左心室流出道的自律性,同时对低O2、酸中毒和EPI所致的该部位自律性改变有一定的影响.

  20. Atrial Mapping of Sustained Atrial Fibrillation and Effects of Amiodarone on Electrophysiological Charactaristics in A Rapid Atrial Pacing Canine Model%犬快速心房起搏心房颤动模型全心房心外膜标测以及静脉胺碘酮对其心电的影响

    Institute of Scientific and Technical Information of China (English)

    王健; 刘兴鹏; 刘小青; 龙德勇; 董建增; 马长生

    2005-01-01

    探讨快速心房起搏心房颤动(简称房颤)模型房颤发作时肺静脉、左右心房各部位激动频率的差异以及胺碘酮对其电生理特性的影响.选健康雄性杂种犬10只,以400次/分的固定频率进行右心耳起搏,建立快速心房起搏房颤模型.10周后终止起搏,行64道全心房心外膜标测.标测部位分别为左右心房游离壁、左右心房顶部、左上肺静脉、左下肺静脉、右上肺静脉和右下肺静脉.记录以上部位的心外膜电图,测量各标测部位的平均房颤波周长(AFCL),并对不同部位心外膜标测电图进行频谱分析.静脉注射胺碘酮300 mg,分析胺碘酮治疗前后各部位有效不应期(ERP)和AFCL的变化.结果: 8只犬完成整个实验.在所有8只犬中,最短AFCL/ERP位于Marshall韧带的有2只,位于左下肺静脉的有6只;AFCL/ERP在心房的分布呈明显的梯度分布,自短至长依次为:肺静脉或Marshall韧带、左房游离壁和左侧Bachmann 束、右侧Bachmann束和右房游离壁;频谱分析结果与AFCL分析结果一致;胺碘酮虽然可延长肺静脉和心房各部位ERP和AFCL,但是不能终止房颤的发作.结论:局灶机制可能是快速心房起搏房颤模型的发生和维持机制.

  1. Safety analysis of intravenous amiodarone in wolff-parkinson-white syndrome with atrial fibrillation%预激综合征经旁路前传的心房颤动患者静脉注射胺碘酮的安全性分析

    Institute of Scientific and Technical Information of China (English)

    单兆亮; 王玉堂; 时向民; 闫俊瑾; 赵立朝

    2005-01-01

    目的探讨预激综合征(W-P-W)合并心房颤动(房颤)患者静脉注射胺碘酮的安全性.方法选择接受射频消融治疗的W-P-W患者及同期行隐匿性房室旁路射频消融治疗的患者(对照组)各16例,测量W-P-W组患者预激旁路前传有效不应期(ERPAP)和对照组的房室结有效不应期(ERPAVN).在10min内缓慢静脉注射胺碘酮150mg,10min后重复上述测量,并对结果进行对比分析.结果 W-P-W组用药后ERPAP有轻微延长(P<0.05),其中1例用药后缩短了60ms;对照组ERPAVN用药后明显延长(P<0.05).结论部分W-P-W合并房颤的患者静脉注射胺碘酮时,可能会促进激动经旁路下传,使心室率加快或引发心室颤动,需格外慎重.

  2. Medication review and transitions of care: a case report of a decade-old medication error.

    Science.gov (United States)

    Comer, Rachel; Lizer, Mitsi

    2015-03-01

    A 69-year-old Caucasian male with a 25-year history of paranoid schizophrenia was brought to the emergency department because of violence toward the staff in his nursing facility. He was diagnosed with a urinary tract infection and was admitted to the behavioral health unit for medication stabilization. History included a five-year state psychiatric hospital admission and nursing facility placement. Because of poor cognitive function, the patient was unable to corroborate medication history, so the pharmacy student on rotation performed an in-depth chart review. The review revealed a transcription error in 2003 deleting amantadine 100 mg twice daily and adding amiodarone 100 mg twice daily. Subsequent hospitalization resulted in another transcription error increasing the amiodarone to 200 mg twice daily. All electrocardiograms conducted were negative for atrial fibrillation. Once detected, the consulted cardiologist discontinued the amiodarone, and the primary care provider was notified via letter and discharge papers. An admission four months later revealed that the nursing facility restarted the amiodarone. Amiodarone was discontinued and the facility was again notified. This case reviews how a 10-year-old medication error went undetected in the electronic medical records through numerous medication reconciliations, but was uncovered when a single comprehensive medication review was conducted.

  3. NEW ANTIARRHYTHMIC DRUG FOR THE TREATMENT OF ATRIAL FIBRILLATION. STUDY DATA, CLINICAL GUIDELINES, REGULATORY AGENCY RECOMMENDATIONS

    Directory of Open Access Journals (Sweden)

    S. Yu. Martsevich

    2011-01-01

    Full Text Available The main objectives and strategies for treatment of atrial fibrillation (AF, one of the most common cardiac arrhythmia, are seen. A combination of strategies for heart rate control in patients with atrial fibrillation receiving rhythm-controling therapy is preferred at present, according to current guidelines. Amiodarone, one of the most effective anti-arrhythmic drugs with an extensive evidence base, remains the drug of reserve because of serious side effects. A new drug, dronedarone, has electrophysiological properties attributable to all four classes of antiarrhythmic drugs. According to meta-analysis of randomized clinical trials dronedarone is inferior to amiodarone in prevention of AF recurrences, but it is superior to amiodaron in safety. However , in 2011 dronedarone was included in the Food and Drug Administration (FDA list of drugs that require further analysis in connection with appearance of the new information about its safety.

  4. Clinical Effect Observation on Propafenone Treatment of Preexcitation Syndrome Complicated with Supraventricular Tachycardia Beckoning%普罗帕酮治疗预激综合征合并室上性心动过速的临床效果观察

    Institute of Scientific and Technical Information of China (English)

    刘瑞浩

    2015-01-01

    Objective To explore the Clinical effect comparison of Propafenone and amiodarone in the treatment of preexcitation syndrome complicated with supraventricular tachycardia beckoning.Methods 58 cases of Preexcitation syndrome complicated with supraventricular tachycardia in patients with beckoning in our hospital from October 2010 to May 2013 were selected ,and were divided into propafenone group and amiodarone group (n=29).Propafenone group were given propafenone intravenous infusion of 70mg treatment,amiodarone group were given amiodarone intravenous infusion of 150mg. Effect of compound rate, average time and the occurrence of adverse reactions were observed.Results There was no significant difference between the treatment efficiency of propafenone group (100%) and amiodarone group (P>0.05); propafenone group complex rate mean time was (27.13 ± 6.98) min and was significantly lower than that of amiodarone group,P0.05);普罗帕酮组复率平均时间(27.13±6.98)min明显低于胺碘酮组,P<0.05,差异具有统计学意义;胺碘酮组不良反应发生率(6.89%)明显低于普罗帕酮组,P<0.05,差异具有统计学意义。结论普罗帕酮及胺碘酮对预激综合征合并室上性心动过速的治疗有着良好的疗效,普罗帕酮可以更加快速的使患者的心率恢复正常,胺碘酮则降低使用药物复率产生的不良反应。

  5. Clinical comparison of three labeled-antibody immunoassays of free triiodothyronine.

    Science.gov (United States)

    Piketty, M L; d'Herbomez, M; Le Guillouzic, D; Lebtahi, R; Cosson, E; Dumont, A; Dilouya, A; Helal, B O

    1996-06-01

    Three labeled-antibody immunoassays of free triiodothyronine (FT3) were studied in hyperthyroid patients, patients with nonthyroidal illness, and patients being treated with amiodarone; we also studied sera presenting known interferences (n for all groups = 465). The results were compared with those of a one-step labeled-analog assay. The precision of the two automated assays were similar to that of the manual assays. The three labeled-antibody FT3 assays demonstrated a satisfactory diagnostic performance for confirming hyperthyroidism and robustness to interference; nevertheless, two assays displayed unusual behavior in some patients with nonthyroidal illness, with chronic renal failure, or after amiodarone therapy.

  6. A review on dronedarone:Pharmacological, pharmacodynamic and pharmacokinetic profile

    Institute of Scientific and Technical Information of China (English)

    Farah Iram; Sadaf Ali; Aftab Ahmad; Shah Alam Khan; Asif Husain

    2016-01-01

    Dronedarone, a benzofuran containing chemical compound, is a derivative of amiodarone which is classified as a Class III antiarrhythmic agent. It is prescribed to the cardiovas-cular patients who have paroxysmal or persistent atrial fibrillation to lower the chances of hospitalization. Amiodarone, sotalol, procainamide dofetilide, quinidine, ibutilide, fle-cainide, and propafenone are the other useful medicinal products used to treat atrial fibrillation or cardiac arrhythmia. Dronedarone was approved for clinical use in atrial fibrillation by the Food and Drug Administration in 2009. The generic name for drone-darone is Multaq (Sanofi Aventis). This article briefly highlights the important pharma-cological, pharmacodynamic and pharmacokinetic properties of dronedarone.

  7. TREATMENT AND PREVENTION OF ATRIAL TACHYARRHYTHMIAS IN CRITICALLY ILL PATIENT: THE ROLEOF MAGNESIUM SULFATE

    Directory of Open Access Journals (Sweden)

    M. MOJTAHEDZADEH

    1999-09-01

    Full Text Available In this prospective, randomized study, in the general intensive care unit at Shanatee teaching hospital, we evaluated twenty patients, mean age 52+18 years and mean acute physiology and chronic health evaluation II score of 20±8, who were experiencing atrial tachyarrhythmias for more than 1 hour. After correction of their plasma potassium concentration to more than 4.0 mmof/1, patients were randomized to receive either 40 mg/kg magnesium sulfate bolus followed by 30 mg/kg/hr or 5mg/kg amiodarone bolus and 10 mg/kg/24hr infusion. Therapeutic end point was conversion to sinus rhythm over 24 hours. By logistic regression, the probability of conversion to sinus rhythm was significantly better for magnesium than for amiodarone at time 0-4 (0.6 vs.0.4, 12 (0.72 vs 0.45, and 24 (0.72vs.0.45 hours. In patients not converting to sinus rhythm, a significant decrease in ventricular response rate occurred at time zero to 0.5 hour (mean decrease 22 beats/min, P=0.0001, but there was no specific treatment effect between the magnesium and the amiodarone groups. Magnesium sulfate is superior to amiodarone in the conversion of acute atrial tachyarrhythmias, while initial slowing of ventricular response rate in non-converters appears equally efficacious with both agents.

  8. Dronedarone in patients with atrial fibrillation

    NARCIS (Netherlands)

    N.M.S. de Groot; C.J. Kirchhof; I.C. van Gelder; J.G. Meeder; A.H.M.M. Balk; A.A. Wilde; M.L. Simoons

    2010-01-01

    Dronedarone is a recently developed new class III antiarrhythmic drug which possesses electrophysiological properties of all four Vaughan-Williams classes. An important difference with amiodarone is that it does not contain an iodine component and therefore lacks the iodine-related adverse effects.

  9. Synthesis and antifungal activity of derivatives of 2- and 3-benzofurancarboxylic acids.

    Science.gov (United States)

    Hejchman, Elzbieta; Ostrowska, Kinga; Maciejewska, Dorota; Kossakowski, Jerzy; Courchesne, William E

    2012-11-01

    We found that amiodarone has potent antifungal activity against a broad range of fungi, potentially defining a new class of antimycotics. Investigations into its molecular mechanisms showed amiodarone mobilized intracellular Ca2+, which is thought to be an important antifungal characteristic of its fungicidal activity. Amiodarone is a synthetic drug based on the benzofuran ring system, which is contained in numerous compounds that are both synthetic and isolated from natural sources with antifungal activity. To define the structural components responsible for antifungal activity, we synthesized a series of benzofuran derivatives and tested them for the inhibition of growth of two pathogenic fungi, Cryptococcus neoformans and Aspergillus fumigatus, to find new compounds with antifungal activity. We found several derivatives that inhibited fungal growth, two of which had significant antifungal activity. We were surprised to find that calcium fluxes in cells treated with these derivatives did not correlate directly with their antifungal effects; however, the derivatives did augment the amiodarone-elicited calcium flux into the cytoplasm. We conclude that antifungal activity of these new compounds includes changes in cytoplasmic calcium concentration. Analyses of these benzofuran derivatives suggest that certain structural features are important for antifungal activity. Antifungal activity drastically increased on converting methyl 7-acetyl-6-hydroxy-3-methyl-2-benzofurancarboxylate (2b) into its dibromo derivative, methyl 7-acetyl-5-bromo-6-hydroxy-3-bromomethyl-2-benzofurancarboxylate (4).

  10. The duration of pacing-induced atrial fibrillation is reduced in vivo by inhibition of small conductance Ca2+-activated K+ channels

    DEFF Research Database (Denmark)

    Skibsbye, Lasse; Diness, Jonas; Sørensen, Ulrik S;

    2011-01-01

    , whereas newer multichannel blockers such as amiodarone and ranolazine have been introduced later. This study was devoted to the evaluation of an acute pacing-induced in vivo model of AF in rats. Antiarrhythmic effects of well-known compounds such as lidocaine, dofetilide, and ranolazine were confirmed...

  11. [Recent progress of strategy of the therapy for the complication of ACS].

    Science.gov (United States)

    Ohno, Minoru

    2010-04-01

    As medicine progress, the strategy of therapy for the complication of ACS has changed. The most important strategy to prevent the complications is the relief of ischemia as soon as possible. Early introduction of drug for myocardial protection, intravenous administration of amiodarone, and many kinds of assisting device for cardiac performance like as PCPS and ICD are widely used nowadays.

  12. Effects of irbesartan on atrial cell electrophysiology

    Institute of Scientific and Technical Information of China (English)

    HUANG Cong-xin; CAO Feng; JIANG Hong; WANG Teng; LI Xia

    2005-01-01

    @@ Atrial fibrillation (AF) is the most common sustained arrhythmia encountered in clinical practice.1 Its incidence increases with age and the presence of structural heart disease. It is a major cause of stroke, especially in the elderly. It has been shown that angiotensin converting enzyme inhibitor (ACEI) can reduce the incidence of AF after acute myocardial infarction.2 Several studies have shown that activation of the rennin-angiotensin system is associated with the mechanisms of AF. Irbesartan is a long-acting angiotensin Ⅱ type 1 receptor antagonist used widely in the treatment of hypertension.3 In recent years, it has been demonstrated that patients treated with amiodarone plus irbesartan had a lower rate of recurrence of atrial fibrillation than did patients treated with amiodarone alone.4 These findings suggest that the inhibition of angiotensin Ⅱ may prevent AF, but its underlying electrophysiological mechanisms are obscure. The purpose of this study is to investigate the effects of irbesartan on atrial cell electrophysiology.

  13. Dasatinib and Prednisolone Induction Therapy for a Case of Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia with Dilated Cardiomyopathy Accompanied by Life-Threatening Ventricular Tachycardia

    Directory of Open Access Journals (Sweden)

    Mitsutaka Nishimoto

    2017-01-01

    Full Text Available A 56-year-old man being treated for dilated cardiomyopathy presented with epigastralgia. He was diagnosed with ventricular tachycardia and Philadelphia chromosome-positive acute lymphoblastic leukemia. After treating incessant ventricular tachycardia, we commenced induction therapy for leukemia with dasatinib and prednisolone to minimize toxicity towards cardiomyocytes and the cardiac conduction system. Although dasatinib was temporarily withheld because of a recurrence of ventricular tachycardia, we rechallenged dasatinib while using bisoprolol and amiodarone and achieved a complete hematological response three weeks later. Although drug interactions between dasatinib and amiodarone were of concern, the blood concentration of each drug remained within the safe range after concomitant use, and there were no adverse cardiac effects such as QT prolongation after rechallenging dasatinib. Induction therapy with dasatinib and prednisolone may be an acceptable therapeutic option for Philadelphia chromosome-positive acute lymphoblastic leukemia with severe cardiac complications.

  14. A benefit-risk assessment of class III antiarrhythmic agents

    DEFF Research Database (Denmark)

    Brendorp, Bente; Pedersen, Oledyg; Torp-Pedersen, Christian;

    2002-01-01

    again increases the frequency of both supraventricular as well as ventricular arrhythmias. Class III antiarrhythmic drugs act by blocking repolarising currents and thereby prolong the effective refractory period of the myocardium. This is believed to facilitate termination of re-entry tachyarrhythmias....... This class of drugs is developed for treatment of both supraventricular and ventricular arrhythmias. Amiodarone, sotalol, dofetilide, and ibutilide are examples of class III drugs that are currently available. Amiodarone and sotalol have other antiarrhythmic properties in addition to pure class III action......, which differentiates them from the others. However, all have potential serious adverse events. Proarrhythmia, especially torsade de pointes, is a common problem making the benefit-risk ratio of these drugs a key question. Class III drugs have been evaluated in different settings: primary and secondary...

  15. Atrial fibrillation pharmacotherapy after hospital discharge between 1995 and 2004: a shift towards beta-blockers

    DEFF Research Database (Denmark)

    Hansen, Morten Lock; Gadsbøll, Niels; Gislason, Gunnar H;

    2008-01-01

    AIMS: To study evolvement in pharmacotherapy of atrial fibrillation from 1995 to 2004. METHODS AND RESULTS: All Danish patients were discharged following first-time atrial fibrillation and their pharmacotherapy was identified by individual-level-linkage of nationwide registers of hospitalization ...... and drug dispensing from pharmacies. A total of 108 791 patients survived 30 days after discharge and were included. In 1995-1996, 7.4% of the patients received beta-blockers, increasing to 44.3% in 2003-2004. The corresponding figures for amiodarone were 2.9 and 5.4%. In contrast, use...... has changed towards increased beta-blocker use with a coincident decrease in the use of other rate-limiting drugs and sotalol. Treatment with amiodarone or class 1C antiarrhythmics remained very low. Oral anticoagulant therapy increased considerably, but women and elderly were apparently undertreated....

  16. Drug: D00636 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available 29I2NO3. HCl 681.0004 681.7725 D00636.gif Antiarrhythmic [DS:H00293] Therapeutic category: 2129 ATC code: C01BD01 Class III antiarrhy...], CYP2D6 [HSA:1565], CYP3A4 [HSA:1576], CYP1A2 [HSA:1544] Transporter inhibition: ABCB1 [HSA:5243] map07037 Antiarrhythmic... [BR:br08301] 2 Agents affecting individual organs 21 Cardiovascular agents 212 Antiarrhythmic agents 2129 O... drug classification [BR:br08302] Cardiovascular Agents Antiarrhythmics Amiodarone D00636 Amiodarone hydroch...r08303] C CARDIOVASCULAR SYSTEM C01 CARDIAC THERAPY C01B ANTIARRHYTHMICS, CLASS I AND III C01BD Antiarrhyt

  17. 胺碘酮致心搏骤停死亡2例的教训

    Institute of Scientific and Technical Information of China (English)

    王林生

    1999-01-01

    @@ 胺碘酮(Amiodarone)对于心律失常的治疗价值已被广泛接受.但其毒副作用,尤其对心血管反应的严重性在某些基层医院及非心血管病专业医师中尚未得到深刻的认识,以致造成严重后果.

  18. Ventricular tachycardia induced by weight loss pills

    DEFF Research Database (Denmark)

    Pareek, Manan; Hansson, Nils Henrik; Grove, Erik Lerkevang

    2013-01-01

    A previously healthy 29-year-old man was admitted with palpitations, dizziness, and near-syncope after he had recently started taking weight loss pills purchased on the internet. The pills contained caffeine and ephedrine. An electrocardiogram and telemetry revealed multiple episodes of non......-sustained monomorphic ventricular tachycardia, which was successfully treated with amiodarone. In conclusion, unauthorized weight loss pills can be harmful. In particular, ephedrine-containing drugs carry a risk of ventricular tachycardia and should be discouraged....

  19. Acute atrial fibrillation during dengue hemorrhagic fever

    Directory of Open Access Journals (Sweden)

    Veloso Henrique Horta

    2003-01-01

    Full Text Available Dengue fever is a viral infection transmitted by the mosquito, Aedes aegypti. Cardiac rhythm disorders, such as atrioventricular blocks and ventricular ectopic beats, appear during infection and are attributed to viral myocarditis. However, supraventricular arrhythmias have not been reported. We present a case of acute atrial fibrillation, with a rapid ventricular rate, successfully treated with intravenous amiodarone, in a 62-year-old man with dengue hemorrhagic fever, who had no structural heart disease.

  20. Class III antiarrhythmic agents in cardiac failure: lessons from clinical trials with a focus on the Grupo de Estudio de la Sobrevida en la Insuficiencia Cardiaca en Argentina (GESICA).

    Science.gov (United States)

    Doval, H C

    1999-11-04

    The results of previous clinical trials, in a variety of clinical settings, showed that class I agents may consistently increase mortality in sharp contrast to the effects of beta blockers. Attention has therefore shifted to class III compounds for potential beneficial effects on long-term mortality among patients with underlying cardiac disease. Clinical trials with d-sotalol, the dextro isomer (devoid of beta blockade) of sotalol, showed increased mortality in patients with low ejection fraction after myocardial infarction and in those with heart failure; whereas in the case of dofetilide, the impact on mortality was neutral. Because of the complex effects of its actions as an alpha-adrenergic blocker and a class III agent, the impact on mortality of amiodarone in patients with heart failure is of particular interest. A meta-analysis of 13 clinical trials revealed significant reductions in all-cause and cardiac mortality among patients with heart failure or previous myocardial infarction. Among these were 5 controlled clinical trials that investigated the effects of amiodarone on mortality among patients with heart failure. None of these trials was large relative to the beta-blocker trials in the postinfarction patients. However, the larger 2 of the 5 amiodarone trials produced discordant effects on mortality, neutral in one and significantly positive in the other. Some of the differences may be accounted for by the differences in eligibility criteria and baseline characteristics. Future trials that may be undertaken to resolve the discrepancies may need to allow for the newer findings on the effects of concomitant beta blockers, implantable devices, and possibly, spironolactone. All these modalities of treatment have been shown in controlled clinical trials to augment survival in patients with impaired ventricular function or manifest heart failure. Additional trials, some of which are currently in progress, compare amiodarone with implantable devices and other

  1. Proteomics Investigations of Drug-Induced Hepatotoxicity in HepG2 Cells

    OpenAIRE

    Van Summeren, Anke; Renes, Johan; Bouwman, Freek G.; Noben, Jean-Paul; van Delft, Joost H. M.; Kleinjans, Jos C.S.; Mariman, Edwin C. M.

    2011-01-01

    Unexpected hepatotoxicity is one of the major reasons of drugs failing in clinical trials. This emphasizes the need for new screening methods that address toxicological hazards early in the drug discovery process. Here, proteomics techniques were used to gain further insight into the mechanistic processes of the hepatotoxic compounds. Drug-induced hepatotoxicity is mainly divided in hepatic steatosis, cholestasis, or necrosis. For each class, a compound was selected, respectively amiodarone, ...

  2. Integrated approach to treatment-resistant atrial fibrillation: additional value of acupuncture

    OpenAIRE

    Jonkman, F A M; Jonkman-Buidin, M L

    2013-01-01

    A 62-year-old patient with chronic bronchitis had treatment-resistant atrial fibrillation. Electrical cardioversion was performed, but sinus rhythm (SR) lasted only for some minutes. Administration of amiodarone was withheld in favour of a course of acupuncture treatment in order to increase the success rate of a second attempt of electrical cardioversion. After two acupuncture treatments, spontaneous conversion to SR occurred. Relapses into atrial fibrillation in the following five winters, ...

  3. Buerger's Disease and Anaesthesia: The Neglected Cardiac Angle

    Directory of Open Access Journals (Sweden)

    Shagun Bhatia Shah

    2015-08-01

    Full Text Available Distal limb amputations and respiratory complications are common in patients with Buerger’s disease. Nicotine in cigarette is arrhythmogenic as it blocks cardiac potassium channels. Preoperative Holter ECG monitoring may be useful if preoperative electrocardiogram is normal. If the patient is undergoing major surgery, preservative free lignocaine & amiodarone infusions and a cardioverter defibrillator should be available for the intraoperative cardiac rhythm disturbances.

  4. Contrast induced hyperthyroidism due to iodine excess

    OpenAIRE

    Mushtaq, Usman; Price, Timothy; Laddipeerla, Narsing; Townsend, Amanda; Broadbridge, Vy

    2009-01-01

    Iodine induced hyperthyroidism is a thyrotoxic condition caused by exposure to excessive iodine. Historically this type of hyperthyroidism has been described in areas of iodine deficiency. With advances in medicine, iodine induced hyperthyroidism has been observed following the use of drugs containing iodine—for example, amiodarone, and contrast agents used in radiological imaging. In elderly patients it is frequently difficult to diagnose and control contrast related hyperthyroidism, as most...

  5. Large right ventricular fibroma in a 6-month-old infant.

    Science.gov (United States)

    Horovitz, Alice; van Geldorp, Irene E; Roubertie, François; Thambo, Jean-Benoit

    2012-12-01

    This report describes the case of a 6-month-old girl with a large cardiac fibroma in the right ventricle. Ventricular tachycardia associated with the fibroma was successfully treated with amiodarone. At the age of 3 years, surgical resection was indicated because of right ventricular outflow tract obstruction caused by progression of the tumor. The fibroma was successfully resected, and further follow-up evaluation was uneventful.

  6. STRATEGIES OF PROPHYLAXIS AND MANAGEMENT OF POSTOPERATIVE ATRIAL FIBRILLATION

    Directory of Open Access Journals (Sweden)

    Dembele, A.

    2016-07-01

    Full Text Available This article analyses different strategies of prophylaxis and management of postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting (CABG at different periods after acute myocardial infarction (AMI. It examines the efficacy of early administration of beta-adrenergic blocking agents (metoprolol and amiodarone (in prophylactic doses in the diminution of the risk of postoperative atrial fibrillation in different groups of patients. The article also discerns the effectiveness of digoxin in the management of episodes of postoperative atrial fibrillation.

  7. DRUG THERAPY OF PAROXYSMAL ATRIAL FIBRILLATION IN THE ELDERLY OVER 75 YEARS OLD

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective To investigate the effectiveness and safety of various agents on paroxysmal atrial fibrillation in the elderly over 75 years old.Methods Totally 264 in-patients (75-91 years old, 185 males and 79 females) with atrial fibrillation history of less than 7 days were enrolled in this study. A total of 611 atrial fibrillation episodes were recorded, but 130 episodes (22. 3% ) of atrial fibrillation were auto-converted to sinus rhythm. The rest 481 episodes of atrial fibrillation were divided into six groups based on the drug used. Results The cardioversion ratio of atrial fibrillation were 9. 5%, 46.9%, 71.7%, 55.9%, 32.7%, and73.6%in control, cedilanid, amiodarone, propafenone, verapamil, and quinidine groups, respectively. Ventricular rate control were 5.4%, 83.6%, 84. 9%, 77.9%, 78.8%, and 11.3% in those groups, respectively. The total effective rates of amiodarone and cedilanid groups were the highest. When the ventricular rate was controlled to below 90 bpm, the patients would almost complain of no discomfort. No severe side-effect was observed in each group. Conclusion Amiodarone and cedilanid may be the proper drugs for the treatment of paroxysmal atrial fibrillation in the elderly. The above antiarrhythmics in each therapeutic group were relatively safe and effective.

  8. Dronedarone.

    Science.gov (United States)

    Tamargo, J; López-Farré, A; Caballero, R; Delpón, E

    2011-02-01

    Atrial fibrillation (AF), the most common cardiac arrhythmia, is associated with substantial morbidity and mortality. Dronedarone is an amiodarone-like benzofuran which lacks the iodine moiety and presents a methane sulfonyl group that decreases its lipophilicity, thus shortening the half-life and decreasing tissue accumulation. Like amiodarone, dronedarone blocks multiple cardiac ion channels and β-adrenoceptors, presenting electrophysiological characteristics of all four Vaughan Williams classes of antiarrhythmic drugs. In clinical trials, dronedarone has been found effective for both rhythm and rate control. Dronedarone was more effective than placebo in maintaining sinus rhythm in patients with paroxysmal and/or persistent AF and was also effective for ventricular rate control during AF recurrences, providing incremental rate control on top of standard drugs in permanent AF. Furthermore, in the ATHENA trial, dronedarone reduced the incidence of hospitalization due to cardiovascular events or death in patients with nonpermanent AF. Even when dronedarone was less effective than amiodarone in decreasing AF recurrence, it had a better safety profile, being devoid of thyroid, pulmonary and neurological toxicity. This review analyzes the electrophysiological and pharmacological properties, as well as the efficacy and safety of dronedarone in patients with atrial fibrillation.

  9. Managing atrial fibrillation in the elderly: critical appraisal of dronedarone

    Directory of Open Access Journals (Sweden)

    Trigo P

    2011-12-01

    Full Text Available Paula Trigo, Gregory W FischerDepartment of Anesthesiology, Mount Sinai School of Medicine, New York, NY, USAAbstract: Atrial fibrillation is the most commonly seen arrhythmia in the geriatric population and is associated with increased cardiovascular morbidity and mortality. Treatment of the elderly with atrial fibrillation remains challenging for physicians, because this unique subpopulation is characterized by multiple comorbidities requiring chronic use of numerous medications, which can potentially lead to severe drug interactions. Furthermore, age-related changes in the cardiovascular system as well as other physiological changes result in altered drug pharmacokinetics. Dronedarone is a new drug recently approved for the treatment of arrhythmias, such as atrial fibrillation and/or atrial flutter. Dronedarone is a benzofuran amiodarone analog which lacks the iodine moiety and contains a methane sulfonyl group that decreases its lipophilicity. These differences in chemical structure are responsible for making dronedarone less toxic than amiodarone which, in turn, results in fewer side effects. Adverse events for dronedarone include gastrointestinal side effects and rash. No dosage adjustments are required for patients with renal impairment. However, the use of dronedarone is contraindicated in the presence of severe hepatic dysfunction.Keywords: atrial fibrillation, elderly, antiarrhythmic agents, amiodarone, dronedarone

  10. Iodine-induced hyperthyroidism as combination of different etiologies: an overlooked entity in the elderly.

    Science.gov (United States)

    Foppiani, Luca; Cascio, Christian; Lo Pinto, Giuliano

    2016-10-01

    Iodine-induced thyrotoxicosis, which raises several diagnostic and therapeutical challenges, is often overlooked. Hyperthyroidism can induce atrial fibrillation, a harmful arrhythmia which can precipitate heart failure and cause stroke. We report the case of an elderly man who was diagnosed with tachyfibrillation secondary to hyperthyroidism. Thyroid hyperfunction was subsequently related both to previous amiodarone therapy (probably mixed form) and the recent use of iodinated contrast medium for computed tomography scan. Thyroid ultrasonography showed a plongeant multinodular goitre. After initial worsening, thyroid function improved slowly but progressively on high-dose thyreostatic therapy combined with steroid therapy; tachyfibrillation caused heart failure and a thrombus in the left atrium, and proved initially resistant to combined antiarrhythmic treatments. Progressive reduction in thyroid hormone levels, together with combined cardiologic therapies, controlled the heart rate, though atrial fibrillation persisted; anticoagulant therapy resolved the atrial thrombus. Alterations in thyroid function are common in amiodarone-treated patients, who therefore require regular hormonal checks. The different forms of amiodarone-induced thyrotoxicosis must be investigated, since they require different therapies, though mixed forms often occur. The superimposition of further iodine excess due to other causes may be catastrophic and cause severe cardiac problems in these patients.

  11. 1例房颤合并真菌感染患者室性心动过速诱因分析%Inducement Analysis of 1 Case of Ventricular Tachycardia in Patient with Atrial Fibrillation Complicated with Fungal Infection

    Institute of Scientific and Technical Information of China (English)

    郑重践; 林妙娴

    2014-01-01

    To analyze the cause of ventricular tachycardia in patient with atrial fibrillation complicated with fungal infection during the course of treatment.An increased risk of arrhythmia will be caused by many factors, such as hypokalemia, fluconazole combined with ami-odarone, et al.However, greater risk will be caused by a combination of amiodarone and fluconazole (0.4 g・ d-1 ).Great attention should be paid to the dosage of fluconazole under the necessary combination of fluconazole and amiodarone.%分析1例房颤合并真菌感染患者治疗过程中出现室性心动过速的诱因。可能导致本例室性心律失常发生的因素有低钾血症、氟康唑与胺碘酮联用,但氟康唑加量至0.4 g・ d -1时联合使用胺碘酮风险更大。临床在不可避免将氟康唑与胺碘酮联用时,应注意氟康唑的给药剂量。

  12. 静脉注射艾司洛尔治疗急性心肌梗死合并交感风暴的临床观察%Clinical observation of intravenous esmolol in the treatment of acute myocardial infarction patients with sympathetic storm

    Institute of Scientific and Technical Information of China (English)

    董小燕; 于东明; 郭伟; 袁靖

    2015-01-01

    Objective To observe the clinical efficacy of intravenous injection of esmolol to treat acute myocardial infarction patients with sympathetic storm. Methods A total of 44 acute myocardial infarction patients with sympathetic storms were randomly divided into three groups:an amiodarone group receiving intravenous amiodarone in addition to conventional cardiopulmonary resuscitation and electrical cardioversion (n=15), a metoprolol tartrate group which was treated with intravenous metoprolol tartrate in addition to the above amiodarone therapy (n=15), and an esmolol group which was intravenously injected with esmolol in addition to the above amiodarone therapy (n=14). Results The esmolol group and metoprolol tartrate group produced markedly higher inhibitory rates of recurrent ventricular tachycardia and ventricular fibrillation than the amiodarone group. The esmolol group and metoprolol tartate groups required substantially less times of electric cardioversion to terminate ventricular tachycardia and ventricular fibrillation than the amiodarone group. There was no statistical difference as to the incidences of hypotension and bradycardia among these three groups. Conclusion Based on the conventional therapy, intravenous injection of esmolol can significantly improve the successful rate of rescue for acute myocardial infarction patients with sympathetic storm.%目的:观察静脉注射艾司洛尔治疗急性心肌梗死合并交感风暴的临床疗效。方法急性心肌梗死合并交感风暴患者44例,随机分为3组。其中胺碘酮组(n=15),应用常规心肺复苏及电复律加静脉应用胺碘酮治疗;酒石酸美托洛尔组(n=15),在胺碘酮组治疗基础上静脉联合酒石酸美托洛尔治疗;艾司洛尔组(n=14),在胺碘酮组治疗基础上联合静脉应用艾司洛尔治疗。结果艾司洛尔组及酒石酸美托洛尔组终止反复室性心动过速、心室颤动成功率明显高于胺碘酮组;艾司洛

  13. Electrophysiological mechanisms of sophocarpine as a potential antiarrhythmic agent

    Institute of Scientific and Technical Information of China (English)

    Zhi-fang YANG; Ci-zhen LI; Wei WANG; Ying-min CHEN; Ying ZHANG; Yuan-mou LIU; Hong-wei WANG

    2011-01-01

    Aim: To examine the electrophysiological effects of sophocarpine on action potentials (AP) and ionic currents of cardiac myocytes and to compare some of these effects with those of amiodarone.Methods: Langendorff perfusion set-up was used in isolated guinea pig heart, and responses to sophocarpine were monitored using electrocardiograph. Conventional microelectrode, voltage clamp technique and perforated patch were employed to record fast response AP (fAP), slow response AP (sAP) and ionic currents in guinea pig papillary muscle or rabbit sinus node cells.Results: Tachyarrhythmia produced by isoprenaline (15 μmol/L) could be reversed by sophocarpine (300 μmol/L). Sophocarpine (10 μmol/L) decreased the amplitude by 4.0%, maximal depolarization velocity (Vmax) of the fAP by 24.4%, and Na+ current (INa) by 18.0%,while it prolonged the effective refractory period (ERP) by 21.1%. The same concentration of sophocarpine could also decrease the amplitude and Vmax of the sAP, by 26.8% and 25.7%, respectively, and attenuated the Ca2+ current (ICaL) and the K+ tail current substantially. Comparison of sophocarpine with amiodarone demonstrated that both prolonged the duration and the ERP of fAP and sAP, both decreased the amplitude and Vmax of the fAP and sAP, and both slowed the automatic heart rate.Conclusion: Sophocarpine could reverse isoprenaline-induced arrhythmia and inhibit INa, IcaL, and Ikr currents. The electrophysiological effects of sophocarpine are similar to those of amiodarone, which might be regarded as a prospective antiarrhythmic agent.

  14. Antikoagulation bei Vorhofflimmern: Wie und mit welchem Medikament?

    Directory of Open Access Journals (Sweden)

    Gary T

    2015-01-01

    Full Text Available Direkte orale Antikoagulantien (DOAKs sind Alternativen zu Vitamin-K-Antagonisten (VKA bei Vorhofflimmerarrhythmie- (VHFA- Patienten und werden diese in dieser Indikation zu weiten Teilen ersetzen. Bei VHFA-Patienten mit Dialyse oder mechanischen Herzklappen sind VKA nach wie vor die einzige Option. Bei der Gabe von DOAKs sollte vor Therapieeinleitung auf das Vorhandensein von Begleiterkrankungen (z. B. Niereninsuffizienz, stattgehabte gastrointestinale Blutungen etc. sowie auf die Begleittherapie der Patienten (z. B. Amiodaron etc. geachtet werden, um die passende Substanz in der richtigen Dosierung zu wählen.

  15. Protective Effect of Wenxin Granula on Heart from Myocardial Infarction through Regulating Intracellular Ca2+

    Institute of Scientific and Technical Information of China (English)

    LI Xiao-xue; YANG Bao-feng; LI Xue-lian; CHU Wen-feng; CAI Rui-jun; SHI Yong-fang; XU Chao-qian; SHAN Hong-li; WANG Xing-yang; LU Yan-jie

    2011-01-01

    Objective To assess the anti-arrhythmic activity and cardioprotective effects of Wenxin Granula, a traditional Chinese formula (consisting of Salviae Miltiorrhizae Radix, Polygonati Rhizoma, Notoginseng Radix et Rhizoma, Nardostachyos Radix et Rhizoma, Angelicae Sinensis Radix, and Succinum), on heart in ischemic-induced myocardial infarction (MI) rats and compare with those of Amiodarone which have been demonstrated in clinic. Methods Rats were randomly divided into Sham-operated (control), Ml + Amiodarone [5 mg/(kg·d)] (MI), and MI + Wenxin Granula [10 mg/(kg·d)] groups and left anterior descending coronary artery was occluded in each group. After left anterior descending for 12 h, standard lead Ⅱ of administration electrocardiogram was recorded in order to analyze the occurrence of arrhythmia. After one month, the size of the infarct area of heart was evaluated by TTC staining method and haemodynamic function was assessed to detect the heart function. Laser scanning confocal microscope and the technique of patch clamp were used to detect the intracellular Ca2+ ([Ca2+]j) and L-type calcium current (ICa-L), respectively. Results Both Wenxin Granula [10 mg/(kg·d)] and Amiodarone [5 mg/(kg·d)] could markedly decrease the incidence of arrhythmia in heart of rats which were subjected to ischemic injury. After one month, Wenxin Granula could significantly decrease mortality to 22.22% and reduce the infarct area (P < 0.05), but Amiodarone did not. The mechanism may involve that Wenxin Granula attenuated [Ca2+]j decreasing in MI rats. Additionally, Wenxin Granula could obviously ameliorate the impaired heart function of MI rats by decreasing the elevated left ventricular end-diastolic pressure and increasing the attenuated maximum change velocity of left ventricular pressure in the isovolumic contraction or relaxation period. On the other hand, electrophysiological experiment results revealed that Wenxin Granula administration one month later also increased the

  16. Paroxysmal Supraventricular Tachycardia on Children: Clinical Analysis of 37 cases%小儿阵发性室上性心动过速37例临床分析

    Institute of Scientific and Technical Information of China (English)

    张文祥; 李自普; 聂娜娜; 王思平; 锡洪敏

    2012-01-01

    目的:对比研究和评价不同方法治疗小儿阵发性室上性心动过速(PSVT)的的疗效,提高转复率.方法:回顾性分析2002.04-2011.05我院住院治疗的37例PSVT患儿的临床资料,并分析比较心律平与胺碘酮的药物转复率,构成比采用x2检验,α=0.05.结果:37例患儿中,13例治疗原发病后自动转率,24例患儿给予心律平治疗,其中1例放弃治疗,5例未见效,心律平转复率为69.77%,5例未见效患儿改用胺碘酮治疗,1例死于原发病,1例控制症状后行射频消融术治愈,胺碘酮转复率为75%,二者之间无显著差异性.结论:心律平与胺碘酮均能较好的治疗小儿PSVT,对于反复发作,药物治疗无效的小儿PSVT,射频消融术已成为最佳选择.%To investigate the curative effect of different methods on treating paroxysmal supraventrieular tachycardia of children.Methods:37 cases were retrospective analyzed with regard.The conversion rates of propafenone and amiodarone were analysis by chi-square test,α=0.05.Results:Of 37 children,13 cases had automatic conversion aiter curing the primary desease,24 cases were given propafenone,1 case gave up,5 cases had no effect.The propafenone conversion rate was 69.77%.5 cases with amiodarone,1case died of dilated cardiomyopathy,1 case cured by Radiofrequency ablation after controlling clinical symptoms,the amiodarone conversion rate was 75%.There was no significant difference between them.Conclusion:The propafenone and amiodarone all lad better conversion rate in children with paroxysmal supraventricular tachycardia,For the complexity and intractable paroxysmal supraventricular tachycardia,radiofrequency catheter ablation was become the best choice for the pediatric patients.

  17. Ventricular Tachycardia Induced by Weight Loss Pills

    Directory of Open Access Journals (Sweden)

    Manan Pareek

    2013-01-01

    Full Text Available A previously healthy 29-year-old man was admitted with palpitations, dizziness, and near-syncope after he had recently started taking weight loss pills purchased on the internet. The pills contained caffeine and ephedrine. An electrocardiogram and telemetry revealed multiple episodes of non-sustained monomorphic ventricular tachycardia, which was successfully treated with amiodarone. In conclusion, unauthorized weight loss pills can be harmful. In particular, ephedrine-containing drugs carry a risk of ventricular tachycardia and should be discouraged.

  18. [Despite medication, overdrive pacing is required to stabilize the electrical storm associated with acute coronary syndrome: a case report].

    Science.gov (United States)

    Umeda, Masanobu; Morimoto, Atsushi; Yokoyama, Kaori; Tateishi, Emi; Makino, Kanako; Yamamoto, Kazuo; Nakagawa, Yoko; Fukuhara, Shinya; Takase, Eiji

    2007-10-01

    A 75-year-old female complained of severe chest pain and was emergently admitted to our hospital because of anterior acute myocardial infarction. Emergent coronary angiography was performed and revealed occlusion in segment 7, so a stent was implanted. Lidocaine, carvedilol, amiodarone, magnesium, and nifekalant were administered successively because non-sustained ventricular tachycardia (NSVT) frequently appeared like an electrical storm. After nifekalant administration, QTc was significantly prolonged and torsades de pointes was induced. Overdrive pacing was performed and finally the NSVT was completely controlled. If fatal arrhythmias such as NSVT show resistance to medication, overdrive pacing should be considered to stabilize the arrhythmia associated with acute coronary syndrome.

  19. [Arrhythmias from swallowing].

    Science.gov (United States)

    Palazzuoli, V; Mondillo, S; Faglia, S; D'Aprile, N; De Luca, G; Kristodhullu, A; Corba, E

    1992-01-01

    We describe the case of a 51-year old, non cardiopathic patient, with recurrent attacks of supraventricular tachycardia induced by swallowing. In the existing literature we found several descriptions of hypokinetic arrhythmias, easily explained by a mechanism of vagal inhibition. The cases of predominantly hyperkinetic arrhythmias, however, are much less common. In these patients the origin of the disease seems to be due to sympathetic oesophageal fibers and superior and medium cardiac nerves. In the present case, as in the others reported in the literature, the drug of choice seems to be Amiodarone which appears to be the most effective in preventing tachyarrhythmias caused by swallowing.

  20. Catheter ablation of atrial fibrillation in patients with severely impaired left ventricular systolic function.

    Science.gov (United States)

    Kato, Ken; Ejima, Koichiro; Fukushima, Noritoshi; Ishizawa, Makoto; Wakisaka, Osamu; Henmi, Ryuta; Yoshida, Kentaro; Nuki, Toshiaki; Arai, Kotaro; Yashiro, Bun; Manaka, Tetsuyuki; Ashihara, Kyomi; Shoda, Morio; Hagiwara, Nobuhisa

    2016-04-01

    Little is known about the outcome of catheter ablation of atrial fibrillation (AF) in patients with heart failure (HF) and a severely reduced left ventricular ejection fraction (LVEF). We aimed to clarify the effectiveness of catheter ablation of AF in patients with a severely low LVEF. This retrospective study included 18 consecutive patients with HF and an LVEF of ≤ 35 % who underwent catheter ablation of AF. We investigated the clinical parameters, echocardiographic parameters and the incidence of hospitalizations for HF. During a median follow-up of 21 months (IQR, 13-40) after the final procedure (9 with repeat procedures), 11 patients (61 %) maintained sinus rhythm (SR) (6 with amiodarone). The LVEF and NYHA class significantly improved at 6 months after the CA in 12 patients (67 %) who were in SR or had recurrent paroxysmal AF (from 25.8 ± 6.3 to 37.0 ± 11.7 %, P = 0.02, and from 2.3 ± 0.5 to 1.5 ± 0.7, P < 0.01, respectively) but not in patients who experienced recurrent persistent AF. The patients with SR or recurrent paroxysmal AF had significantly fewer hospitalizations for HF than those with recurrent persistent AF after the AF ablation (log-rank test; P < 0.01). Catheter ablation of AF improved the clinical status in patients with an LVEF of ≤ 35 %. A repeat ablation procedure and amiodarone were often necessary to obtain a favorable outcome.

  1. Hypersensitivity pneumonitis secondary to lovebirds: a new cause of bird fancier's disease.

    Science.gov (United States)

    Funke, M; Fellrath, J-M

    2008-08-01

    Hypersensitivity pneumonitis (HP) is an immunologically mediated lung disease due to the repetitive inhalation of antigens. Most new cases arise from residential exposures, notably to birds, and are thus more difficult to recognise. The present authors report a 59-yr-old male who complained of dyspnoea and cough while being treated with amiodarone. Pulmonary function tests revealed restriction and obstruction with low diffusing lung capacity for carbon monoxide and partial pressure of oxygen. A high-resolution computed tomography chest scan and bronchoalveolar lavage showed diffuse bilateral ground-glass attenuation and lymphocytic alveolitis, respectively. Initial diagnosis was amiodarone pulmonary toxicity, but because of a rapidly favourable evolution, this diagnosis was questioned. A careful environmental history revealed a close contact with lovebirds shortly before the onset of symptoms. Precipitins were strongly positive against lovebird droppings, but were negative against other avian antigens. The patient was diagnosed with hypersensitivity pneumonitis to lovebirds. Avoidance of lovebirds and steroid treatment led to rapid improvement. The present observation identifies a new causative agent for hypersensitivity pneumonitis and highlights the importance of a thorough environmental history and of searching for precipitins against antigens directly extracted from the patient's environment. These two procedures should allow a more precise classification of some cases of pneumonitis, and thus might avoid progression of active undiagnosed hypersensitivity pneumonitis to irreversible fibrosis or emphysema.

  2. Requirement for ergosterol in V-ATPase function underlies antifungal activity of azole drugs.

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    Yong-Qiang Zhang

    Full Text Available Ergosterol is an important constituent of fungal membranes. Azoles inhibit ergosterol biosynthesis, although the cellular basis for their antifungal activity is not understood. We used multiple approaches to demonstrate a critical requirement for ergosterol in vacuolar H(+-ATPase function, which is known to be essential for fungal virulence. Ergosterol biosynthesis mutants of S. cerevisiae failed to acidify the vacuole and exhibited multiple vma(- phenotypes. Extraction of ergosterol from vacuolar membranes also inactivated V-ATPase without disrupting membrane association of its subdomains. In both S. cerevisiae and the fungal pathogen C. albicans, fluconazole impaired vacuolar acidification, whereas concomitant ergosterol feeding restored V-ATPase function and cell growth. Furthermore, fluconazole exacerbated cytosolic Ca(2+ and H(+ surges triggered by the antimicrobial agent amiodarone, and impaired Ca(2+ sequestration in purified vacuolar vesicles. These findings provide a mechanistic basis for the synergy between azoles and amiodarone observed in vitro. Moreover, we show the clinical potential of this synergy in treatment of systemic fungal infections using a murine model of Candidiasis. In summary, we demonstrate a new regulatory component in fungal V-ATPase function, a novel role for ergosterol in vacuolar ion homeostasis, a plausible cellular mechanism for azole toxicity in fungi, and preliminary in vivo evidence for synergism between two antifungal agents. New insights into the cellular basis of azole toxicity in fungi may broaden therapeutic regimens for patient populations afflicted with systemic fungal infections.

  3. Autophagy-preferential degradation of MIR224 participates in hepatocellular carcinoma tumorigenesis.

    Science.gov (United States)

    Lan, Sheng-Hui; Wu, Shan-Ying; Zuchini, Roberto; Lin, Xi-Zhang; Su, Ih-Jen; Tsai, Ting-Fen; Lin, Yen-Ju; Wu, Cheng-Tao; Liu, Hsiao-Sheng

    2014-09-01

    Autophagy and microRNA (miRNA) are important regulators during cancer cell tumorigenesis. Impaired autophagy and high expression of the oncogenic microRNA MIR224 are prevalent in hepatocellular carcinoma (HCC); however, the relationship between the 2 phenomena remains elusive. In this study, we are the first to reveal that autophagy selectively regulates MIR224 expression through an autophagosome-mediated degradation system. Based on this finding, we further demonstrated that in hepatitis B virus (HBV)-related HCC, aberrant autophagy (low autophagic activity) results in accumulation of MIR224 and decreased expression of the target gene Smad4, which leads to increased cell migration and tumor formation. Preferential recruitment of MIR224 into the autophagosome was clearly demonstrated by a) miRNA in situ hybridization under confocal microscopy, and b) immunogold labeling of MIR224 under electron microscopy compared with a ubiquitously expressed microRNA MIRlet7e/let-7. Furthermore, we found that off-label use of amiodarone, an antiarrhythmic agent, effectively suppressed HCC tumorigenesis through autophagy-mediated MIR224 degradation both in vitro and in vivo. In summary, we identified amiodarone as a new autophagy inducer, which may provide an alternative approach in HCC therapy through a novel tumor suppression mechanism.

  4. Taquiarritmias supraventriculares fetales refractarias al tratamiento inicial Fetal supraventricular tachyarrhythmias refractory to initial therapy

    Directory of Open Access Journals (Sweden)

    Eduardo Malvino

    2005-04-01

    Full Text Available Las arritmias fetales representan un motivo infrecuente de ingreso a la unidad de cuidados intensivos. Se presenta tres casos de gestantes entre 27 y 32 semanas, con el diagnóstico de taquiarri-tmias supraventriculares fetales sostenidas, que exhibían fracaso en el intento inicial de reversión con digoxina. Dos casos con taquicardia supraventricular respondieron favorablemente cuando se asoció flecainida. Un feto hidrópico con aleteo auricular y bloqueo 2:1 no revirtió con la asociación de flecainida ni amiodarona a la digoxina y requirió la interrupción de la gestación en la 30ª semana. El neonato presentó disfunción tiroidea transitoria atribuida a la administración de amiodarona.Fetal arrhythmia is an unusual cause of admission in critical care unit. We report three cases of pregnant patients with gestational age of 27 to 32 weeks, with diagnosis of fetal sustained supraventricular tachyarrhymias; which were resistant to digoxin as first line therapy. Two fetuses had supraventricular tachycardia and were converted with flecainide in association with digoxin. A remaining hydropic fetus suffering atrial flutter with 2:1 auriculo-ventricular conduction, failed to restore sinus rhythm with digoxin alone or in association with flecainide nor amiodarone, and required premature c-section at 30ª week of gestation. Due to amiodarone administration the neonate suffered transient neonatal hypothyroidism.

  5. [Recurrent refractory ventricular fibrillation: how many times is it necessary to defibrillate?].

    Science.gov (United States)

    Moreno-Millán, E; Castarnado-Calvo, M; Moreno-Cano, S; Pozuelo-Pozuelo, S

    2010-04-01

    Recurrent ventricular fibrillation is that which persists after three consecutive defibrillation attempts. It generally appears in almost 25% of all heart arrests and entails high mortality. Use of amiodarone during resuscitation maneuvers is recommended, this having better results than lidocaine. Neither procainamide nor bretylium should be used in this type of arrhythmia, however beta blockers or magnesium can be used when ischemic heart disease or hypomagnesiemia, respectively, is suspected as the cause. We present the case of a male patient with a background of heart disease (stent in circunflex 8 years earlier) that began with an episode of primary ventricular fibrillation when entering the Emergency Service. He was given 35 shocks of 360 J, without using thoracic compressions at any time since he recovered an effective post-shock pulse with normal neurological condition. Amiodarone and thrombolytics (tenecteplase) were administered during the intervention, achieving favorable resolution after 52 min, once stabilized showing an electrocardiogram of acute coronary syndrome without ST elevation and verifying obstruction of the right coronary artery in the catheterism, on which a stent was placed. He was discharged from the hospital six days after with no neurological sequels. In agreement with the 2005 International Liaison Committee on Resuscitation Recommendations, the resuscitation maneuvers and electrical shocks should be continued while there is a defibrillable rhythm, as occurred in our patient.

  6. Delayed ventricular repolarization as an anti-arrhythmic principle.

    Science.gov (United States)

    Vaughan Williams, E M

    1985-11-01

    Depolarization of cardiac muscle is achieved by 'fast inward current' through channels which are inactivated within about 1 ms. When the cells are repolarized the process of inactivation of fast channels is rapidly reversed. The class 1 anti-arrhythmic drugs delay the disappearance of inactivation until long after repolarization is complete. In theory, it should be possible to produce a similar extension of refractory period by delaying the repolarization itself. Quinidine and disopyramide caused minor delays of repolarization, but both were primarily class 1 agents, and in addition had undesirable anticholinergic activity. Amiodarone, already in use for many years as an antianginal drug, prolonged action potential duration (APD) and was shown to have an anti-arrhythmic action in rabbits, dogs and man. Although prolongation of APD lengthens QT, a long QT may be caused by phenomena other than prolonged APD, such as heterogeneity of sympathetic drive. Association of long QT with arrhythmia does not, therefore, invalidate the principle that homogeneously prolonged APD should be anti-arrhythmic. In practice, amiodarone, bretylium, sotalol, thyroidectomy, and long-term beta-blockade prolong APD, and are associated with low incidence of arrhythmia. Many mechanisms controlling cardiac repolarization have been proposed, but how repolarization is delayed by individual agents is not fully elucidated.

  7. Dronedarone: a new antiarrhythmic agent.

    Science.gov (United States)

    Oyetayo, Ola O; Rogers, Carrie E; Hofmann, Prudence O

    2010-09-01

    Dronedarone is an antiarrhythmic agent recently approved by the United States Food and Drug Administration for the reduction of cardiovascular-related hospitalizations in patients with paroxysmal or persistent atrial fibrillation or atrial flutter. The drug is a derivative of amiodarone and has been modified to reduce the organ toxicities frequently encountered with amiodarone. Dronedarone exerts its antiarrhythmic effects through multichannel blockade of the sodium, potassium, and calcium channels and also possesses antiadrenergic activity, thereby exhibiting pharmacologic effects of all four Vaughan Williams classes of antiarrhythmics. The efficacy of dronedarone for the maintenance of sinus rhythm, ventricular rate control, and reduction in cardiovascular-related hospitalizations has been demonstrated in several randomized, placebo-controlled trials. Although a high rate of gastrointestinal events (e.g., nausea, vomiting, and diarrhea) has been associated with dronedarone, more serious adverse events such as thyroid, liver, or pulmonary toxicities have not been observed. Because of a possible increase in mortality, dronedarone should be avoided in patients with New York Heart Association class IV or II-III heart failure with a recent decompensation. Given the efficacy and safety data currently available, dronedarone represents a reasonable alternative for maintenance of sinus rhythm in appropriately selected patients.

  8. November 2015 Tucson critical care journal club: atrial fibrillation in sepsis

    Directory of Open Access Journals (Sweden)

    Nahapetian RR

    2015-12-01

    Full Text Available No abstract available. Article truncated at 150 words. Sepsis is a major public health concern in the United States (1. Nearly one-third of in-hospital deaths are the result of sepsis (2. Atrial fibrillation (A-fib is the most common arrhythmia in sepsis and its development portends worse outcomes (3. Current guidelines recommend cardioversion in hemodynamically unstable patients with sepsis; however, there is scant evidence to guide the choice between amiodarone, beta-blockers, calcium-channel blockers, and digoxin (4. In patients with decompensated heart failure, digoxin and amiodarone are preferred over beta-blockers and calcium channel blockers (4. In patients with multiple organ failure there is no evidence to suggest any one agent is superior to the others. This study by Walkey et al. sought to identify current practice patterns in the pharmacologic treatment of A-fib among hospitalized patients with sepsis and to compare outcomes after controlling for potential confounding variables. This retrospective cohort study used a nationally representative source of hospital billing ...

  9. Study of warfarin utilization in hospitalized patients: analysis of possible drug interactions.

    Science.gov (United States)

    Guidoni, Camilo Molino; Camargo, Helen Palmira Miranda; Obreli-Neto, Paulo Roque; Girotto, Edmarlon; Pereira, Leonardo Regis Leira

    2016-10-01

    Background Drug-drug interactions in patients taking warfarin may contribute to a higher risk of adverse events. Objective To identify and evaluate the prevalence and characteristics of potential DDIs with warfarin. Methods A cross-sectional study was performed in a Brazilian tertiary hospital. The electronic prescriptions of the patients receiving warfarin between January 2004 and December 2010 were analyzed. Socio-demographic, clinical, and therapeutic variables were collected. Warfarin drug-drug interactions were classified as either risk A, B, C, D, or X according to the Lexi-Interact™ Online database. Results A total of 3048 patients were identified who were prescribed warfarin. Of the 154,161 total drug prescriptions issued, 42,120 (27.3 %) were for warfarin. Evaluation of the prescriptions showed that 63.1 and 0.1 % of patients received concomitant drugs classified as having class D or X risk. It was found that 20,539 (48.7 %) prescriptions had at least one drug with a D or X risk. Patients were prescribed an average of 1.4 (±0.4) concomitant medications with a class D or X warfarin-DDI risk, the most frequent being acetylsalicylic acid and amiodarone. Conclusion The results demonstrate a high prevalence of concomitant drug prescriptions with the potential for clinically relevant DDIs with warfarin, the most frequent being acetylsalicylic acid and amiodarone.

  10. 1例心力衰竭患者的药学监护%Pharmaceutical care on a patient with heart failure

    Institute of Scientific and Technical Information of China (English)

    白颖; 王家伟

    2016-01-01

    1例58岁女性患者,因心力衰竭加重合并房颤、肺部感染和慢性丙型肝炎入院治疗,给予抗心衰、控制房颤及抗感染等药物治疗。入院后予以托拉塞米(20 mg,iv)、去乙酰毛花苷(0.4 mg,iv)抗心衰治疗,给予莫西沙星(0.4 g,qd,ivgtt)抗感染治疗,给予胺碘酮(150 mg,iv)控制房颤,患者肝功能及凝血功能进一步恶化,ALT 1052 IU·L-1,AST 2784 IU·L-1,INR 13.18。临床药师分析患者所用药物中莫西沙星和胺碘酮可加重肝脏损伤及凝血障碍,此外,胺碘酮还可促进华法林的抗凝作用。临床药师建议停用莫西沙星和胺碘酮,输注新鲜冰冻血浆,抗生素更换为美罗培南,同时给予保肝治疗。停药9 d,INR 1.31。停药13 d,ALT 51 IU·L-1,AST 29 IU·L-1。在此监护过程中,临床药师与医生进行及时的沟通,根据患者情况分析治疗方案并提出个体化治疗方案建议,提高了药物治疗效果,确保了患者的用药安全。%One 58-year-old female patient with atrial fibrillation, pulmonary infection and chronic hepatitis C was hospitalized because of aggravation of heart failure. The patient received torasemide (20 mg, iv) and deslanoside (0.4 mg, iv) for heart failure therapy, moxilfoxacin (0.4 g, qd, ivgtt) for anti-infection and amiodarone (150 mg, iv) for atrial ifbrillation control. But the liver function and coagulative function of patient were aggravated. The alanine aminotransferase (ALT) was 1052 IU·L-1, aspartate aminotransferase (AST) was 2784 IU·L-1 and international normalized ratio (INR) was 13.18. The clinical pharmacists suggested to withdraw the moxifloxacin and amiodarone. Considering that moxifloxacin and amiodarone could lead to the deterioration of liver and coagulative function and amiodarone could promote the anticoagulation of warfarin, clinical pharmacists advised that moxilfoxacin and amiodarone should be stopped, while fresh

  11. Potassium ion channels remodeling in rapid atrial pacing right atrium of rabbits with Microelectrode arrays%钾通道阻断剂对心房快速起搏兔右心耳场电位时限的影响

    Institute of Scientific and Technical Information of China (English)

    孙娟; 侯月梅; 刘政疆; 张玲; 冯艳

    2010-01-01

    目的 应用微电极阵列(MEA)研究钾通道阻断剂对快速起搏(RAP)兔右心耳场电位时限(fAPD)的变化.方法 成年新西兰大白兔40只,体重2.5~3.0 kg,雌雄不拘,由新疆医科大学动物实验中心提供,动物质量属于一级标准.随机分为3组,对照组(non-pace,n=8),起搏+钾通道阻断剂组(TEA、4-AP和BaCl2,每组n=8),起搏+胺碘酮组(n=8).RAP 24 h后,迅速开胸取心脏,剪下右心耳,随即切片(厚度500 μm),将标本固定在MEA记录系统.分别记录正常对照组,给予阻断剂及胺碘酮组MEA形态和fAPD改变.结果 对照组右心耳fAPD为(188.33±18.29)ms,起搏组fAPD为(173.91±6.83)ms.给予20 mmol/L TEA阻断IK,fAPD由(176.67±8.66)ms延长到(196.11±10.76)ms(P=0.012),5 mmol/L 4-AP阻断Ito,fAPD由(169.38±10.56)ms延长到(188.56±13.82)ms(P=0.005).10-4mol/L BaCl2阻断I Kir,fAPD由(182.22±12.87)ms延长到(191.11±13.09)ms(P=0.039).2×10-6mmol/L胺碘酮使fAPD由(167.38±13.67)ms延长到(185.00±15.14)ms(P=0.002).结论 应用MEA技术町真实客观反映心肌组织切片的电生理特性.24 h RAP后,以阻断,Ito,IKur,IK1和IKs为主的钾通道阻断剂延长右心耳fAPD.胺碘酮可有效逆转或阻止右心耳fAPD的延长.%Objective To explore the effects of potassium ion channel blocker on field action potential duration (fAPD) of right atrial appendage (RAA) during rapid atrial pacing (RAP) by Microelectrode arrays.Methods Fourty New Zealand white rabbits of either sex (weight 2.5 to 3.0 kg,n=40)were randomly divided into 3 groups:control groups,potassium ion channel blocker groups(TEA,4-Ap and BaCl2)and amiodarone groups.All animals were anesthetized with pentobarbital(30 ms/kg followed by 5 mg/kg/h,i.v.).The hearts were quickly removed and right atrial appendage (RAA) sliced (slice thickness 500 μm).Each slice was perfused with Tyrode's solution and continuously stimulated about 30 min.Control groups received Tyrode's solution superfusion 10 min,blocker groups and

  12. 影响电击除颤效果的因素分析%Influential Factors of Defibrillation in Patients with Ventricular Fibrillation

    Institute of Scientific and Technical Information of China (English)

    马承君; 马哲; 马永才; 白岩松; 韩图亚

    2011-01-01

    目的 分析影响心室颤动(VF)电击除颤效果的因素,提高VF的救治质量.方法 对本院2001年1月至2010年1月收治的VF患者206例进行分析,比较电击除颤成功组与失败组年龄、VF持续时间、VF振幅、VF频率、除颤次数、胺碘酮用量、肾上腺素用量.结果 VF电击除颤成功组与失败组在年龄、除颤次数上比较差异无统计学意义(P>0.05).在VF振幅、VF 频率、VF持续时间、胺碘酮、肾上腺素用量方面比较差异有统计学意义(P<0.05).结论 VF振幅、频率及持续时间决定电击除颤时机,正确把握才能保证电击除颤效果.合理应用胺碘酮、肾上腺素可以提高电击除颤成功率.%Objective To analyze several factors of defibrillation in the patients with ventricular fibrillation ( VF ). Methods 206 VF cases on our hospital from Janaury 2001 to Janaury 2010 were analyzed. VF duration, VF amplitude, VF frequency, the number of defibrillation, dosage of amiodarone and adrenaline was compared between success and failure group of VF. Results There was no significant difference in age and number of previous defibrillation between the two groups ( P > 0.05 ). There was significant difference in VF amplitude, VF frequency, VF duration, dosage of amiodarone and adrenaline ( P < 0.05 ). Conclusions The achievement of defibrillation was related to amplitude ,frequency and duration of VF. The using of amiodarone and epinephrine properly can improve the success rate of defibrillation.

  13. [Effect of anti-arrhythmia drugs on mouse arrhythmia induced by Bufonis Venenum].

    Science.gov (United States)

    Lu, Wen-juan; Zhou, Jing; Ma, Hong-yue; Lü, Gao-hong; You, Fen-qiang; Ding, An-wei; Duan, Jin-ao

    2011-10-01

    This study is to investigate the effects of phenytoin sodium, lidocaine (sodium channel blockers), propranolol (beta-adrenergic receptor antagonist), amiodarone (drugs prolonging the action potential duration) and verapamil (calcium channel blockers) on arrhythmia of mice induced by Bufonis Venenum (Chansu) and isolated mouse hearts lethal dose of Chansu. Arrhythmia of mice were induced by Chansu and then electrocardiograms (ECGs) were recorded. The changes of P-R interval, QRS complex, Q-T interval, T wave amplitude, heart rate (HR) were observed. Moreover, arrhythmia rate, survival rate and arrhythmia score were counted. Isolated mouse hearts were prefused, and the lethal dose of Chansu was recorded. Compared with control group, after pretreatment with phenytoin sodium, broadening of QRS complex and HR were inhibited, and the incidence of ventricular arrhythmia was reduced dramatically, while survival rate was improved; the isolated mouse hearts lethal dose of Chansu was increased significantly. After pretreatment with lidocaine, the prolongation of P-R interval and broadening of QRS complex were inhibited, and the incidences of ventricular arrhythmia were reduced dramatically, while survival rate was improved; the isolated mouse hearts lethal dose of Chansu was increased significantly. After pretreatment with propranolol, prolongation of P-R interval, broadening of QRS complex, prolongation of Q-T interval and HR were inhibited, and the incidences of both supraventricular and ventricular arrhythmias were reduced dramatically, while survival rate was improved. After pretreatment with amiodarone, HR was inhibited, the incidences of ventricular tachycardia were reduced dramatically. Lastly, after pretreatment with verapamil, the prolongation of P-R interval and Q-T interval were inhibited and the incidences of both supraventricular and ventricular arrhythmias were reduced dramatically; the isolated mouse hearts lethal dose of Chansu was reduced significantly. In in

  14. Ventricular fibrillation after bortezomib therapy in a patient with systemic amyloidosis

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    Satoshi Yamasaki

    2013-09-01

    Full Text Available A 64-year-old female was diagnosed with systemic amyloidosis associated with multiple myeloma. Bortezomib and dexamethasone-therapy was initiated; however, she developed lethal ventricular fibrillation (VF and cardiac arrest after 84 hours of therapy. Cardiopulmonary resuscitation using direct current shocks with epinephrine and amiodarone was initiated but failed to receive cardiac function. Although her arterial pulsations recovered immediately after the injection of vasopressin, she died of heart failure 8 hours after the onset of VF. Cardiac amyloidosis was verified by autopsy. Although the direct association of bortezomib with lethal VF remained to be clarified in our patient, the current report emphasizes on bortezomib as a substantial risk factor for cardiomyocyte damage. The potential risk of lethal events associated with cardiac amyloidosis should be carefully considered during bortezomib treatment for patients with AL amyloidosis.

  15. A rhythmic chest pain

    Directory of Open Access Journals (Sweden)

    Lorenzo Cristoni

    2013-11-01

    Full Text Available A middle-aged man with a history of ischemic heart disease presented at the emergency department having had a forty-minute long precordial pain at home and with an electrocardiogram showing a wide complex tachycardia with left bundle branch block shaped QRS. While preparing for urgent electrical cardioversion, the physician practiced a carotid sinus massage which helped to i unveil the supraventricular origin of the arrhythmia (by slowing down heart frequency and thus displaying p waves previously hidden and ii to exclude that the aberrancy was the expression of a transmural ischemia, thanks to the narrowing of the QRS complex. The final diagnosis was atrial tachycardia. The patient consequently received amiodarone IV and was discharged in normal sinus rhythm. We emphasize the importance of correctly diagnosing any rhythm disorder before administering the treatment, if the patient’s clinical condition permits it, in order to ensure the best treatment in urgency and the most appropriate prophylaxis.

  16. Permanent junctional reciprocating tachycardia in a dog.

    Science.gov (United States)

    Santilli, Roberto A; Santos, Luis F N; Perego, Manuela

    2013-09-01

    A 5-year-old male English Bulldog was presented with a 1-year history of paroxysmal supraventricular tachycardia (SVT) partially responsive to amiodarone. At admission the surface ECG showed sustained runs of a narrow QRS complex tachycardia, with a ventricular cycle length (R-R interval) of 260 ms, alternating with periods of sinus rhythm. Endocardial mapping identified the electrogenic mechanism of the SVT as a circus movement tachycardia with retrograde and decremental conduction along a concealed postero-septal atrioventricular pathway (AP) and anterograde conduction along the atrioventricular node. These characteristics were indicative of a permanent junctional reciprocating tachycardia (PJRT). Radiofrequency catheter ablation of the AP successfully terminated the PJRT, with no recurrence of tachycardia on Holter monitoring at 12 months follow-up.

  17. [The efficacy of verapamil in sustained monomorphic ventricular tachycardia].

    Science.gov (United States)

    Rumoroso, J R; Bodegas, A; Subinas, J; Montes, P M; Sanz, R; Rodrigo, D; Barrenetxea, J I

    1994-09-01

    We present a 36-year-old male without overt cardiac disease who suffered, since he was 15 years old, from sustained monomorphic ventricular tachycardia of left bundle branch block with a right axis, lasting for several hours; sometimes, syncope was a clinical form of manifestation. Electrophysiologic study, twenty-four hours Holter recording, cardiac catheterization and blood analysis were not useful in order to find its etiology. Efficacy of different drugs, like Mexiletil, Amiodarone, Atenolol and Verapamil (at a dose of 240 mg/day) were tested through multistaged graded-treadmill stress-testing using the Bruce protocol. Ventricular tachycardia was suppressed by administration of Lidocaine. Oral verapamil given at a dose of 360 mg/day prevented the induction of the arrhythmia, the efficacy was tested with maximal treadmill exercise and twenty-four hours Holter recording.

  18. Estimation of iodine intake from various urinary iodine measurements in population studies

    DEFF Research Database (Denmark)

    Vejbjerg, P.; Knudsen, N.; Perrild, H.;

    2009-01-01

    , are considered in this article. Summary: There are two main ways in which urine can be collected for iodine measurement. The first is the collection of urine over a period, usually 24 hours. The second is the collection of a spot urinary sample. Urinary iodine values can be expressed as the content...... are difficult to perform for large number of persons, single spot urinary samples are preferable to the 24-hour urinary collections in population studies. The iodine concentration in urine depends on the intake of both iodine and fluid. This, and the fact that there is a considerable variability in the daily...... iodine intake, makes the iodine measurement in spot urine samples unreliable for evaluating individuals for iodine deficiency, though they can be used to screen for exposure to large amounts of iodine from sources such as amiodarone and certain radiographic contrast agents. In populations of at least 500...

  19. Practical aspects of apixaban use in clinical practice: continuing the theme

    Directory of Open Access Journals (Sweden)

    S. N. Bel'diev

    2015-01-01

    Full Text Available Currently there are no generally accepted guidelines for the use of apixaban together with CYP3A4 and/or P-glycoprotein (P-gp inhibitors. Analysis of clinical and pharmacological studies suggests that apixaban dose should be reduced to 2.5 mg twice daily when co-administered with a strong CYP3A4 and P-gp inhibitors, such as azole antimycotics, HIV protease inhibitors and clarithromycin. However, it is preferred to avoid apixaban combination with strong CYP3A4 and P-gp inhibitors in patients with a creatinine clearance (CrCl <30 mL/min. According to preliminary calculations, apixaban dose should also be adjusted in patients with CrCl <70-80 ml/min, receiving less potent inhibitors of CYP3A4 and/or P-gp, such as diltiazem, naproxen, verapamil, amiodarone and quinidine. 

  20. Long QT syndrome and torsades de pointes induced by acute sulpiride poisoning.

    Science.gov (United States)

    Chang, Jia-How; Weng, Te-I; Fang, Cheng-Chung

    2009-10-01

    Sulpiride, a selective dopamine D2 antagonist and a substituted benzamide derivative, is considered a safe antipsychotic and antidepressant agent with few adverse effects on the cardiovascular system. Sulpiride-induced torsades de pointes is rare. We report a case of long QT syndrome and torsades de pointes induced by ingestion of 1.5 g of sulpiride. Ventricular arrhythmia was initially treated with amiodarone, without success. Eventually, lidocaine and magnesium sulfate successfully terminated the ventricular arrhythmia. The patient was discharged uneventfully after 3 days of hospitalization. This case illustrates the fact that acute sulpiride poisoning may lead to life-threatening ventricular arrhythmia. Early recognition followed by effective therapy is crucial. Intensive cardiac monitoring is recommended for sulpiride poisoning.

  1. La néphrotoxicite secondaire à l'hyperbilribinemie: à propos d'un cas

    Science.gov (United States)

    Jomni, Med Taieb; Largueche, Mouna; Kaab, Badreddine Ben; Abdelaal, Imen; Bellakhal, Syrine; Douggui, Med Hédi

    2015-01-01

    L'hyperbilirubinémie à des taux élevés est nephrotoxique par divers mécanismes allant de la tubulopathie proximale aux dépôts massifs de bilirubine. Cette entité bien que décrite depuis le début du vingtième siècle est souvent méconnue dans la littérature moderne. Nous rapportons le cas d'un patient présentant une cirrhose probablement d'origine médicamenteuse (Amiodarone*), dont la fonction rénale s'est altérée parallèlement à la majoration de l'hyperbilirubinémie. Aucune autre cause de l'insuffisance rénale aigue n'a été retrouvée. PMID:26977222

  2. Antiarrhythmic therapy and risk of death in patients with atrial fibrillation: a nationwide study

    DEFF Research Database (Denmark)

    Andersen, Søren Skøtt; Hansen, Morten Lock; Gislason, Gunnar H;

    2009-01-01

    by individual-level linkage of nationwide registries. Multivariable Cox proportional-hazard models with time-dependent covariates were used to analyse the risk of death associated with AAD therapy. A total of 141,500 patients were included in the study; of these 3356 (2.4%) patients received treatment......AIMS: To examine the risk of death associated with antiarrhythmic drug (AAD) therapy in a nationwide unselected cohort of patients with atrial fibrillation (AF). METHODS AND RESULTS: All patients admitted with AF in Denmark from 1995 to 2004 and their subsequent use of AADs were identified...... increased risk of death associated with any of the AADs. Hazard ratio (95% confidence interval) for flecainide 0.38 (0.32-0.44), propafenone 0.65 (0.58-0.71), sotalol 0.65 (0.63-0.67), and amiodarone 0.94 (0.89-1.00). CONCLUSION: In an unselected cohort of patients with AF, antiarrhythmic treatment...

  3. Brain natriuretic peptide and optimal management of heart failure

    Institute of Scientific and Technical Information of China (English)

    LI Nan; WANG Jian-an

    2005-01-01

    Aside from the important role of brain natriuretic peptide (BNP) in diagnosis, and differential diagnosis of heart failure, this biological peptide has proved to be an independent surrogate marker of rehospitalization and death of the fatal disease.Several randomized clinical trials demonstrated that drugs such as beta blocker, angiotensin converting enzyme inhibitor, spironolactone and amiodarone have beneficial effects in decreasing circulating BNP level during the management of chronic heart failure. The optimization of clinical decision-making appeals for a representative surrogate marker for heart failure prognosis. The serial point-of-care assessments of BNP concentration provide a therapeutic goal of clinical multi-therapy and an objective guidance for optimal treatment of heart failure. Nevertheless new questions and problems in this area remain to be clarified. On the basis of current research advances, this article gives an overview of BNP peptide and its property and role in the management of heart failure.

  4. The Expanding Role of NMR in Drug Discovery and Development

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    @@ The role of NMR in the pharmaceutical industry has changed dramatically over the last decade. Once thought of as an analytical technique used primarily to support synthetic chemistry, NMR now has an important role in the investigation of biochemical changes involved in clinical diseases and drug toxicity. It is also used extensively to elucidate the structures of drug metabolites. Data obtained using LC NMR MS and 19F NMR will be used to illustrate the utility of hyphenated methods in identifying xenobiotic metabolites as part of a drug development program. The application of NMR to the study of potential drug toxicity will also be described using the cationic, amphiphilic drugs chloroquine and amiodarone. These drugs are known to induce phospholipidosis characterized by lysosomal lamellar bodies and drug accumulation. Using a metabonomic approach, NMR spectroscopy of urine allowed the identification of a combination of urinary biomarkers of phospholipidosis.

  5. [Principle histoclinical forms of iatrogenic eruptions].

    Science.gov (United States)

    Duperrat, B

    1976-01-01

    The staggering multiplication of chemotherapy and polychemotherapy, in addition to artificial substances introduced into foodstuffs (such as saccharin in certain so-called fruit juices), has resulted in innumerable visceral and cutaneous disorders. Confining ourselves to "iatrogenic" rashes, the mechanism of which is far from being a single entity, we have riviewed the six most common varieties: recurrent fixed pigmented erythema, in which stovarsol has given way to the sulphaguanidines; pigmentogenic rashes with the renewed use of amiodarone; eczema and erythrodermia which may be due to any drug, with or without the influence of the sun; iatrogenic lichens, atebrine having provided all types; bullous conditions, sometimes the final stage of the previous group; finally, Lyell's syndrome. Our aim was to study skin biopsies in all these problems, in order to attempt to discover typical lesions.

  6. Evaluation and characterization of thyroid-disrupting activities in soil samples along the Second Songhua River, China.

    Science.gov (United States)

    Kong, Dongdong; Wang, Yafei; Wang, Jinsheng; Teng, Yanguo; Li, Na; Li, Jian

    2016-11-01

    In this study, a recombinant thyroid receptor (TR) gene yeast assay combined with Monte Carlo simulation were used to evaluate and characterize soil samples collected from Jilin (China) along the Second Songhua River, for their ant/agonist effect on TR. No TR agonistic activity was found in soils, but many soil samples exhibited TR antagonistic activities, and the bioassay-derived amiodarone hydrochloride equivalents, which was calculated based on Monte Carlo simulation, ranged from not detected (N.D.) to 35.5μg/g. Hydrophilic substance fractions were determined to be the contributors to TR antagonistic activity in these soil samples. Our results indicate that the novel calculation method is effective for the quantification and characterization of TR antagonists in soil samples, and these data could provide useful information for future management and remediation efforts for contaminated soils.

  7. Increased mortality after dronedarone therapy for severe heart failure

    DEFF Research Database (Denmark)

    Køber, Lars; Torp-Pedersen, Christian; McMurray, John J V;

    2008-01-01

    of death from any cause or hospitalization for heart failure. RESULTS: After inclusion of 627 patients (310 in the dronedarone group and 317 in the placebo group), the trial was prematurely terminated for safety reasons, at the recommendation of the data and safety monitoring board, in accordance......BACKGROUND: Dronedarone is a novel antiarrhythmic drug with electrophysiological properties that are similar to those of amiodarone, but it does not contain iodine and thus does not cause iodine-related adverse reactions. Therefore, it may be of value in the treatment of patients with heart failure...... mortality was predominantly related to worsening of heart failure--10 deaths in the dronedarone group and 2 in the placebo group. The primary end point did not differ significantly between the two groups; there were 53 events in the dronedarone group (17.1%) and 40 events in the placebo group (12...

  8. Atrial fibrillation with wide QRS tachycardia and undiagnosed Wolff-Parkinson-White syndrome: diagnostic and therapeutic dilemmas in a pediatric patient.

    Science.gov (United States)

    Panduranga, Prashanth; Al-Farqani, Abdullah; Al-Rawahi, Najib

    2012-11-01

    A 10-year-old girl presented to the emergency department of a regional hospital with 1 episode of generalized tonic-clonic seizures. Postictal monitoring followed by a 12-lead electrocardiogram showed fast atrial fibrillation with intermittent wide QRS regular tachycardia. Immediately following this, her rhythm changed to wide QRS irregular tachycardia without hemodynamic compromise. She was suspected to have ventricular tachycardia and was treated with intravenous amiodarone with cardioversion to sinus rhythm. Subsequent electrocardiogram in sinus rhythm showed typical features of manifest Wolff-Parkinson-White (WPW) accessory pathway. This case illustrates the diagnostic and therapeutic dilemmas in patients with atrial fibrillation, wide QRS tachycardia, and undiagnosed WPW syndrome with antidromic conduction of atrial arrhythmias through the accessory pathway. Furthermore, this case demonstrates that undiagnosed wide QRS tachycardias need to be treated with drugs acting on the accessory pathway, thus keeping in mind underlying WPW syndrome as a possibility to avoid potentially catastrophic events.

  9. An unexpected side-effect of a commonly used drug.

    Science.gov (United States)

    Fernández González, Francisco; Miranda, Samayra; Santiago Casiano, Mónica; Nieves, José; Adorno, Edgardo; Fernández González, Ricardo

    2013-01-01

    We report a case of a 68 year-old-female patient with clinical features of drug-induced lupus erythematosus after five years of treatment with amiodarone. She presented generalized skin rash, arthralgia on upper and lower extremities, associated with difficulty to walk. Remarkable laboratory results revealed a positive antinuclear antibody test and a skin rash biopsy showing a superficial and deep perivascular infiltrate of lymphocytes, histiocytes, and eosinophils. Once the etiology of the patient's symptoms was identified, the culprit drug was removed and she had a complete remission of all signs and symptoms. Early diagnose should be recognized for prompt intervention and avoid further complications associated with this rare side-effect.

  10. Taquicardia supraventricular en recién nacido: Un reto diagnóstico y terapéutico en la práctica médica / Supraventriculartachycardia in a newborn: A diagnostic and therapeuticchallenge in medical practice

    Directory of Open Access Journals (Sweden)

    Elibet Chávez González

    2015-10-01

    Full Text Available Supraventricular tachycardias in children are the fastest rhythms most frequently reported (70%. Orthodromic tachycardia is that which usually occurs in newborns, and its treatment with amiodarone together with beta blockers has an effectiveness of 63%. However, the combination of antiarrhythmic drugs in children and infants is not recommended because of the proarrhythmic effects. Electrophysiological study and radiofrequency ablation are reserved for older children, where there is less risk of procedures; besides little risk has been reported in children with accessory pathways. The case of an 11-day-old newborn who presented two electrocardiographically different episodes of tachycardia is reported. Those episodes suggested unequal production mechanisms of the arrhythmia, which was difficult to control and needed the combination of three antiarrhythmic drugs for maintaining sinus rhythm.

  11. Serious arrhythmias in patients with apical hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Okishige, Kaoru; Sasano, Tetsuo; Yano, Kei; Azegami, Kouji; Suzuki, Kou; Itoh, Kuniyasu [Yokohama Red Cross Hospital (Japan)

    2001-05-01

    We report cases of serious arrhythmias associated with apical hypertrophic cardiomyopathy (AHCM). Thirty-one patients were referred to our institute to undergo further assessment of their AHCM from 1988 to 1999. Three patients with nonsustained ventricular tachycardia demonstrated an {sup 123}I-MIBG regional reduction in the tracer uptake. In two patients with ventricular fibrillation (VF), the findings from {sup 123}I-MIBG imaging revealed regional sympathetic denervation in the inferior and lateral regions. Electrophysiologic study demonstrated reproducible induction of VF in aborted sudden death and presyncopal patients, resulting in the need for an implantable defibrillator device and amiodarone in each patient. Patients with refractory atrial fibrillation with a rapid ventricular response suffered from serious congestive heart failure. A prudent assessment and strategy in patients with this disease would be indispensable in avoiding a disastrous outcome. (author)

  12. Narrow-band UVB (TL-01) phototherapy: an effective preventative treatment for the photodermatoses

    Energy Technology Data Exchange (ETDEWEB)

    Collins, P.; Ferguson, J. [Ninewells Hospital and Medical School, Dundee (United Kingdom)

    1995-06-01

    Twenty patients with photodermatoses [actinic prurigo (n = 6), hydroa vacciniforme (n = 4), idiopathic solar urticaria (n 1), amiodarone-induced photosensitivity (n = 1) and a range of cutaneous porphyrias (n = 8)] were treated with a ``hardening`` course of narrow-band ultraviolet B (TL-01) phototherapy in springtime. The response to phototherapy was monitored subjectively, by interviewing patients after the summer, and objectively by monochromator phototesting, before and after phototherapy. Fifteen patients reported that treatment was worthwhile. Monochromator phototesting after phototherapy revealed a fourfold increase in the minimal erythema dose in those with abnormal photosensitivity to ultraviolet A wavebands. Adverse effects included erythema (seven patients), pruritus (five) and provocation of the eruption (four). We now routinely consider narrow-band UVB phototherapy for problem photodermatoses. (author).

  13. Potential proarrhythmic effect of cardiac resynchronization therapy during perioperative period: data from a single cardiac center

    Institute of Scientific and Technical Information of China (English)

    LUO Nian-sang; YUAN Wo-liang; LIN Yong-qing; CHEN Yang-xin; MAO Xiao-qun; XIE Shuang-lun; KONG Min-yi; ZHOU Shu-xian; WANG Jing-feng

    2010-01-01

    Background Cardiac resynchronization therapy (CRT) could improve heart function, symptom status, quality of life and reduce hospitalization and mortality in patients with severe heart failure (HF) with optimal medical management. However,the possible adverse effects of CRT are often ignored by clinicians.Method A retrospective analysis of CRT over a 6-year period was made in a single cardiac center.Results Fifty-four patients were treated with CRT(D) device, aged (57±11) years, with left ventricular ejection fraction of (32.1±9.8)%, of which 4 (7%) developed ventricular tachycardia/ventricular fibrillation (VT/VF) or junctional tachycardia after operation. Except for one with frequent ventricular premature beat before operation, the others had no previous history of ventricular arrhythmia. Of the 4 patients, 3 had dilated cardiomyopathy and 1 had ischemic cardiomyopathy,and tachycardia occurred within 3 days after operation. Sustained, refractory VT and subsequent VF occurred in one patient, frequent nonsustained VT in two patients and nonparoxysmal atrioventricular junctional tachycardia in one patient. VT was managed by amiodarone in two patients, amiodarone together with beta-blocker in one patient, and junctional tachycardia was terminated by overdrive pacing. During over 12-month follow-up, except for one patient's death due to refractory heart and respiratory failure in hospital, the others remain alive and arrhythmia-free.Conclusions New-onset VT/VF or junctional tachycardia may occur in a minority of patients with or without prior history of tachycardia after biventricular pacing. Arrhythmia can be managed by conventional therapy, but may require temporary discontinuation of pacing. More observational studies should be performed to determine the potential proarrhythmic effect of CRT.

  14. Dronedarone: an emerging therapy for atrial fibrillation.

    Science.gov (United States)

    Rosei, Enrico Agabiti; Salvetti, Massimo

    2010-06-01

    Atrial fibrillation (AF) is a common arrhythmia, with a prevalence ranging from 0.1% to 9.0% at different ages, and is associated with increased cardiovascular events and mortality. A significant increase in the prevalence of the disease is expected to occur in the coming years as a consequence of the aging of the population and advances in the management of coronary artery disease and heart failure. Effective rhythm control may be difficult to obtain in a significant proportion of patients with AF. The limited efficacy and the possible adverse effects of antiarrhythmic drugs has led researchers to focus their attention on new molecules, in a search of compounds with antiarrhythmic efficacy and a more favourable safety profile. Among several new drugs developed for the management of AF, dronedarone, a benzofuran derivative that shares many of the antiarrhythmic properties of amiodarone, but with a more favourable safety profile, seems particularly promising. The drug is noniodinated, has less lipophilicity, reaches therapeutic concentrations over a shorter period of time and has lower tissue accumulation. Dronedarone, similarly to amiodarone, exhibits electrophysiologic characteristics of all 4 Vaughan Williams classes. Clinical studies have shown that dronedarone effectively reduces ventricular rate, may prevent or delay the recurrence of AF, and may reduce cardiovascular morbidity and mortality in patients with AF or atrial flutter. The drug has an overall good safety profile, in particular with low pulmonary and thyroid toxicity. An important exception is represented by patients with unstable haemodynamic conditions, in which the use of dronedarone has been found to be associated with an increase in mortality. Dronedarone has been recently approved for clinical use by the Food and Drug Administration and by the European Medicines Agency. Further results from trials and clinical use will better define the efficacy and safety profile of dronedarone in AF compared

  15. Administration of a probiotic can change drug pharmacokinetics: effect of E. coli Nissle 1917 on amidarone absorption in rats.

    Directory of Open Access Journals (Sweden)

    Zuzana Matuskova

    Full Text Available The growing interest in the composition and effects of microbiota raised the question how drug pharmacokinetics could be influenced by concomitant application of probiotics. The aim of this study was to find whether probiotic E. coli strain Nissle 1917 (EcN influences the pharmacokinetics of concomitantly taken antiarrhythmic drug amiodarone (AMI. Live bacterial suspension of probiotic EcN (or non-probiotic E. coli strain ATCC 25922 was applied orally to male Wistar rats for seven days, while a control group of rats was treated with a saline solution. On the eighth day, the amiodarone hydrochloride was administered as one single oral dose (50 mg/kg to all rats (N = 60. After 0, 1, 2, 3, 4, 5.5, 7, 9, 14, 22, and 30 hours, blood samples were taken from the rat abdominal aorta. The plasma level of AMI and its metabolite N-desethylamiodarone (DEA was determined using the HPLC with UV detection. Administration of EcN led to a 43% increase of AMI AUC0-30 in comparison with control samples. However, this effect was not observed if EcN was replaced by a reference non-probiotic E. coli strain. Thus, EcN administration was most probably responsible for better drug absorption from the gastrointestinal tract. Plasma levels of DEA were also increased in plasma samples from animals treated with EcN. This change was again not found in the experiment with the reference non-probiotic strain. Higher DEA levels in samples from EcN-treated rats may be explained either by better absorption of AMI and/or by an increased activity of CYP2C forms, known to participate in metabolism of this drug, after EcN administration. In this paper, it is documented that concomitantly taken probiotic EcN may modulate pharmacokinetics of a drug; in this case, it led to an increased bioavailability of AMI.

  16. Drug-induced interstitial lung diseases. Often forgotten; Medikamenteninduzierte interstitielle Lungenerkrankungen. Haeufig vergessen

    Energy Technology Data Exchange (ETDEWEB)

    Poschenrieder, F.; Stroszczynski, C. [Universitaetsklinikum Regensburg, Institut fuer Roentgendiagnostik, Regensburg (Germany); Hamer, O.W. [Universitaetsklinikum Regensburg, Institut fuer Roentgendiagnostik, Regensburg (Germany); Lungenfachklinik Donaustauf, Donaustauf (Germany)

    2014-12-15

    Drug-induced interstitial lung diseases (DILD) are probably more common than diagnosed. Due to their potential reversibility, increased vigilance towards DILD is appropriate also from the radiologist's point of view, particularly as these diseases regularly exhibit radiological correlates in high-resolution computed tomography (HRCT) of the lungs. Based on personal experience typical relatively common manifestations of DILD are diffuse alveolar damage (DAD), eosinophilic pneumonia (EP), hypersensitivity pneumonitis (HP), organizing pneumonia (OP), non-specific interstitial pneumonia (NSIP) and usual interstitial pneumonia (UIP). These patterns are presented based on case studies, whereby emphasis is placed on the clinical context. This is to highlight the relevance of interdisciplinary communication and discussion in the diagnostic field of DILD as it is a diagnosis of exclusion or of probability in most cases. Helpful differential diagnostic indications for the presence of DILD, such as an accompanying eosinophilia or increased attenuation of pulmonary consolidations in amiodarone-induced pneumopathy are mentioned and the freely available online database http://www.pneumotox.com is presented. (orig.) [German] Medikamenteninduzierte interstitielle Lungenerkrankungen (engl. ''drug-induced interstitial lung diseases'', DILD) sind wahrscheinlich haeufiger, als sie diagnostiziert werden. Aufgrund ihrer potenziellen Reversibilitaet ist eine erhoehte Vigilanz gegenueber DILD auch seitens der Radiologie angebracht, da diese regelmaessig ein radiomorphologisches Korrelat in der hochaufloesenden Computertomographie (''high-resolution CT'', HRCT) der Lunge aufweisen. Typische, nach eigener Erfahrung relativ haeufige Manifestationsformen von DILD sind der diffuse Alveolarschaden (engl. ''diffuse alveolar damage'', DAD), die eosinophile Pneumonie (EP), die Hypersensitivitaetspneumonitis (HP), die organisierende

  17. Cytochrome P450 inhibition potential of new psychoactive substances of the tryptamine class.

    Science.gov (United States)

    Dinger, Julia; Woods, Campbell; Brandt, Simon D; Meyer, Markus R; Maurer, Hans H

    2016-01-22

    New psychoactive substances (NPS) are not tested for their cytochrome P450 (CYP) inhibition potential before consumption. Therefore, this potential was explored for tryptamine-derived NPS (TDNPS) including alpha-methyl tryptamines (AMTs), dimethyl tryptamines (DMTs), diallyl tryptamines (DALTs), and diisopropyl tryptamines (DiPTs) using test substrates preferred by the Food and Drug Administration in a cocktail assay. All tested TDNPS with the exception of DMT inhibited CYP2D6 activity with IC50 values below 100μM. DALTs inhibited CYP2D6 activity similar to paroxetine and quinidine and CYP1A2 activity comparable to fluvoxamine. 5-Methoxy-N,N-diallyltryptamine reduced in vivo the caffeine metabolism in rats consistent with in vitro results. Five of the AMTs also inhibited CYP1A2 activity comparable to amiodarone. AMT and 6-F-AMT inhibited CYP2A6 activity in the range of the test inhibitor tranylcypromine. CYP2B6 activity was inhibited by 19 tryptamines, but weakly compared to efavirenz. CYP2C8 activity was inhibited by five of the tested TDNPS and three showed values comparable to trimethoprim and gemfibrozil. Six tryptamines inhibited CYP2C9 and seven CYP2C19 activities comparable to fluconazole and chloramphenicol, respectively. Nineteen compounds showed inhibition of CYP2E1 and 18 of CYP3A activity, respectively. These results showed that the CYP inhibition by TDNPS might be clinically relevant, but clinical studies are needed to explore this further.

  18. Beeinflussung der Schilddrüsenfunktion durch Medikamente

    Directory of Open Access Journals (Sweden)

    Wolf P

    2014-01-01

    Full Text Available Die Funktion der Schilddrüse unterliegt einem strengen Regelkreis, der zahlreiche Angriffspunkte für unerwünschte Wechselwirkungen mit verschiedenen Medikamenten und Wirkstoffklassen bietet, teilweise mit klinisch relevanten Folgen. In dieser Übersichtsarbeit sollen daher einerseits die häufigsten Medikamentenwirkungen auf die Schilddrüsenfunktion beschrieben sowie andererseits auch auf die Folgen einer gestörten Resorption bei bereits bestehender Schilddrüsenhormonsubstitutionstherapie hingewiesen werden. Während diese Wechselwirkungen beispielsweise für Amiodaron oder Lithium schon lange bekannt sind, kommt es vor allem durch die Entwicklung neuer immunmodulierender Wirkstoffklassen, wie Tyrosinkinaseinhibitoren und monoklonaler Autoantikörper, zu gehäuften Beobachtungen von Schilddrüsenfunktionsbeeinträchtigungen. Neben Lithium wird auch auf die Wechselwirkung anderer Psychopharmaka eingegangen sowie der Einfluss von Wirkstoffklassen wie Gallensäurebinder, Antazida und Phosphatbinder auf die Resorption von Levothyroxin bei bestehender Schilddrüsenhormonsubstitutionstherapie näher beschrieben. Das Ziel dieser Arbeit ist es daher, einen für den praktisch tätigen Arzt tauglichen Überblick über Medikamentenwirkungen auf die Schilddrüse zu schaffen.

  19. Determination of the sputtering yield of cholesterol using Arn(+) and C60(+(+)) cluster ions.

    Science.gov (United States)

    Rakowska, P D; Seah, M P; Vorng, J-L; Havelund, R; Gilmore, I S

    2016-08-01

    The sputtering yield of cholesterol films on silicon wafers is measured using Arn(+) and C60(+(+)) ions in popular energy (E) and cluster size (n) ranges. It is shown that the C60(+(+)) ions form a surface layer that stabilizes the film so that a well-behaved profile is obtained. On the other hand, the Arn(+) gas clusters leave the material very clean but, at room temperature, the layer readily restructures into molecular bilayers, so that, although a useful measure may be made of the sputtering yield, the profiles become much more complex. This restructuring does not occur at room temperature normally but results from the actions of the beams in the sputtering process for profiling in secondary ion mass spectrometry. Better profiles may be made by reducing the sample temperature to -100 °C. This is likely to be necessary for many lower molecular weight materials (below 1000 Da) to avoid the movement of molecules. Measurements for cholesterol films on 37 nm of amiodarone on silicon are even better behaved and show the same sputtering yields at room temperature as those films directly on silicon at -100 °C. The yields for both C60(+(+)) and Arn(+) fit the Universal Equation to a standard deviation of 11%.

  20. Rational design, synthesis and 2D-QSAR study of novel vasorelaxant active benzofuran-pyridine hybrids.

    Science.gov (United States)

    Srour, Aladdin M; Abd El-Karim, Somaia S; Saleh, Dalia O; El-Eraky, Wafaa I; Nofal, Zeinab M

    2016-05-15

    Reaction of 3-aryl-1-(benzofuran-2-yl)-2-propen-1-ones 3a-c with malononitrile in the presence of sufficient amount of sodium alkoxide in the corresponding alcohol proceeds in a regioselective manner to afford 2-alkoxy-4-aryl-6-(benzofuran-2-yl)-3-pyridinecarbonitriles 4-37, which also obtained by treating ylidenemalononitriles 6a-q with 2-acetylbenzofuran 1 in the presence of sufficient amount of sodium alkoxide in the corresponding alcohol. The new chemical entities showed significant vasodilation properties using isolated thoracic aortic rings of rats pre-contracted with norepinephrine hydrochloride standard technique. Compounds 11, 16, 21, 24 and 30 exhibited remarkable activity compared with amiodarone hydrochloride the reference standard used in the present study. CODESSA-Pro software was employing to obtain a statistically significant QSAR model describing the bioactivity of the newly synthesized analogs (N=31, n=5, R(2)=0.846, R(2)cvOO=0.765, R(2)cvMO=0.778, F=27.540. s(2)=0.002).

  1. Ventricular assist device support for management of sustained ventricular arrhythmias.

    Science.gov (United States)

    Fasseas, Panayotis; Kutalek, Steven P; Samuels, Fania L; Holmes, Elena C; Samuels, Louis E

    2002-01-01

    We describe herein the cases of 2 patients who had ventricular arrhythmias. In one, a short-term biventricular assist device, the ABIOMED BVS 5000, was placed because the patient had sustained ventricular tachycardia and could not be weaned from cardiopulmonary bypass. Excellent hemodynamic support was maintained for several days while the antiarrhythmic therapy was maximized. Sinus rhythm was restored, and the patient was successfully weaned from the ventricular assist device. However, the substrate for the arrhythmia persisted, and a recurrence, 1 week later, resulted in the patient's death. In the 2nd patient, the use of an implantable left ventricular assist device was successful in temporarily alleviating the ventricular tachycardia associated with ischemic cardiomyopathy. However, after 2 days of device assistance, the patient experienced a recurrence of the tachycardia, which degenerated into ventricular fibrillation with a marked deterioration in the patient's hemodynamics. The arrhythmia persisted despite multiple attempts at external cardioversion, and internal cardioversion and placement of an automatic implantable cardioverter-defibrillator were necessary. This treatment, along with repeated boluses of amiodarone, led to successful suppression of the arrhythmias, and the patient eventually underwent transplantation. The mechanical hemodynamic support of the circulation by ventricular assist devices was effective in supporting these 2 patients who had sustained ventricular arrhythmias.

  2. Ventricular Assist Device Support

    Science.gov (United States)

    Fasseas, Panayotis; Kutalek, Steven P.; Samuels, Fania L.; Holmes, Elena C.; Samuels, Louis E.

    2002-01-01

    We describe herein the cases of 2 patients who had ventricular arrhythmias. In one, a short-term biventricular assist device, the ABIOMED BVS 5000, was placed because the patient had sustained ventricular tachycardia and could not be weaned from cardiopulmonary bypass. Excellent hemodynamic support was maintained for several days while the antiarrhythmic therapy was maximized. Sinus rhythm was restored, and the patient was successfully weaned from the ventricular assist device. However, the substrate for the arrhythmia persisted, and a recurrence, 1 week later, resulted in the patient's death. In the 2nd patient, the use of an implantable left ventricular assist device was successful in temporarily alleviating the ventricular tachycardia associated with ischemic cardiomyopathy. However, after 2 days of device assistance, the patient experienced a recurrence of the tachycardia, which degenerated into ventricular fibrillation with a marked deterioration in the patient's hemodynamics. The arrhythmia persisted despite multiple attempts at external cardioversion, and internal cardioversion and placement of an automatic implantable cardioverter-defibrillator were necessary. This treatment, along with repeated boluses of amiodarone, led to successful suppression of the arrhythmias, and the patient eventually underwent transplantation. The mechanical hemodynamic support of the circulation by ventricular assist devices was effective in supporting these 2 patients who had sustained ventricular arrhythmias. (Tex Heart Inst J 2002;29:33–6) PMID:11995847

  3. The Clinical Application and Effect of Implantable Cardioverter Defibrillator(ICD)%经静脉植入埋藏式心脏复律除颤器的临床应用及效果观察

    Institute of Scientific and Technical Information of China (English)

    江自强

    2015-01-01

    Objective:to explore the clinical application and effect of implantable cardioverter defibrillator(icd). Methods:selecting and analyzing 80 cases of malignant ventricular arrhythmia, which are randomly divided into control group (treated with amiodarone) and treatment group(treated with the icd) . then comparing the effects. Results:the overall response rate(rr) of the treatment group is 95%, much higher than the other one(85%)(P0.05);yet after treatment, the heart rate of the treatment group is signiifcantly lower than the control group (P0.05);实验组治疗后心率,显著低于对照组(P<0.05);实验组治疗后Pr间期,显著高于对照组(P<0.05)。结论恶性室性心律失常采用静脉植入埋藏式心脏复律除颤器治疗效果理想,值得推广应用。

  4. Use of an Implantable Loop Recorder in a Chimpanzee (Pan troglodytes) to Monitor Cardiac Arrhythmias and Assess the Effects of Acupuncture and Laser Therapy.

    Science.gov (United States)

    Magden, Elizabeth R; Sleeper, Meg M; Buchl, Stephanie J; Jones, Rebekah A; Thiele, Erica J; Wilkerson, Gregory K

    2016-02-01

    Cardiovascular disease is a leading cause of death in captive chimpanzees and is often associated with myocardial fibrosis, which increases the risk of cardiac arrhythmias. In this case report, we present a 36-y-old male chimpanzee (Pan troglodytes) diagnosed with frequent ventricular premature complexes (VPC). We placed a subcutaneous implantable loop recorder for continual ECG monitoring to assess his arrhythmias without the confounding effects of anesthetics. During his initial treatment with the antiarrhythmia medication amiodarone, he developed thrombocytopenia, and the drug was discontinued. After reviewing other potential therapies for the treatment of cardiac arrhythmias, we elected to try acupuncture and laser therapy in view of the positive results and the lack of adverse side effects reported in humans. We used 2 well-known cardiac acupuncture sites on the wrist, PC6 (pericardium 6) and HT7 (heart 7), and evaluated the results of the therapy by using the ECG recordings from the implantable loop recorder. Although periodic increases in the animal's excitement level introduced confounding variables that caused some variation in the data, acupuncture and laser therapy appeared to decrease the mean number of VPC/min in this chimpanzee.

  5. Effect of Taurine on The Respiratory System of Rats

    Directory of Open Access Journals (Sweden)

    Ammer E.M

    2013-08-01

    Full Text Available The present study was designed to investigate the effect of taurine on isolated trachea and pulmonary artery of rats and the possible mechanism(s of action. The possible antioxidant effect of taurine was also studied by measuring its protective effect against cyclophosphamide induced lung injuiry. Taurine produced a concentration dependent relaxation in the isolated tracheal strips and pulmonary arterial rings precontracted by serotonin (2x10-4 mM. The relaxing effect of taurine was not influenced by pretreatment with nitric oxide synthase inhibitor (L-NAME , cysteinyl leukotreines receptor 1 blocker (montelukast , H1 receptor blocker (chlorpheniramine , β-adrenoceptor blocker (propranolol, potassium channel blocker (amiodarone , cyclo-oxygenase inhibitor (indomethacin or muscarinic receptor blocker (atropine. Preincubation with adenosine receptor blocker (aminophylline significantly potentiated the relaxing effect of taurine in the tracheal strips and pulmonary arterial rings. Cyclophosphamide (CYP, 150 mg/kg administerated i.p. in a single dose was used to produce lung injuiry in rats. CYP caused marked increase in lung lipid peroxides (MDA and decrease in lung reduced glutathione (GSH. Administration of taurine (1% in drinking water starting 7 days before CYP and continuing throughout the duration of the experiment (24 hours improved significantly the lung GSH and MDA. It can be concluded that taurine relaxes precontracted rat tracheal strips and pulmonary arterial rings probably by direct effect on the smooth muscles. Also, the observed antioxidant activity of taurine which may contribute to its relaxant effect suggesting the usefulness of turine in pulmonary hypertension.

  6. Semiempirical Rules To Determine Drug Sensitivity and Ionization Efficiency in Secondary Ion Mass Spectrometry Using a Model Tissue Sample.

    Science.gov (United States)

    Vorng, Jean-Luc; Kotowska, Anna M; Passarelli, Melissa K; West, Andrew; Marshall, Peter S; Havelund, Rasmus; Seah, Martin P; Dollery, Colin T; Rakowska, Paulina D; Gilmore, Ian S

    2016-11-15

    There is an increasing need in the pharmaceutical industry to reduce drug failure at late stage and thus reduce the cost of developing a new medicine. Since most drug targets are intracellular, this requires a better understanding of the drug disposition within a cell. Secondary ion mass spectrometry has been identified as a potentially important technique to do this, as it is label-free and allows imaging in 3D with subcellular resolution and recent studies have shown promise for amiodarone. An important analytical parameter is sensitivity, and we measure this in a bovine liver homogenate reference sample for 20 drugs representing important class types relevant to the pharmaceutical industry. We also measure the sensitivity for pure drug and show, for the first time, that the secondary ion mass spectrometry (SIMS) positive ionization efficiency for small molecules is a simple power-law relationship to the log P value. This discovery will be important for advancing the understanding of the SIMS ionization process in small molecules that has, until now, been elusive. This simple relationship is found to hold true for drug doped in the bovine liver homogenate reference sample, except for fluticasone, nicardipine, and sorafenib which suffer from severe matrix suppression. This relationship provides a simple semiempirical method to determine drug sensitivity for positive secondary ions. Furthermore, we show, on chosen models, how the use of different solvents during sample preparation can affect the ionization of analytes.

  7. In vitro detection of cardiotoxins or neurotoxins affecting ion channels or pumps using beating cardiomyocytes as alternative for animal testing.

    Science.gov (United States)

    Nicolas, Jonathan; Hendriksen, Peter J M; de Haan, Laura H J; Koning, Rosella; Rietjens, Ivonne M C M; Bovee, Toine F H

    2015-03-01

    The present study investigated if and to what extent murine stem cell-derived beating cardiomyocytes within embryoid bodies can be used as a broad screening in vitro assay for neurotoxicity testing, replacing for example in vivo tests for marine neurotoxins. Effect of nine model compounds, acting on either the Na(+), K(+), or Ca(2+) channels or the Na(+)/K(+) ATP-ase pump, on the beating was assessed. Diphenhydramine, veratridine, isradipine, verapamil and ouabain induced specific beating arrests that were reversible and none of the concentrations tested induced cytotoxicity. Three K(+) channel blockers, amiodarone, clofilium and sematilide, and the Na(+)/K(+) ATPase pump inhibitor digoxin had no specific effect on the beating. In addition, two marine neurotoxins i.e. saxitoxin and tetrodotoxin elicited specific beating arrests in cardiomyocytes. Comparison of the results obtained with cardiomyocytes to those obtained with the neuroblastoma neuro-2a assay revealed that the cardiomyocytes were generally somewhat more sensitive for the model compounds affecting Na(+) and Ca(2+) channels, but less sensitive for the compounds affecting K(+) channels. The stem cell-derived cardiomyocytes were not as sensitive as the neuroblastoma neuro-2a assay for saxitoxin and tetrodotoxin. It is concluded that the murine stem cell-derived beating cardiomyocytes provide a sensitive model for detection of specific neurotoxins and that the neuroblastoma neuro-2a assay may be a more promising cell-based assay for the screening of marine biotoxins.

  8. Interaction of metaiodobenzylguanidine with cardioactive drugs: an in vitro study

    Energy Technology Data Exchange (ETDEWEB)

    Huguet, F. [INSERM, Tours Univ. Hospital (France)]|[Inst. of Xenobiotic Studies, Poitiers Univ. Hospital (France); Fagret, D. [URA, CNRS, Grenoble Univ. Hospital (France); Caillet, M. [INSERM, Tours Univ. Hospital (France); Piriou, A. [Inst. of Xenobiotic Studies, Poitiers Univ. Hospital (France); Besnard, J.C. [INSERM, Tours Univ. Hospital (France); Guilloteau, D. [INSERM, Tours Univ. Hospital (France)

    1996-05-01

    Metaiodobenzylguanidine (MIBG), an analogue of noradrenaline, is used to explore the functional integrity of sympathetic nerve endings in the human heart. Various drugs inhibit noradrenaline transport systems and may block the uptake of MIBG. As in vivo studies of the effect of these drugs on myocardial [{sup 123}]MIBG uptake are often difficult to perform, we used an in vitro human blood platelet model for this purpose. A platelet preparation from healthy volunteers was incubated with [{sup 125}I]MIBG alone or different concentrations of drugs currently used in cardiology. Labetalol and propranolol inhibited [{sup 125}I]MIGB uptake, whereas all other drugs tested (other {beta}-blockers, calcium inhibitors, digoxin and amiodarone) had no effecft even at doses exceeding 50 {mu}M. The labetalol dose inhibiting 50% of [{sup 125}I]MIBG uptake was lower than the plasma concentration of this drug in treated patients, whereas the propranolol dose was higher. This in vitro study of the effect of drugs on MIBG uptake by human blood platelets is predictive of their in vivo effect on myocardial uptake of [{sup 123}I]MIBG in treated patients, provided that plasma concentration is taken into account. (orig.)

  9. Developmental toxicity of thyroid-active compounds in a zebrafish embryotoxicity test.

    Science.gov (United States)

    Jomaa, Barae; Hermsen, Sanne A B; Kessels, Maurijn Y; van den Berg, Johannes H J; Peijnenburg, Ad A C M; Aarts, Jac M M J G; Piersma, Aldert H; Rietjens, Ivonne M C M

    2014-01-01

    Zebrafish embryos were exposed to concentration ranges of selected thyroid-active model compounds in order to assess the applicability of zebrafish-based developmental scoring systems withinan alternative testing strategy to detect the developmental toxicity ofthyroid-active compounds. Model compounds tested included triiodothyronine (T3), propylthiouracil (PTU), methimazole (MMI), sodium perchlorate (NaClO4) and amiodarone hydrochloride (AMI), selected to represent different modes of action affecting thyroid activity. Tested time windows included 48-120 hours post fertilization (hpf), 0-72 hpf and 0-120 hpf. All tested compounds resulted in developmental changes, with T3 being the most potent. The developmental parameters affected included reflective iridophores, beat and glide swimming, inflated swim bladders, as well as resorbed yolk sacs. These effects are only evident by 120 hpf and therefore an existing General Morphology Score (GMS) system was extended to create a General Developmental Score(GDS) that extends beyond the 72 hpfscoring limit of GMS and includes additional parameters that are affected by exposure to model thyroid-active compounds. Moreover, the GDS is cumulative as it includes not only the scoring of developmental morphologies but also integrates developmental dysmorphologies. Exposures from 48-120 hpf did not provide additional information to exposures from 0-120 hpf. The results indicate that the zebrafish GDS can detect the developmental toxicity of thyroid toxicants and may be of use in an integrated testing strategy to reduce, refine and in certain cases replace animal testing.

  10. The virtual heart as a platform for screening drug cardiotoxicity.

    Science.gov (United States)

    Yuan, Yongfeng; Bai, Xiangyun; Luo, Cunjin; Wang, Kuanquan; Zhang, Henggui

    2015-12-01

    To predict the safety of a drug at an early stage in its development is a major challenge as there is a lack of in vitro heart models that correlate data from preclinical toxicity screening assays with clinical results. A biophysically detailed computer model of the heart, the virtual heart, provides a powerful tool for simulating drug-ion channel interactions and cardiac functions during normal and disease conditions and, therefore, provides a powerful platform for drug cardiotoxicity screening. In this article, we first review recent progress in the development of theory on drug-ion channel interactions and mathematical modelling. Then we propose a family of biomarkers that can quantitatively characterize the actions of a drug on the electrical activity of the heart at multi-physical scales including cellular and tissue levels. We also conducted some simulations to demonstrate the application of the virtual heart to assess the pro-arrhythmic effects of cisapride and amiodarone. Using the model we investigated the mechanisms responsible for the differences between the two drugs on pro-arrhythmogenesis, even though both prolong the QT interval of ECGs. Several challenges for further development of a virtual heart as a platform for screening drug cardiotoxicity are discussed.

  11. The virtual heart as a platform for screening drug cardiotoxicity

    Science.gov (United States)

    Yuan, Yongfeng; Bai, Xiangyun; Luo, Cunjin; Wang, Kuanquan

    2015-01-01

    To predict the safety of a drug at an early stage in its development is a major challenge as there is a lack of in vitro heart models that correlate data from preclinical toxicity screening assays with clinical results. A biophysically detailed computer model of the heart, the virtual heart, provides a powerful tool for simulating drug–ion channel interactions and cardiac functions during normal and disease conditions and, therefore, provides a powerful platform for drug cardiotoxicity screening. In this article, we first review recent progress in the development of theory on drug–ion channel interactions and mathematical modelling. Then we propose a family of biomarkers that can quantitatively characterize the actions of a drug on the electrical activity of the heart at multi‐physical scales including cellular and tissue levels. We also conducted some simulations to demonstrate the application of the virtual heart to assess the pro‐arrhythmic effects of cisapride and amiodarone. Using the model we investigated the mechanisms responsible for the differences between the two drugs on pro‐arrhythmogenesis, even though both prolong the QT interval of ECGs. Several challenges for further development of a virtual heart as a platform for screening drug cardiotoxicity are discussed. Linked Articles This article is part of a themed section on Chinese Innovation in Cardiovascular Drug Discovery. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2015.172.issue-23 PMID:25363597

  12. Sirolimus-induced pneumonitis complicated by pentamidine-induced phospholipidosis in a renal transplant recipient: a case report.

    Science.gov (United States)

    Filippone, E J; Carson, J M; Beckford, R A; Jaffe, B C; Newman, E; Awsare, B K; Doria, C; Farber, J L

    2011-09-01

    The proliferation signal inhibitors (PSIs)-sirolimus, everolimus, and temsirolimus-have been associated with a noninfectious pneumonitis characterized by lymphocytic alveolitis and bronciolitis obliterans with organizing pneumonia (BOOP). This condition usually occurs within the first year. Herein we presented a case of a deceased donor renal transplant with interstitial pneumonitis developing 6 years after a switch from tacrolimus to sirolimus due to chronic graft dysfunction. After the addition of intravenous pentamidine due to the suspicion of Pneumocystis pneumonia, there was marked clinical deterioration requiring intubation. Open lung biopsy revealed sirolimus-induced pulmonary toxicity (BOOP) with the additional finding of a drug-induced phospholipidosis (DIPL) that we ascribe to pentamidine treatment. After cessation of both drugs and application of corticosteroid therapy, there was only partial improvement. Eight months later the residual interstitial fibrosis demands supplemental home oxygen. We review the literature on PSI-induced pneumonitis and discuss the pathophysiology of a potential interaction with pentamidine. We caution against its use in the setting of PSI-induced pneumonitis. It is currently unknown whether these concerns also apply to prescription of other more commonly used medications associated with DIPL, eg, amiodarone and aminoglycosides.

  13. Three Vessel Coronary Cameral Fistulae Associated with New Onset Atrial Fibrillation and Angina Pectoris

    Directory of Open Access Journals (Sweden)

    Murat Yuksel

    2014-01-01

    Full Text Available Coronary cameral fistulas are abnormal communications between a coronary artery and a heart chamber or a great vessel which are reported in less than 0.1% of patients undergoing diagnostic coronary angiography. All three major coronary arteries are even less frequently involved in fistula formation as it is the case in our patient. A 68-year-old woman was admitted to cardiology clinic with complaints of exertional dyspnea and angina for two years and a new onset palpitation. Standard 12-lead electrocardiogram revealed atrial fibrillation (AF with a ventricular rate of 114 beat/minute and accompanying T wave abnormalities and minimal ST-depression on lateral derivations. Transthoracic echocardiographic examination was normal except for diastolic dysfunction, minimally mitral regurgitation, and mild to moderate enlargement of the left atrium. Sinus rhythm was achieved by medical cardioversion with amiodarone infusion. Coronary angiography revealed diffuse and multiple coronary-left ventricle fistulas originating from the distal segments of both left and right coronary arterial systems without any stenosis in epicardial coronary arteries. The patient’s symptoms resolved almost completely with medical therapy. High volume shunts via coronary artery to left ventricular microfistulas may lead to increased volume overload and subsequent increase in end-diastolic pressure of the left ventricle and may cause left atrial enlargement.

  14. 静脉用乙胺碘呋酮在心律失常急诊中的应用

    Institute of Scientific and Technical Information of China (English)

    杜军

    2002-01-01

    @@ 乙胺碘呋酮(Amiodarone,简称胺碘酮,AMD)是1962年作为冠状动脉扩张剂开发的.1967年作为治疗心绞痛药物在比利时等国家上市.1974年Rasenbaum等报告作为抗心律失常药物也有效.1985年在美国上市,1992年获得日本厚生省认可[1].以前按Vaughan Williams分类属Ⅲ型药物,其后的研究显示AMD具有类似Ⅰ型和Ⅱ型药物作用,还具有甲状腺修饰,改变膜磷脂代谢,抑制细胞因子产生等作用,其药理作用十分复杂.本文仅就静脉用AMD在心律失常急诊中的应用介绍如下.

  15. A classification of antiarrhythmic actions reassessed after a decade of new drugs.

    Science.gov (United States)

    Vaughan Williams, E M

    1984-04-01

    The past decade has seen the introduction of many new class 1 drugs, restricting fast inward current. Confirmative evidence has been obtained that the antiarrthymic action of lidocaine and diphenylhydantoin is indeed due to their effect as class 1 agents depressing conduction. The original class 3 drug, amiodarone, is increasingly in use as an antiarrhythmic of first choice for WPW and for arrhythmias associated with hypertrophic myopathy, and as a reserve drug in resistant arrhythmias of other types. Other compounds delaying repolarization have proved to be clinically effective as antiarrhythmics. In addition to their class 2 antiarrhythymic action exhibited acutely, on long-term treatment beta blockers have a class 3 action, which might be, at least in part, responsible for the protection of postinfarction patients against sudden death. Recent research suggests that inhibition of slow inward current may lead, as a secondary consequence of lowered [Ca]i, to improved cell-to-cell conduction. Finally, all but one of the new antiarrhythmic drugs, none of which existed in 1972, have turned out to possess one or more of the four classes of action originally described. This can hardly be a coincidence. The single exception, alinidine, a selective bradycardic agent, may restrict anionic currents, which would constitute a fifth class of action, but this is far from proved.

  16. Ventricular ectopy and QTc-interval prolongation associated with dronedarone therapy.

    Science.gov (United States)

    Gonzalez, Jaime E; Sauer, William H; Krantz, Mori J

    2013-10-01

    Amiodarone is an effective treatment for atrial and ventricular arrhythmias, but its use is limited by a toxic adverse-effect profile. Although dronedarone has been touted as an antiarrhythmic agent devoid of both solid organ toxicity and proarrhythmic properties, its potential for prolonging ventricular repolarization may augment triggered ectopy. We describe a 66-year-old man who began dronedarone 400 mg twice/day for new-onset paroxysmal atrial fibrillation; he had no left ventricular dysfunction or clinical heart failure. Three months after starting the drug, he complained of malaise, fatigue, and rare palpitations. Twenty four-hour Holter monitoring revealed increased premature ventricular complexes, and the rate-corrected QT (QTc) interval was prolonged (range 525-760 msec). Dronedarone was discontinued and the patient's symptoms gradually resolved over the next 3 weeks. Holter monitoring revealed a marked reduction in ventricular ectopy burden, and the QTc interval decreased to his baseline values. Even in the absence of documented symptomatic torsade de pointes, this case suggests that caution should be exercised when prescribing dronedarone and that serial QTc interval monitoring may be appropriate. In addition, clinicians should have a low threshold to perform Holter monitoring if symptoms develop during dronedarone therapy.

  17. TR{alpha}- and TSH-mRNA levels after temporal exposition with methimazole in zebrafish, Danio rerio

    Energy Technology Data Exchange (ETDEWEB)

    Schulz, A.E.I.; Stocker, A.; Hollosi, L.; Schramm, K.W. [Inst. of Ecological Chemistry, GSF - National Research Center for Environment and Health (Germany)

    2004-09-15

    The group of dioxin and dioxin-like substances are highly persistent in the environment. There are evidences from present investigations that a variety of substances are capable of disrupting the endocrine system in the aquatic environment. These substances are called endocrine disruptors. Dioxin and related compounds can act as endocrine disruptors. Aquatic animals like amphibian and fish are especially affected of the impact of these compounds. Investigations concerned so far in particular the domain of reproduction biology and the thyroid axis especially. Recent investigations showed that the TR{alpha}-mRNA level change after a short temporal expression with T3, methimazole and amiodarone. The objective of the project is to identify effects of thyroid endocrine disruptors on the regulation of gene expression of the thyroid receptors TR{alpha}a, TR{beta} and thyroid stimulating hormone TSH and associated effects on other system. In preliminary studies the effects of the drug methimazole as model substance on gene expression of TR{alpha} and TSH were investigated. Methimazole is an inhibitor of the thyroid peroxidase so that the formation of thyroid hormones is disrupted.

  18. March 2016 critical care case of the month

    Directory of Open Access Journals (Sweden)

    Loftsgard T

    2016-03-01

    Full Text Available No abstract available. Article truncated at 150 words. History of Present Illness: A 58-year-old man was admitted to the ICU in stable condition after an aortic valve replacement with a mechanical valve. Past Medical History: He had with past medical history significant for endocarditis, severe aortic regurgitation related to aortic valve perforation, mild to moderate mitral valve regurgitation, atrial fibrillation, depression, hypertension, hyperlipidemia, obesity, and previous cervical spine surgery. As part of his preop workup, he had a cardiac catheterization performed which showed no significant coronary artery disease. Pulmonary function tests showed an FEV1 of 55% predicted and a FEV1/FVC ratio of 65% consistent with moderate obstruction. Medications: Amiodarone 400 mg bid, digoxin 250 mcg, furosemide 20 mg IV bid, metoprolol 12.5 mg bid. Heparin nomogram since arrival in the ICU. Physical Examination: He was extubated shortly after arrival in the ICU. Vitals signs were stable. His weight had increased 3 Kg compared to admission. He was awake ...

  19. Atrial fibrillation in rats induced by rapid transesophageal atrial pacing during brief episodes of asphyxia: a new in vivo model.

    Science.gov (United States)

    Haugan, Ketil; Lam, Henrik Rye; Knudsen, Carsten Boye; Petersen, Jørgen Søberg

    2004-07-01

    Non-pharmacological in vivo models of atrial fibrillation (AF) have been developed in large animals only. We aimed to develop and characterize a new small animal non-pharmacological in vivo model of AF. AF was induced by transesophageal atrial burst pacing during 35 seconds periods of asphyxia in anesthetized male Sprague-Dawley rats. AF was reproducibly induced in 81% of the rats. The presence of AF was associated with an increased heart rate, and a decreased blood pressure. Treatment with amiodarone, D,L-sotalol, flecainide, and propranolol all reduced duration of AF, whereas verapamil treatment was associated with a marked profibrillatory effect. Increasing gap junction intracellular communication using the antiarrhythmic peptide analogue AAP10 did not affect AF duration. Basal plasma level of epinephrine and norepinephrine were increased 5- to 20-fold relative to values reported by others, but unchanged following 35 seconds of asphyxia. The results from our study demonstrate that the rat model shares several clinical key characteristics with human AF: (1) hemodynamic response to AF; (2) increased autonomic tone; (3) antiarrhythmic effects of clinically used drugs; (4) profibrillatory effect of verapamil. Relative to existing models of AF in larger animals, this model offers rapid, predictive, and inexpensive testing of antiarrhythmic/profibrillatory effects of new drugs.

  20. Calcium dependence of eugenol tolerance and toxicity in Saccharomyces cerevisiae.

    Science.gov (United States)

    Roberts, Stephen K; McAinsh, Martin; Cantopher, Hanna; Sandison, Sean

    2014-01-01

    Eugenol is a plant-derived phenolic compound which has recognised therapeutical potential as an antifungal agent. However little is known of either its fungicidal activity or the mechanisms employed by fungi to tolerate eugenol toxicity. A better exploitation of eugenol as a therapeutic agent will therefore depend on addressing this knowledge gap. Eugenol initiates increases in cytosolic Ca2+ in Saccharomyces cerevisiae which is partly dependent on the plasma membrane calcium channel, Cch1p. However, it is unclear whether a toxic cytosolic Ca2+elevation mediates the fungicidal activity of eugenol. In the present study, no significant difference in yeast survival was observed following transient eugenol treatment in the presence or absence of extracellular Ca2+. Furthermore, using yeast expressing apoaequorin to report cytosolic Ca2+ and a range of eugenol derivatives, antifungal activity did not appear to be coupled to Ca2+ influx or cytosolic Ca2+ elevation. Taken together, these results suggest that eugenol toxicity is not dependent on a toxic influx of Ca2+. In contrast, careful control of extracellular Ca2+ (using EGTA or BAPTA) revealed that tolerance of yeast to eugenol depended on Ca2+ influx via Cch1p. These findings expose significant differences between the antifungal activity of eugenol and that of azoles, amiodarone and carvacrol. This study highlights the potential to use eugenol in combination with other antifungal agents that exhibit differing modes of action as antifungal agents to combat drug resistant infections.

  1. [Classification and etiology of hyperthyroidism].

    Science.gov (United States)

    Łacka, Katarzyna; Fraczek, Magdalena Maria

    2014-03-01

    The prevalence of hyperthyroidism in women is between 0.5-2% and it is 10 times less common in men. The most common causes are Graves' disease, toxic multinodular goiter, and autonomously functioning thyroid adenoma. Rare causes of hyperthyroidisms are as follow: pituitary adenoma, autoimmune thyroiditis (Hashitoxicosis), levothyroxine overdose, inadequate iodine supplementation (including amiodaron induced hyperthyroidism, iodine-based contrast media), hCG excess (pregnancy, gestational trophoblastic disease, germ-cell tumors), drug induced hyperthyroidism, differentiated thyroid carcinomas and/or their metastases, struma ovarii, and familial nonautoimmune hyperthyroidism. This article focuses on the current data of etiopathogenesis of hyperthyroidisms. Genetic factors (like HLA-DR3,CD40, CTLA-4, PTPN22, FOXP3 CD25) and thyroid specific genes (thyroglobulin, TSHR, G(s)alpha) and environmental and endogenous factors (such as age, iodine, selenium, emotional stress, smoking, gender, pregnancy, sex hormones, fetal microchimerism, fetal growth, bacterial infections, viral infections, allergies, drugs (alemtuzumab, interferon alpha, iplimumab/tremelimumab, tyrosine kinase inhibitors, denileukindiftitox, thalidomide/lenalidomide, exposition to fallout and radiotherapy) have been described.

  2. Prediction of positive food effect: Bioavailability enhancement of BCS class II drugs.

    Science.gov (United States)

    Raman, Siddarth; Polli, James E

    2016-06-15

    High-throughput screening methods have increased the number of poorly water-soluble, highly permeable drug candidates. Many of these candidates have increased bioavailability when administered with food (i.e., exhibit a positive food effect). Food is known to impact drug bioavailability through a variety of mechanisms, including drug solubilization and prolonged gastric residence time. In vitro dissolution media that aim to mimic in vivo gastrointestinal (GI) conditions have been developed to lessen the need for fed human bioequivalence studies. The objective of this work was to develop an in vitro lipolysis model to predict positive food effect of three BCS Class II drugs (i.e., danazol, amiodarone and ivermectin) in previously developed lipolysis media. This in vitro lipolysis model was comparatively benchmarked against FeSSIF and FaSSIF media that were modified for an in vitro lipolysis approach, as FeSSIF and FaSSIF are widely used in in vitro dissolution studies. The in vitro lipolysis model accurately predicted the in vivo positive food effect for three model BCS class II drugs. The in vitro lipolysis model has potential use as a screening test of drug candidates in early development to assess positive food effect.

  3. 食管切除术后的重症监护治疗%Postoperative Intensive Care Treatment after Esophageal Resection

    Institute of Scientific and Technical Information of China (English)

    Dirk L.Stippel; K.Tobias E.Beckurts

    2004-01-01

    The aim of this article is to give a short review of problems associated with the intensive care treatment of patients after esophageal resection. Pulmonary dysfunction, supraventricular tachyarrhythmia, anastomotic leakage and mental disorders are the topics covered. Systemic inflammatory reaction and sepsis is the linking topic between these specific complications. Pulmonary dysfunction having an incidence of up to 40% is the most important complication. Low tidal volume ventilation, pain management including epidural analgesia and early tracheostomy are the mainstay of therapy. Supraventricular tachyarrhythmia is an early indicator of emerging complications. Its symptomatic treatment is standardized using electric cardioversion, beta-blockers and amiodarone. Anastomotic leakage must be suspect in any septic episode.Endoscopy and contrast studies allow for precise diagnosis. Interventional endoscopy is increasingly successful in the therapy of these leakages. Microbiological surveillance and specific antibiotic therapy ensure that a complication does not cause a septic cascade leading to multiorgan failure. The workload on ICU caused by a patient after esophageal resection still exceeds that of most other patients with gastrointestinal surgery.

  4. Postoperative Intensive Care Treatment after Esophageal Resection

    Institute of Scientific and Technical Information of China (English)

    DirkL.Stippel; K.TobiasE.Beckurts

    2004-01-01

    The aim of this article is to give a short review of problems associated with the intensive care treatment of patients after esophageal resection. Pulmonary dysfunction, supraventricular tachyarrhythmia, anastomotic leakage and mental disorders are the topics covered. Systemic inflammatory reaction and sepsis is the linking topic between these specific complications. Pulmonary dysfunction having an incidence of up to 40% is the most important complication. Low tidal volume ventilation, pain management including epidural analgesia and early tracheostomy are the mainstay of therapy. Supraventricular tachyarrhythmia is an early indicator of emerging complications. Its symptomatic treatment is standardized using electric cardioversion, beta-blockers and amiodarone. Anastomotic leakage must be suspect in any septic episode.Endoscopy and contrast studies allow for precise diagnosis. Interventional endoscopy is increasingly successful in the therapy of these leakages. Microbiological surveillance and specific antibiotic therapy ensure that a complication does not cause a septic cascade leading to multiorgan failure. The workload on ICU caused by a patient after esophageal resection still exceeds that of most other patients with gastrointestinal surgery.

  5. Calcium dependence of eugenol tolerance and toxicity in Saccharomyces cerevisiae.

    Directory of Open Access Journals (Sweden)

    Stephen K Roberts

    Full Text Available Eugenol is a plant-derived phenolic compound which has recognised therapeutical potential as an antifungal agent. However little is known of either its fungicidal activity or the mechanisms employed by fungi to tolerate eugenol toxicity. A better exploitation of eugenol as a therapeutic agent will therefore depend on addressing this knowledge gap. Eugenol initiates increases in cytosolic Ca2+ in Saccharomyces cerevisiae which is partly dependent on the plasma membrane calcium channel, Cch1p. However, it is unclear whether a toxic cytosolic Ca2+elevation mediates the fungicidal activity of eugenol. In the present study, no significant difference in yeast survival was observed following transient eugenol treatment in the presence or absence of extracellular Ca2+. Furthermore, using yeast expressing apoaequorin to report cytosolic Ca2+ and a range of eugenol derivatives, antifungal activity did not appear to be coupled to Ca2+ influx or cytosolic Ca2+ elevation. Taken together, these results suggest that eugenol toxicity is not dependent on a toxic influx of Ca2+. In contrast, careful control of extracellular Ca2+ (using EGTA or BAPTA revealed that tolerance of yeast to eugenol depended on Ca2+ influx via Cch1p. These findings expose significant differences between the antifungal activity of eugenol and that of azoles, amiodarone and carvacrol. This study highlights the potential to use eugenol in combination with other antifungal agents that exhibit differing modes of action as antifungal agents to combat drug resistant infections.

  6. Important drug interactions in patients with rheumatic disorders: interactions of glucocorticoids, immunosuppressants and antimalarial drugs.

    Science.gov (United States)

    Hromadkova, L; Soukup, T; Vlcek, J

    2012-08-01

    Despite the fact that biological treatments are very promising, classical immunosuppressants, antimalarial drugs and glucocorticosteroids are still very important and widely used in practice. Although drug interactions can have fatal consequences, few studies have reviewed drug interactions of these classical drugs used in rheumatology, and very few guidelines are available on this subject. Therefore, this report summarizes important interactions of immunosuppressants, antimalarial drugs and glucocorticosteroids with drugs commonly used in internal medicine. In the present study, more than 300 interactions were retrieved from the Micromedex ® database. The selection was reduced to the interactions rated as moderate, major or contraindicated. The selected interactions were further checked against PubMed ®, MEDLINE ®, InfoPharm Compendium of Drug Interactions and Summaries of Product Characteristics. For each interaction, its nature, mechanism, onset and clinical severity were indicated, documentation quality was rated and recommendations for clinical practice were formulated. Twenty significant interactions that we rated as moderate, severe and very severe were identified. Interacting drugs were warfarin, fluoroquinolones, azole antifungals, co-trimoxazole, proton pump inhibitors, amiodarone, cholestyramine, activated carbon, allopurinol, angiotensin-converting enzyme inhibitors, statins, digoxin, iron, aluminium and magnesium salts, and hepatotoxic and nephrotoxic agents.

  7. Targeted toxicological screening for acidic, neutral and basic substances in postmortem and antemortem whole blood using simple protein precipitation and UPLC-HR-TOF-MS

    DEFF Research Database (Denmark)

    Telving, Rasmus; Hasselstrøm, Jørgen Bo; Andreasen, Mette Findal

    2016-01-01

    -HR-TOF-MS was achieved in one injection. This method covered basic substances, substances traditionally analyzed in negative ESI (e.g., salicylic acid), small highly polar substances such as beta- and gamma-hydroxybutyric acid (BHB and GHB, respectively) and highly non-polar substances such as amiodarone. The new method......A broad targeted screening method based on broadband collision-induced dissociation (bbCID) ultra-performance liquid chromatography high-resolution time-of-flight mass spectrometry (UPLC-HR-TOF-MS) was developed and evaluated for toxicological screening of whole blood samples. The acidic, neutral...... was performed on spiked whole blood samples and authentic postmortem and antemortem whole blood samples. For most of the basic drugs, the established cut-off limits were very low, ranging from 0.25ng/g to 50ng/g. The established cut-off limits for most neutral and acidic drugs, were in the range from 50ng...

  8. Appropriate evaluation and treatment of heart failure patients after implantable cardioverter-defibrillator discharge: time to go beyond the initial shock.

    Science.gov (United States)

    Mishkin, Joseph D; Saxonhouse, Sherry J; Woo, Gregory W; Burkart, Thomas A; Miles, William M; Conti, Jamie B; Schofield, Richard S; Sears, Samuel F; Aranda, Juan M

    2009-11-24

    Multiple clinical trials support the use of implantable cardioverter-defibrillators (ICDs) for prevention of sudden cardiac death in patients with heart failure (HF). Unfortunately, several complicating issues have arisen from the universal use of ICDs in HF patients. An estimated 20% to 35% of HF patients who receive an ICD for primary prevention will experience an appropriate shock within 1 to 3 years of implant, and one-third of patients will experience an inappropriate shock. An ICD shock is associated with a 2- to 5-fold increase in mortality, with the most common cause being progressive HF. The median time from initial ICD shock to death ranges from 168 to 294 days depending on HF etiology and the appropriateness of the ICD therapy. Despite this prognosis, current guidelines do not provide a clear stepwise approach to managing these high-risk patients. An ICD shock increases HF event risk and should trigger a thorough evaluation to determine the etiology of the shock and guide subsequent therapeutic interventions. Several combinations of pharmacologic and device-based interventions such as adding amiodarone to baseline beta-blocker therapy, adjusting ICD sensitivity, and employing antitachycardia pacing may reduce future appropriate and inappropriate shocks. Aggressive HF surveillance and management is required after an ICD shock, as the risk of sudden cardiac death is transformed to an increased HF event risk.

  9. Heart Surgery Experience in Hitit University Faculty of Medicine Corum Research and Training Hospital: First Year Results

    Directory of Open Access Journals (Sweden)

    Adem Diken

    2014-03-01

    Full Text Available Aim: We aimed to assess the clinical outcomes of our department of cardiac surgery which was newly introduced in Hitit University Corum Education and Research Hospital. Material and Method: Between November 2012 and November 2013, a total of 110 open-heart surgeries were performed. Ten out of these (9.1% were emergency operations for acute ST elevation myocardial infarction Off-pump technique was used in 31 (29.2% patients and cardiopulmonary bypass was used in 75 (70.8%. A total of 106 patients received coronary artery bypass grafting, 1 received mitral reconstruction, 1 received Bentall procedure, 1 received tricuspid valve repair, 1 received mitral valve replacement, 1 received aortic valve replacement with aortic root enlargement and 1 received aortic supracoronary graft replacement. Results: Hospital mortality occurred in 1 (0.9% patient. Four patients (3.6% who were on dual antiaggregants underwent a revision for bleeding on the day of the operation. Morbidities occurred in 3 (2.7% patients. Atrial fibrillation occurred in 11 (10% patients and the normal sinus rhythm was achieved by amiodarone. Intraaortic balloon counterpulsation was used in 5 (4.5% patients. Discussion: The newly introduced cardiac surgery department of the Hitit University Corum Education and Research Hospital, which provides tertiary care to a wide rural community, serves with low morbidity and mortality.

  10. Evaluation of drug-induced neurotoxicity based on metabolomics, proteomics and electrical activity measurements in complementary CNS in vitro models.

    Science.gov (United States)

    Schultz, Luise; Zurich, Marie-Gabrielle; Culot, Maxime; da Costa, Anaelle; Landry, Christophe; Bellwon, Patricia; Kristl, Theresa; Hörmann, Katrin; Ruzek, Silke; Aiche, Stephan; Reinert, Knut; Bielow, Chris; Gosselet, Fabien; Cecchelli, Romeo; Huber, Christian G; Schroeder, Olaf H-U; Gramowski-Voss, Alexandra; Weiss, Dieter G; Bal-Price, Anna

    2015-12-25

    The present study was performed in an attempt to develop an in vitro integrated testing strategy (ITS) to evaluate drug-induced neurotoxicity. A number of endpoints were analyzed using two complementary brain cell culture models and an in vitro blood-brain barrier (BBB) model after single and repeated exposure treatments with selected drugs that covered the major biological, pharmacological and neuro-toxicological responses. Furthermore, four drugs (diazepam, cyclosporine A, chlorpromazine and amiodarone) were tested more in depth as representatives of different classes of neurotoxicants, inducing toxicity through different pathways of toxicity. The developed in vitro BBB model allowed detection of toxic effects at the level of BBB and evaluation of drug transport through the barrier for predicting free brain concentrations of the studied drugs. The measurement of neuronal electrical activity was found to be a sensitive tool to predict the neuroactivity and neurotoxicity of drugs after acute exposure. The histotypic 3D re-aggregating brain cell cultures, containing all brain cell types, were found to be well suited for OMICs analyses after both acute and long term treatment. The obtained data suggest that an in vitro ITS based on the information obtained from BBB studies and combined with metabolomics, proteomics and neuronal electrical activity measurements performed in stable in vitro neuronal cell culture systems, has high potential to improve current in vitro drug-induced neurotoxicity evaluation.

  11. Optimal tachycardia programming in ICDs : Recommendations in the post-MADIT-RIT era.

    Science.gov (United States)

    Israel, Carsten W; Burmistrava, Tatsiana

    2016-09-01

    Optimal implantable cardioverter-defibrillator (ICD) programming can reduce the incidence of inappropriate shock therapy and improve prognosis in patients with an ICD. Only after results from randomized trials became available was the "safety first" feeling overcome that mandated early shock therapy, waived the use of antitachycardia pacing and forced shock therapy after a time of 30 s expired, even if tachycardia discriminators would have withheld the therapy. The strong evidence to limit ICD therapy to longer ventricular tachycardia (VT) should not result in individually dangerous ICD programming, particularly in patients with a high risk of slow VT (known monomorphic VT, post VT ablation, during treatment with amiodarone, very dilated left ventricle). Monitoring zones may aid to detect unexpected slow VT and to explain symptoms such as presyncope without exposing the patient to an unnecessary risk of inappropriate therapy. This review summarizes our current knowledge on optimal ICD programming and explains exactly how we should program device parameters in practice in single- or dual-chamber ICDs by different manufacturers and in different groups of patients.

  12. 53例药源性间质性肺炎的文献分析%Literature Analysis of 53 Reports of Drug-induced Interstitial Pneumonia

    Institute of Scientific and Technical Information of China (English)

    胡美绘; 孙安修

    2014-01-01

    目的:探讨引起间质性肺炎的药品种类及其临床表现特点。方法检索中国医院数字图书馆、中国知网、万方数据库中1994~2013年,关键词为“间质性肺炎”的相关文献,进行归纳总结。结果共检索出相关文献74篇,报道53例药源性间质性肺炎,涉及15种药物,包括吉非替尼(15例)、利妥西单抗(9例)、来氟米特(8例)、胺碘酮(8例)、厄洛替尼(5例)、干扰素(2例)、5-氟尿嘧啶(1例)、粒细胞集落刺激因子(1例)、吉西他滨(1例)、卡莫司汀(1例)、麻疹疫苗(1例)、百草枯(1例)等。53例患者中,2例治疗结果不详;治愈17例(33.33%),好转19例(37.26%),死亡15例(29.41%)。结论各药品引起间质性肺炎发病机制尚不明确,临床表现相似。发病率较高的药物有吉非替尼、利妥西单抗、来氟米特、胺碘酮、厄洛替尼。%Objective To study the drugs leading to interstitial pneumonia and analyze their clinical characteristics. Methods We searched the literatures from 1994 to 2013 by key words of "interstitial pneumonia" in China Digital Library, China National Knowledge Infrastructure, Wanfang Database, and summarized them. Results A total of 74 relevant articles were identified, which reported 53 cases of drug-induced interstitial neumonia, involving 15 kinds of drugs. The drugs included gefitinib(15), rituximab(9), leflunomide(8), amiodarone(8), erlotinib(5), interferon(2), 5-fluorouracil(1), granulocyte colony-stimulating factor(1), gemcitabine(1), carmustine (1), measles vaccine (1), paraquat(1), et al.The result showed that 53 cases contained 17 cases(33.33%) cured, 19 cases(37.26%) improved , 15 cases(29.41%) died and 2 cases unclear. Conclusion The clinical manifestations of interstitial pneumonia induced by drugs were similar, but the pathogenesis was unknown. The drugs leading to higher incidence were gefitinib, rituximab

  13. Reliability of the thyroid stimulating hormone receptor antibodies level determination in diagnosing and prognosing of immunogenic hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Aleksić Aleksandar Z.

    2009-01-01

    Full Text Available Background/Aim. Graves disease (GD is defined as hyperthyroidism with diffuse goiter caused by immunogenic disturbances. Antibodies to the thyroid stimulating hormone (TSH receptors of thyroid gland (TRAb have crucial pathogenetic importance in the development and maintenance of autoimmune hyperthyroidism. The aim of this study was to identify sensitivity, specificity, positive an negative predictive value of TRAb level in sera of patients with GD as well as to estimate significance of TRAb level for remission and GD relapses occurrence. Methods. We studied prospectively and partly retrospectively 149 patients, 109 female and 40 male patients, 5-78 years old, in the period 1982-2007. There were 96 patients with GD. The control group consisted of 53 patients, 21 with hyperthyroidism of second etiology and 32 patients on amiodarone therapy, with or without thyroid dysfunction TRAb was measured by radioreceptor assay (TRAK Assay and DYNO Test TRAK Human Brahms Diagnostica GMBH. Results. According to the results the sensitivity (Sn of TRAb test was 80%, specificity (Sp 100%, positive predictive value (PP 100% and negative predictive value (NP 83%. Also, the Sn of hTRAb test was 94%, Sp 100%, PP 100% and NP 94%. Our results show that an increased level of TRAb/hTRAb at the beginning of the disease and the level at the end of medical therapy is associated with an increased number of GD relapses and a shorter remission duration. Conclusion. Detection and measurement of TRAb in serum is a very sensitive method for diagnosing GD and very highly specific in vitro method for differential diagnosis of various forms of hyperthyroidism. Clinical significance of differentiating various forms of hyperthyroidism, using this in vitro assay, lays in adequate therapeutic choice for these entities.

  14. Adverse drug events associated with vitamin K antagonists: factors of therapeutic imbalance

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    El-Helou N

    2013-03-01

    Full Text Available Nancy El-Helou, Amal Al-Hajje, Rola Ajrouche, Sanaa Awada, Samar Rachidi, Salam Zein, Pascale SalamehClinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Beirut, LebanonBackground: Adverse drug events (ADE occur frequently during treatment with vitamin K antagonists (AVK and contribute to increase hemorrhagic risks.Methods: A retrospective study was conducted over a period of 2 years. Patients treated with AVK and admitted to the emergency room of a tertiary care hospital in Beirut were included. The aim of the study was to identify ADE characterized by a high international normalized ratio (INR and to determine the predictive factors responsible for these events. Statistical analysis was performed with the SPSS statistical package.Results: We included 148 patients. Sixty-seven patients (47.3% with an INR above the therapeutic range were identified as cases. The control group consisted of 81 patients (54.7% with an INR within the therapeutic range. Hemorrhagic complications were observed in 53.7% of cases versus 6.2% of controls (P < 0.0001. No significant difference was noticed between cases and controls regarding the indication and the dose of AVK. Patients aged over 75 years were more likely to present an INR above the therapeutic range (58.2%, P = 0.049. Recent infection was present in 40.3% of cases versus 6.2% of controls (P < 0.0001 and hypoalbuminemia in 37.3% of cases versus 6.1% of controls (P < 0.0001. Treatment with antibiotics, amiodarone, and anti-inflammatory drugs were also factors of imbalance (P < 0.0001.Conclusion: Many factors may be associated with ADE related to AVK. Monitoring of INR and its stabilization in the therapeutic range are important for preventing these events.Keywords: adverse drug events, vitamin K antagonists, bleeding risks, therapeutic imbalance

  15. In vitro thyroid disrupting effects of organic extracts from WWTPs in Beijing

    Institute of Scientific and Technical Information of China (English)

    Na Li; Mei Ma; Kaifeng Rao; Zijian Wang

    2011-01-01

    It is generally known that there are many endocrine disrupting compounds (EDCs) in the effluents from wastewater treatment plants (WWTPs). Most research has focused on the occurrence of estrogenic or androgenic activities, while ignoring that there are environmental chemicals disrupting thyroid system, which is essential for growth and development in both humans and animals. In the present work, a two-hybrid yeast assay was conducted to evaluate the removal efficiencies of agonistic or antagonistic thyroid receptor (TR) mediated effects in different treatment processes of three WWTPs located in Beijing. We found no TR agonistic, but TR antagonistic activities in all processes from the WWTPs. The TR antagonistic activities in organic extracts of water samples were then calibrated regarding to a known TR-inhibitor, amiodarone hydrochloride (AH). The observed concentration of TR disrupting substances ranged from 2.35 × 10-8 to 6.19 × 10-7 mol/L AH in Gaobeidian WWTP, 3.76 × 10-8 to 8.75 × 10-8 mol/L AH in Lugouqiao WWTP,and 4.80 × 10-9 to 2.55 × 10-8 mol/L AH in Beixiaohe WWTP. Of the three WWTPs, the removal rates were 92.7%, 42.2%, and 23.1% respectively. Industrial sewage may contain more TR disrupting substances compared with domestic sewage. The recipient waters were found to contain considerable concentrations of TR disrupting substances that may cause adverse effects on the exposed organisms.

  16. Die MAZE-Operation zur Behandlung des chronischen Vorhofflimmerns im Langzeitverlauf: 3-Jahres-Ergebnisse

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    Aigner C

    2005-01-01

    Full Text Available Grundlagen: Die MAZE-Operation mittels Ablation mit Mikrowelle oder Radiofrequenz ist ein etabliertes Verfahren zur Behandlung des chronischen Vorhofflimmerns. Diese Studie untersucht die Langzeitergebnisse nach 36 Monaten. Methodik: Zwischen 2/2001 und 12/2002 wurden 42 Patienten (64,5 ± 2,2 Jahre; 21 Männer mit chronischem Vorhofflimmern 6 Monate und zusätzlicher teils kombinierter Klappenerkrankung mittels Mitralklappenersatz/-rekonstruktion ± Trikuspidalklappenrekonstruktion (n = 30, Aortenklappenersatz ± Trikuspidalklappenrekonstruktion (n = 6 und Mitralklappen- und Aortenklappenersatz/- rekonstruktion ± Trikuspidalklappenrekonstruktion (n = 6 und MAZE operiert. Die mittlere Dauer des Vorhofflimmerns lag bei 63 ± 29 Monaten (7–384 Monate. Bei der MAZE-Operation wurden, dem Cox-III-Konzept folgend, in beiden Vorhöfen lineare Läsionen mit Mikrowellen- bzw. Radiofrequenzablation gesetzt. Ergebnisse: Die MAZE-Operation führte zu 23 ± 2 Minuten zusätzlicher Aortenklemmzeit (total: 89 ± 3 Min.. Aufgrund eines SIRS war bei einem Patienten der Intensivaufenthalt verlängert. Bei den restlichen Patienten war die Intubationsdauer 18,3 ± 6,7 Stunden, der Intensivaufenthalt 1,7 ± 0,6 Tage. 52,3 % wurden mit Amiodaron behandelt, 64,3 % kardiovertiert. 23,8 % Patienten benötigten einen Schrittmacher wegen eines AV-Blocks bzw. eines Sick-Sinus-Syndroms. Nach 12 Monaten waren 80,8 % frei von Vorhofflimmern. Beim letzten Nachuntersuchungszeitpunkt (36 ± 8 Monate waren 78,6 % frei von Vorhofflimmern. Schlußfolgerungen: Die MAZE-Operation mittels Mikrowellen- bzw. Radiofrequenzablation, folgend dem Cox-III-MAZE-Konzept, erhöht das chirurgische Risiko nur gering. Die Freiheit von Vorhofflimmern ist nach 1 und 3 Jahren praktisch gleich. Es ist also auch langfristig möglich, Patienten mit chronischem Vorhofflimmern einen stabilen Sinusrhythmus zu gewährleisten.

  17. Identification of high risk patients with hypertrophic cardiomyopathy in a northern Greek population

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    Karvounis Charalambos

    2009-07-01

    Full Text Available Abstract Background The percentage of hypertrophic cardiomyopathy (HCM patients who are in high risk for Sudden Death (SD constitutes only a minority of all HCM population but the incidence of SD in this subset is high (at least 5% annually. The identification of this small but important proportion of high risk HCM patients has been the clue in the clinical evaluation of these patients. Methods Our study cohort consisted from 123 patients with HCM who are currently followed up in our Institution. Five clinical risk factors were assessed: a family history of premature SD, unexplained syncope, Non Sustained Ventricular Tachycardia (NSVT on 24-h ECG monitoring, Abnormal Blood Pressure Response (ABPR during upright exercise testing and Maximum left ventricular Wall Thickness (MWT ≥30 mm. The purpose of our study was the identification of high risk HCM patients coming from Northern Greece. Results Fifteen patients (12.2% of the whole cohort had MWT ≥ 30 mm, 30 patients (24.4% had an ABPR to exercise, 17 patients (13.8% had episodes of NSVT in 24-h Holter monitoring, 17 patients (13.8% suffered from syncope, and 8 patients (6.5% had a positive family history of premature SD. Data analysis revealed that 74 patients (60.1% had none risk factor. Twenty four patients (19.5% had 1 risk factor, 17 patients (13.8% had 2 risk factors, 4 patients (3.25% had 3 risk factors, and 4 patients (3.25% had 4 risk factors, while none patient had 5 risk factors. Twenty five patients (20.3% had 2 or more risk factors. Conclusion This study for the first time confirms that, although a 60% of patients with HCM coming from a regional Greek population are in low risk for SD, a substantial proportion (almost 20% carries a high risk for SD justifying prophylactic therapy with amiodaron or ICD implantation.

  18. Herzbeteiligung bei Myopathien

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    Finsterer J

    2001-01-01

    Full Text Available Herzbeteiligung bei Patienten mit Myopathien wird zunehmend häufiger diagnostiziert. Sie manifestiert sich bei diesen Patienten als Störung der Erregungsbildung und -ausbreitung, Wandverdickung, abnorme Textur des Myokards, linksventrikuläre Hypertrabekulierung, Dilatation der Herzhöhlen mit/ohne sekundärer Klappeninsuffizienz, Reduktion der Koronarreserve, intrakardiale Thrombusbildung, Endo-/Myokardfibrose, regionale Wandbewegungsstörung und systolische und/oder diastolische Funktionsstörung mit/ohne Herzinsuffizienz. Herzbeteiligung wurde bisher bei Dystrophinopathien, Emery-Dreifuss-Muskeldystrophie, fazioskapulohumeraler Muskeldystrophie, Sarcoglycanopathien, kongenitaler Muskeldystrophie Fukuyama, myotoner Dystrophie Typ 1 und 2, Glykogenose Typ II, III, IV, VII und IX, Carnitinmangel, Myoadenylat-Deaminase-Mangel, Acyl-CoA-Dehydrogenase-Mangel, lysosomaler Glykogen-Speicherkrankheit, Mitochondriopathien, Desmin-Myopathie, Nemalin-Myopathie, Central Core-Krankheit, kongenitaler Fasertypen-Dysproportion, Barth-Syndrom, McLeod-Syndrom und Bethlem-Myopathie beschrieben. Herzbeteiligung bei Myopathien kann über Monate oder Jahre progredient verlaufen oder auch akut auftreten bzw. sich bis hin zum kardialen Notfall verschlechtern. Die Therapie der Herzbeteiligung richtet sich nach den spezifischen kardialen Abnormitäten und umfaßt Digitalis, Diuretika, ACE-Hemmer, Kalziumantagonisten, Amiodaron, Betablocker, L-Carnitin, Antikoagulation, Kardioversion, Schrittmacher, Defibrillator, Hochfrequenz-Katheter-Ablation und die Herztransplantation. Generell sollten Myopathie-Patienten kardiologisch untersucht werden, sobald die neurologische Diagnose feststeht, da eine suffiziente kardiale Therapie die Herzbeteiligung bei Myopathien positiv beeinflußt. Ein kardiologisches Follow-up ist angezeigt, wenn die Herzbeteiligung klinisch manifest wird bzw. bei rascher Progredienz.

  19. Herzbeteiligung bei Myopathien

    Directory of Open Access Journals (Sweden)

    Finsterer J

    2001-01-01

    Full Text Available Herzbeteiligung bei Patienten mit Myopathien wird zunehmend häufiger diagnostiziert. Sie manifestiert sich bei diesen Patienten als Störung der Erregungsbildung und -ausbreitung, Wandverdickung, abnorme Textur des Myokards, linksventrikuläre Hypertrabekulierung, Dilatation der Herzhöhlen mit/ohne sekundärer Klappeninsuffizienz, Reduktion der Koronarreserve, intrakardiale Thrombusbildung, Endo-/Myokardfibrose, regionale Wandbewegungsstörung und systolische und/oder diastolische Funktionsstörung mit/ohne Herzinsuffizienz. Herzbeteiligung wurde bisher bei Dystrophinopathien, Emery-Dreifuss-Muskeldystrophie, fazioskapulohumeraler Muskeldystrophie, Sarcoglycanopathien, kongenitaler Muskeldystrophie Fukuyama, myotoner Dystrophie Typ 1 und 2, proximal myotoner Myopathie, Glykogenose Typ II, III, IV, VII und IX, Carnitinmangel, Myoadenylat-Deaminase-Mangel, Acyl-CoA-Dehydrogenase-Mangel, lysosomaler Glykogen-Speicherkrankheit, Mitochondriopathien, Desmin-Myopathie, Nemalin-Myopathie, Central Core-Krankheit, kongenitaler Fasertypen-Dysproportion, Barth-Syndrom, McLeod-Syndrom und Bethlem-Myopathie beschrieben. Herzbeteiligung bei Myopathien kann über Monate oder Jahre progredient verlaufen oder auch akut auftreten bzw. sich bis hin zum kardialen Notfall verschlechtern. Die Therapie der Herzbeteiligung richtet sich nach den spezifischen kardialen Abnormitäten und umfaßt Digitalis, Diuretika, ACE-Hemmer, Kalziumantagonisten, Amiodaron, Betablocker, L-Carnitin, Antikoagulation, Kardioversion, Schrittmacher, Defibrillator, Hochfrequenz-Katheter-Ablation und die Herztransplantation. Generell sollten Myopathie-Patienten kardiologisch untersucht werden, sobald die neurologische Diagnose feststeht, da eine suffiziente kardiale Therapie die Herzbeteiligung bei Myopathien positiv beeinflußt. Ein kardiologisches Follow-up ist angezeigt, wenn die Herzbeteiligung klinisch manifest wird bzw. bei rascher Progredienz.

  20. Medikamentöse und alternative Konzepte zur Behandlung von Vorhofflimmern: Neuere Klasse-III-Antiarrhythmika, Hybridtherapien (Kardioversion-Defibrillation, Ablation, Pacing

    Directory of Open Access Journals (Sweden)

    Pürerfellner H

    2004-01-01

    Full Text Available Trotz Fortschritten in der nicht-pharmakologischen Therapie spielen antiarrhythmische Medikamente noch immer eine führende Rolle in der Behandlung kardialer Arrhythmien. Große randomisierte kontrollierte klinische Studien haben die Wichtigkeit einer geeigneten Risiko-Nutzen-Evaluierung bei unterschiedlichen Patientengruppen herausgearbeitet. Das hat dazu geführt, daß Natrium-Kanal-Blocker wegen ihrer potentiell proarrhythmischen Wirkung speziell bei Patienten mit eingeschränkter linksventrikulärer Funktion und ischämischer Herzerkrankung immer weniger eingesetzt wurden. Dagegen wurden Betablocker und komplexere Klasse- III-Substanzen wie Sotalol und Amiodaron immer öfter verordnet. Allerdings haben häufig auftretende Nebenwirkungen die Entwicklung von Substanzen mit einer einfachen Ionen-Kanal-Blockade vorangetrieben. In diesem Review werden neuere sogenannte reine Klasse-III-Substanzen diskutiert. Ihr gemeinsamer Wirkmechanismus ist ein antifibrillatorischer Effekt auf Vorhof und Kammer. Klinisch werden sie bei der medikamentösen Kardioversion und zur Prävention von Vorhofflimmern oder Vorhofflattern genauso wie zum Erhalt des Sinusrhythmus nach dessen erfolgreicher Wiederherstellung eingesetzt. Der Bericht enthält eine detaillierte Analyse zur Pharmakokinetik, referiert die Ergebnisse klinischer Studien und erläutert Implikationen in bezug auf die tägliche Anwendung dreier spezieller Substanzen: Ibutilid, Dofetilid und Azimilid. Nachdem ihre Effektivität noch immer begrenzt ist, wird die gegenwärtige und zukünftige Rolle von Hybridtherapien, d. h. eine Kombination von medikamentöser Therapie mit alternativen Behandlungsmethoden (implantierbare Kardioverter-Defibrillatoren, Katheterablation, Schrittmacher diskutiert. Darüber hinaus gibt es einen Ausblick auf ein zukünftiges Medikamentendesign, dessen Ziel das im Sinne eines Remodellings elektrisch veränderte Vorhofgewebe darstellt.

  1. Increase in thyroid stimulating hormone levels in patients with gout treated with inhibitors of xanthine oxidoreductase.

    Science.gov (United States)

    Perez-Ruiz, Fernando; Chinchilla, Sandra Pamela; Atxotegi, Joana; Urionagüena, Irati; Herrero-Beites, Ana Maria; Aniel-Quiroga, Maria Angeles

    2015-11-01

    Increase in thyroid stimulating hormone (TSH) levels over the upper normal limit has been reported in a small percentage of patients treated with febuxostat in clinical trials, but a mechanistic explanation is not yet available. In an observational parallel longitudinal cohort study, we evaluated changes in TSH levels in patients with gout at baseline and during urate-lowering treatment with febuxostat. Patients to be started on allopurinol who had a measurement of TSH in the 6-month period prior to baseline evaluation were used for comparison. TSH levels and change in TSH levels at 12-month follow-up were compared between groups. Patients with abnormal TSH levels or previous thyroid disease or on amiodarone were not included for analysis. Eighty-eight patients treated with febuxostat and 87 with allopurinol were available for comparisons. Patients to be treated with febuxostat had higher urate levels and TSH levels, more severe gout, and poorer renal function, but were similar regarding other characteristics. A similar rise in TSH levels was observed in both groups (0.4 and 0.5 µUI/mL for febuxostat and allopurinol, respectively); at 12-mo, 7/88 (7.9 %) of patients on febuxostat and 4/87 (3.4 %) of patients on allopurinol showed TSH levels over 0.5 µUI/mL. Doses prescribed (corrected for estimated glomerular filtration rate in the case if patients on allopurinol) and baseline TSH levels were determinants of TSH levels at 12-month follow-up. No impact on free T4 (fT4) levels was observed. Febuxostat, but also allopurinol, increased TSH levels in a dose-dependent way, thus suggesting rather a class effect than a drug effect, but with no apparent impact on either clinical or fT4 levels.

  2. Paroxysmal supraventricular tachycardia: physiopathology and management

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    Paola Neroni

    2014-06-01

    Full Text Available Paroxysmal supraventricular tachycardia (PSVT is the most frequent arrhythmia in newborns and infants. Most supraventricular tachycardias affect structurally healthy hearts. Apart from occasional detection by parents, most tachycardias in this age group are revealed by heart failure signs, such as poor feeding, sweating and shortness of breath. The main symptom reported by school-age children is palpitations. The chronic tachycardia causes a secondary form of dilative cardiomyopathy. Treatment of acute episode usually has an excellent outcome. Vagal manoeuvres are effective in patients with atrioventricular reentrant tachycardia. Adenosine is the drug of choice at all ages for tachycardias involving the atrioventricular node. Its key advantage is its short half life and minimum or no negative inotropic effects. Verapamil is not indicated in newborns and children as it poses a high risk of electromechanical dissociation. Antiarrhythmic prophylaxis of PSVT recurrence is usually recommended in the first year of life, because the diagnosis of tachycardia may be delayed up to the appearance of symptoms. Digoxin can be administered in all forms of PSVT involving the atrioventricular node, except for patients with Wolff-Parkinson-White syndrome below one year of age. Patients with atrioventricular reentrant PSVT can be treated effectively by class Ic drugs, such as propaphenone and flecainide. Amiodarone has the greatest antiarrhythmic effect, but should be used with caution owing to the high incidence of side effects. Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy · October 22nd-25th, 2014 · The last ten years, the next ten years in Neonatology Guest Editors: Vassilios Fanos, Michele Mussap, Gavino Faa, Apostolos Papageorgiou

  3. Postoperative nursing of patients with rheumatic heart disease combined with atrial fibrillation treated with valve replacement and radio frequency ablation%瓣膜置换术同期行射频消融术治疗风湿性心脏病合并房颤的术后护理

    Institute of Scientific and Technical Information of China (English)

    于环; 曾丽华

    2012-01-01

    Objective To summarize the postoperative nursing of patients with rheumatic heart disease combined with atrial fibrillation treated with valve replacement and radio frequency ablation. Methods The nursing experience in 54 patients with rheumatic heart disease combined with atrial fibrillation treated with valve replacement and radio frequency ablation was summarized including monitoring heart rate, cardiac rhythm, reasonably use of amiodarone, standardized use of temporary pacemaker, maintaining cardiac function, keeping cardiac function, observing drainage volume and instructing them to take oral anticoagulant drugs. Results Of all, 53 cases were succeeded. One case died of renal failure and no complications occurred in other cases. Conclusion The nursing care after radio frequency ablation is critical and may be effective in enhancing their quality of life.%目的 总结瓣膜置换术同期行射频消融术治疗风湿性心脏病合并房颤的术后护理要点.方法 对行瓣膜置换术同期行射频消融术后的患者做好各项护理,包括监测心率、心律变化及合理应用胺碘酮,临时起搏器的规范使用,维护内环境稳定及心功能,胸腔引流液量的重要性和及时处理,以及应用口服抗凝药的护理指导.结果 本组53例患者手术成功,均为窦性心律,1例因肝肾功能衰竭死亡.结论 射频消融术后护理尤其重要,对患者术后生活质量的提高有一定的改善.

  4. A yeast bioassay for direct measurement of thyroid hormone disrupting effects in water without sample extraction, concentration, or sterilization.

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    Li, Jian; Ren, Shujuan; Han, Shaolun; Li, Na

    2014-04-01

    The present study introduces an improved yeast bioassay for rapid yet sensitive evaluation of thyroid hormone disruption at the level of thyroid receptor (TR) in environmental water samples. This assay does not require water sample preparation and thus requires very little hands-on time. Based on different β-galactosidase substrates, two modified bioassays, a colorimetric bioassay and a chemiluminescent bioassay, were developed. The compounds tested included the known thyroid hormone 3,3',5-triiodo-l-thyronine (T3), the specific TR antagonist amiodarone hydrochloride (AH) and phthalate esters (PAEs), which potentially disrupt thyroid hormone signaling. The EC50 values for T3 were similar to those previously obtained using a 96-well plate bioassay. TR antagonism by AH was studied in the presence of 2.5 × 10(-7)M T3, and the concentration producing 20% of the maximum effect (RIC20) for AH was 3.1 × 10(-7)M and 7.8 × 10(-9)M for the colorimetric bioassay and chemiluminescent bioassay, respectively. None of the tested PAEs induced β-galactosidase expression, but diethylhexyl phthalate, benzyl butyl phthalate and dibutyl phthalate demonstrated TR antagonism. Furthermore, water samples collected from Guanting reservoir in Beijing were evaluated. Although TR agonism was not observed, antagonism was detected in all water samples and is expressed as AH equivalents. The toxicology equivalent quantity values obtained by the chemiluminescent bioassay ranged from 21.2 ± 1.6 to 313.9 ± 28.8 μg L(-1) AH, and similar values were obtained for the colorimetric bioassay. The present study shows that the modified yeast bioassay can be used as a valuable tool for quantification of thyroid hormone disrupting effects in environmental water samples.

  5. In vitro efficacies of clinically available drugs against growth and viability of an Acanthamoeba castellanii keratitis isolate belonging to the T4 genotype.

    Science.gov (United States)

    Baig, Abdul Mannan; Iqbal, Junaid; Khan, Naveed Ahmed

    2013-08-01

    The effects of clinically available drugs targeting muscarinic cholinergic, adrenergic, dopaminergic, and serotonergic receptors; intracellular calcium levels and/or the function of calcium-dependent biochemical pathways; ion channels; and cellular pumps were tested against a keratitis isolate of Acanthamoeba castellanii belonging to the T4 genotype. In vitro growth inhibition (amoebistatic) assays were performed by incubating A. castellanii with various concentrations of drugs in the growth medium for 48 h at 30°C. To determine amoebicidal effects, amoebae were incubated with drugs in phosphate-buffered saline for 24 h, and viability was determined using trypan blue exclusion staining. For controls, amoebae were incubated with the solvent alone. Of the eight drugs tested, amlodipine, prochlorperazine, and loperamide showed potent amoebicidal effects, as no viable trophozoites were observed (>95% kill rate), while amiodarone, procyclidine, digoxin, and apomorphine exhibited up to 50% amoebicidal effects. In contrast, haloperidol did not affect viability, but all the drugs tested inhibited A. castellanii growth. Importantly, amlodipine, prochlorperazine, and loperamide showed compelling cysticidal effects. The cysticidal effects were irreversible, as cysts treated with the aforementioned drugs did not reemerge as viable amoebae upon inoculation in the growth medium. Except for apomorphine and haloperidol, all the tested drugs blocked trophozoite differentiation into cysts in encystation assays. Given the limited availability of effective drugs to treat amoebal infections, the clinically available drugs tested in this study represent potential agents for managing keratitis and granulomatous amoebic encephalitis caused by Acanthamoeba spp. and possibly against other meningoencephalitis-causing amoebae, such as Balamuthia mandrillaris and Naegleria fowleri.

  6. Atrial Fibrillation Ablation in Systolic Dysfunction: Clinical and Echocardiographic Outcomes

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    Tasso Julio Lobo

    2015-01-01

    Full Text Available Background: Heart failure and atrial fibrillation (AF often coexist in a deleterious cycle. Objective: To evaluate the clinical and echocardiographic outcomes of patients with ventricular systolic dysfunction and AF treated with radiofrequency (RF ablation. Methods: Patients with ventricular systolic dysfunction [ejection fraction (EF <50%] and AF refractory to drug therapy underwent stepwise RF ablation in the same session with pulmonary vein isolation, ablation of AF nests and of residual atrial tachycardia, named "background tachycardia". Clinical (NYHA functional class and echocardiographic (EF, left atrial diameter data were compared (McNemar test and t test before and after ablation. Results: 31 patients (6 women, 25 men, aged 37 to 77 years (mean, 59.8±10.6, underwent RF ablation. The etiology was mainly idiopathic (19 p, 61%. During a mean follow-up of 20.3±17 months, 24 patients (77% were in sinus rhythm, 11 (35% being on amiodarone. Eight patients (26% underwent more than one procedure (6 underwent 2 procedures, and 2 underwent 3 procedures. Significant NYHA functional class improvement was observed (pre-ablation: 2.23±0.56; postablation: 1.13±0.35; p<0.0001. The echocardiographic outcome also showed significant ventricular function improvement (EF pre: 44.68%±6.02%, post: 59%±13.2%, p=0.0005 and a significant left atrial diameter reduction (pre: 46.61±7.3 mm; post: 43.59±6.6 mm; p=0.026. No major complications occurred. Conclusion: Our findings suggest that AF ablation in patients with ventricular systolic dysfunction is a safe and highly effective procedure. Arrhythmia control has a great impact on ventricular function recovery and functional class improvement.

  7. Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions.

    Science.gov (United States)

    Miller, L G

    1998-11-09

    Herbal medicinals are being used by an increasing number of patients who typically do not advise their clinicians of concomitant use. Known or potential drug-herb interactions exist and should be screened for. If used beyond 8 weeks, Echinacea could cause hepatotoxicity and therefore should not be used with other known hepatoxic drugs, such as anabolic steroids, amiodarone, methotrexate, and ketoconazole. However, Echinacea lacks the 1,2 saturated necrine ring associated with hepatoxicity of pyrrolizidine alkaloids. Nonsteroidal anti-inflammatory drugs may negate the usefulness of feverfew in the treatment of migraine headaches. Feverfew, garlic, Ginkgo, ginger, and ginseng may alter bleeding time and should not be used concomitantly with warfarin sodium. Additionally, ginseng may cause headache, tremulousness, and manic episodes in patients treated with phenelzine sulfate. Ginseng should also not be used with estrogens or corticosteroids because of possible additive effects. Since the mechanism of action of St John wort is uncertain, concomitant use with monoamine oxidase inhibitors and selective serotonin reuptake inhibitors is ill advised. Valerian should not be used concomitantly with barbiturates because excessive sedation may occur. Kyushin, licorice, plantain, uzara root, hawthorn, and ginseng may interfere with either digoxin pharmacodynamically or with digoxin monitoring. Evening primrose oil and borage should not be used with anticonvulsants because they may lower the seizure threshold. Shankapulshpi, an Ayurvedic preparation, may decrease phenytoin levels as well as diminish drug efficacy. Kava when used with alprazolam has resulted in coma. Immunostimulants (eg, Echinacea and zinc) should not be given with immunosuppressants (eg, corticosteroids and cyclosporine). Tannic acids present in some herbs (eg, St John wort and saw palmetto) may inhibit the absorption of iron. Kelp as a source of iodine may interfere with thyroid replacement therapies. Licorice

  8. Availability of human induced pluripotent stem cell-derived cardiomyocytes in assessment of drug potential for QT prolongation

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    Nozaki, Yumiko, E-mail: yumiko-nozaki@ds-pharma.co.jp [Preclinical Research Laboratories, Dainippon Sumitomo Pharma. Co., Ltd., Suita, Osaka 564-0053 (Japan); Honda, Yayoi, E-mail: yayoi-honda@ds-pharma.co.jp [Preclinical Research Laboratories, Dainippon Sumitomo Pharma. Co., Ltd., Suita, Osaka 564-0053 (Japan); Tsujimoto, Shinji, E-mail: shinji-tsujimoto@ds-pharma.co.jp [Regenerative and Cellular Medicine Office, Dainippon Sumitomo Pharma. Co., Ltd., Chuo-ku, Tokyo 104-0031 (Japan); Watanabe, Hitoshi, E-mail: hitoshi-1-watanabe@ds-pharma.co.jp [Preclinical Research Laboratories, Dainippon Sumitomo Pharma. Co., Ltd., Suita, Osaka 564-0053 (Japan); Kunimatsu, Takeshi, E-mail: takeshi-kunimatsu@ds-pharma.co.jp [Preclinical Research Laboratories, Dainippon Sumitomo Pharma. Co., Ltd., Suita, Osaka 564-0053 (Japan); Funabashi, Hitoshi, E-mail: hitoshi-funabashi@ds-pharma.co.jp [Preclinical Research Laboratories, Dainippon Sumitomo Pharma. Co., Ltd., Suita, Osaka 564-0053 (Japan)

    2014-07-01

    Field potential duration (FPD) in human-induced pluripotent stem cell-derived cardiomyocytes (hiPS-CMs), which can express QT interval in an electrocardiogram, is reported to be a useful tool to predict K{sup +} channel and Ca{sup 2+} channel blocker effects on QT interval. However, there is no report showing that this technique can be used to predict multichannel blocker potential for QT prolongation. The aim of this study is to show that FPD from MEA (Multielectrode array) of hiPS-CMs can detect QT prolongation induced by multichannel blockers. hiPS-CMs were seeded onto MEA and FPD was measured for 2 min every 10 min for 30 min after drug exposure for the vehicle and each drug concentration. I{sub Kr} and I{sub Ks} blockers concentration-dependently prolonged corrected FPD (FPDc), whereas Ca{sup 2+} channel blockers concentration-dependently shortened FPDc. Also, the multichannel blockers Amiodarone, Paroxetine, Terfenadine and Citalopram prolonged FPDc in a concentration dependent manner. Finally, the I{sub Kr} blockers, Terfenadine and Citalopram, which are reported to cause Torsade de Pointes (TdP) in clinical practice, produced early afterdepolarization (EAD). hiPS-CMs using MEA system and FPDc can predict the effects of drug candidates on QT interval. This study also shows that this assay can help detect EAD for drugs with TdP potential. - Highlights: • We focused on hiPS-CMs to replace in vitro assays in preclinical screening studies. • hiPS-CMs FPD is useful as an indicator to predict drug potential for QT prolongation. • MEA assay can help detect EAD for drugs with TdP potentials. • MEA assay in hiPS-CMs is useful for accurately predicting drug TdP risk in humans.

  9. Pharmacoelectrophysiology of viral-free induced pluripotent stem cell-derived human cardiomyocytes.

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    Mehta, Ashish; Chung, YingYing; Sequiera, Glen Lester; Wong, Philip; Liew, Reginald; Shim, Winston

    2013-02-01

    Development of pharmaceutical agents for cardiac indication demands elaborate safety screening in which assessing repolarization of cardiac cells remains a critical path in risk evaluations. An efficient platform for evaluating cardiac repolarization in vitro significantly facilitates drug developmental programs. In a proof of principle study, we examined the effect of antiarrhythmogenic drugs (Vaughan Williams class I-IV) and noncardiac active drugs (terfenadine and cisapride) on the repolarization profile of viral-free human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs). Extracellular field potential (FP) recording using microelectrode arrays demonstrated significant delayed repolarization as prolonged corrected FP durations (cFPDs) by class I (quinidine and flecainide), class III (sotalol and amiodarone), and class IV (verapamil), whereas class II drugs (propranolol and nadolol) had no effects. Consistent with their sodium channel-blocking ability, class I drugs also significantly reduced FPmin and conduction velocity. Although lidocaine (class IB) had no effects on cFPDs, verapamil shortened cFPD and FPmin by 25 and 50%, respectively. Furthermore, verapamil reduced beating frequencies drastically. Importantly, the examined drugs exhibited dose-response curve on prolongation of cFPDs at an effective range that correlated significantly with therapeutic plasma concentrations achieved clinically. Consistent with clinical outcomes, drug-induced arrhythmia of tachycardia and bigeminy-like waveforms by quinidine, flecainide, and sotalol was demonstrated at supraphysiological concentrations. Furthermore, off-target effects of terfenadine and cisapride on cFPD and Na( + ) channel blockage were similarly revealed. These results suggest that hiPSC-CMs may be useful for safety evaluation of cardioactive and noncardiac acting drugs for personalized medicine.

  10. Development of a liquid chromatography-mass spectrometry (LC/MS) assay method for the quantification of PSC 833 (Valspodar) in rat plasma.

    Science.gov (United States)

    Binkhathlan, Ziyad; Somayaji, Vishwa; Brocks, Dion R; Lavasanifar, Afsaneh

    2008-06-15

    A liquid chromatography-mass spectrometry (LC/MS) assay method was developed for the quantification of PSC 833 in rat plasma, using amiodarone as internal standard (IS). Separation was achieved using a C(8) 3.5 microm (2.1 mm x 50 mm) column heated to 60 degrees C with a mobile phase consisting of acetonitrile-ammonium hydroxide 0.2% (90:10 v/v) pumped at a rate of 0.2 mL/min. Detection was accomplished by mass spectrometer using selected ion monitoring (SIM) in positive mode. An excellent linear relationship was present between peak height ratios and rat plasma concentrations of PSC 833 ranging from 10 to 5000 ng/mL (R(2)>0.99). Intra-day and inter-day coefficients of variation (CV%) were less than 15%, and mean error was less than 10% for the concentrations above the limit of quantification. The validated limit of quantification of the assay was 10 ng/mL based on 0.1 mL rat plasma. The method limit of detection, based on an average signal-to-noise (S/N) ratio of 3, was found to be 2.5 ng/mL. The assay was capable of measuring the plasma concentrations of PSC 833 in rats injected with a single dose of 5 mg/kg of the drug. PSC 833 and IS eluted within 4 min, free of interfering peaks. The method was found to be fast, sensitive, and specific for the quantification of PSC 833 in rat plasma.

  11. Hepatocyte-based in vitro model for assessment of drug-induced cholestasis

    Energy Technology Data Exchange (ETDEWEB)

    Chatterjee, Sagnik, E-mail: Sagnik.Chatterjee@pharm.kuleuven.be [Drug Delivery and Disposition, KU Leuven Department of Pharmaceutical and Pharmacological Sciences, O and N2, Herestraat 49 — bus 921, 3000 Leuven (Belgium); Richert, Lysiane, E-mail: l.richert@kaly-cell.com [KaLy-Cell, 20A rue du Général Leclerc, 67115 Plobsheim (France); Augustijns, Patrick, E-mail: Patrick.Augustijns@pharm.kuleuven.be [Drug Delivery and Disposition, KU Leuven Department of Pharmaceutical and Pharmacological Sciences, O and N2, Herestraat 49 — bus 921, 3000 Leuven (Belgium); Annaert, Pieter, E-mail: Pieter.Annaert@pharm.kuleuven.be [Drug Delivery and Disposition, KU Leuven Department of Pharmaceutical and Pharmacological Sciences, O and N2, Herestraat 49 — bus 921, 3000 Leuven (Belgium)

    2014-01-01

    Early detection of drug-induced cholestasis remains a challenge during drug development. We have developed and validated a biorelevant sandwich-cultured hepatocytes- (SCH) based model that can identify compounds causing cholestasis by altering bile acid disposition. Human and rat SCH were exposed (24–48 h) to known cholestatic and/or hepatotoxic compounds, in the presence or in the absence of a concentrated mixture of bile acids (BAs). Urea assay was used to assess (compromised) hepatocyte functionality at the end of the incubations. The cholestatic potential of the compounds was expressed by calculating a drug-induced cholestasis index (DICI), reflecting the relative residual urea formation by hepatocytes co-incubated with BAs and test compound as compared to hepatocytes treated with test compound alone. Compounds with clinical reports of cholestasis, including cyclosporin A, troglitazone, chlorpromazine, bosentan, ticlopidine, ritonavir, and midecamycin showed enhanced toxicity in the presence of BAs (DICI ≤ 0.8) for at least one of the tested concentrations. In contrast, the in vitro toxicity of compounds causing hepatotoxicity by other mechanisms (including diclofenac, valproic acid, amiodarone and acetaminophen), remained unchanged in the presence of BAs. A safety margin (SM) for drug-induced cholestasis was calculated as the ratio of lowest in vitro concentration for which was DICI ≤ 0.8, to the reported mean peak therapeutic plasma concentration. SM values obtained in human SCH correlated well with reported % incidence of clinical drug-induced cholestasis, while no correlation was observed in rat SCH. This in vitro model enables early identification of drug candidates causing cholestasis by disturbed BA handling. - Highlights: • Novel in vitro assay to detect drug-induced cholestasis • Rat and human sandwich-cultured hepatocytes (SCH) as in vitro models • Cholestatic compounds sensitize SCH to toxic effects of accumulating bile acids • Drug

  12. 注射剂溶媒选择与说明书不符致医患矛盾3例分析%Analysis of doctor-patient contradictions induced by drug solvents inconsistent with drug package insert

    Institute of Scientific and Technical Information of China (English)

    司继刚

    2015-01-01

    Objective To explore how to handle doctor-patient contradictions induced by drug solvents incon-sistent with drug package insert,to provide references for solving the doctor-patient contradictions by multidisciplinar-y. Methods Pharmacist participated in solving the doctor-patient contradictions caused by injective omeprazole sodi-um,injective alanyl glutamine and amiodarone injection for dilution solvent inconsistent with drug instructions. Results By pharmacy service and pharmacy education,doctor-patient contradictions resolved. Conclusion Hospital should develop pharmacists professional technical service,carry out rational drug use,reduce medical contradictions and dis-putes caused by improper irrational drug use and drug incompatibility.%目的:探讨药物溶媒选择与药品说明书不符致医患矛盾的处理,为医院多学科处理医患矛盾提供参考。方法对于注射用奥美拉唑钠、注射用丙氨酰谷氨酰胺及胺碘酮注射液3种药物因为稀释溶媒与药品说明书不符所引起医患矛盾进行了分析,药师发挥了在处理此类纠纷方面的积极作用。结果通过药师的药学服务和用药宣教工作,医患矛盾得以化解。结论医院应发挥药师专业技术特长,开展合理用药的药学服务工作,减少因不合理用药和药物配伍不当引起的医患矛盾和医患纠纷。

  13. Meta-analysis of randomized controlled trials on magnesium in addition to beta-blocker for prevention of postoperative atrial arrhythmias after coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Wu Xiaosan

    2013-01-01

    Full Text Available Abstract Background Atrial arrhythmia (AA is the most common complication after coronary artery bypass grafting (CABG. Only beta-blockers and amiodarone have been convincingly shown to decrease its incidence. The effectiveness of magnesium on this complication is still controversial. This meta-analysis was performed to evaluate the effect of magnesium as a sole or adjuvant agent in addition to beta-blocker on suppressing postoperative AA after CABG. Methods We searched the PubMed, Medline, ISI Web of Knowledge, Cochrane library databases and online clinical trial database up to May 2012. We used random effects model when there was significant heterogeneity between trials and fixed effects model when heterogeneity was negligible. Results Five randomized controlled trials were identified, enrolling a total of 1251 patients. The combination of magnesium and beta-blocker did not significantly decrease the incidence of postoperative AA after CABG versus beta-blocker alone (odds ratio (OR 1.12, 95% confidence interval (CI 0.86-1.47, P = 0.40. Magnesium in addition to beta-blocker did not significantly affect LOS (weighted mean difference −0.14 days of stay, 95% CI −0.58 to 0.29, P = 0.24 or the overall mortality (OR 0.59, 95% CI 0.08-4.56, P = 0.62. However the risk of postoperative adverse events was higher in the combination of magnesium and beta-blocker group than beta-blocker alone (OR 2.80, 95% CI 1.66-4.71, P = 0.0001. Conclusions This meta-analysis offers the more definitive evidence against the prophylactic administration of intravenous magnesium for prevention of AA after CABG when beta-blockers are routinely administered, and shows an association with more adverse events in those people who received magnesium.

  14. P-glycoprotein expression and pharmacological modulation in larval stages of Echinococcus granulosus.

    Science.gov (United States)

    Nicolao, María Celeste; Denegri, Guillermo M; Cárcamo, Juan Guillermo; Cumino, Andrea C

    2014-02-01

    P-glycoprotein (Pgp) is an ATP-dependent transporter involved in the efflux of a wide variety of lipophilic substrates, such as toxins and xenobiotics, out of cells. Pgp expression level is associated with the ineffective therapeutic treatment of cancer cells and microbial pathogens which gives it high clinical importance. Research on these transporters in helminths is limited. This work describes for the first time the Echinococcus granulosus Pgp (Eg-Pgp) expression, in a model cestode parasite and an important human pathogen. Based on calcein efflux assays in the presence of common Pgp modulators, we demonstrated the occurrence of active Eg-Pgp in protoscoleces and metacestodes. Eg-Pgp, which showed a molecular mass of ~130 kDa in western blots, is localized in the suckers and the tegument of control protoscoleces as well as in the subtegument or all parenchymatous cells of protoscoleces treated with Pgp-interfering agents. We also identified five genes encoding Pgp which are constitutively expressed in protoscoleces and metacestodes. We showed that the Eg-pgp1 and Eg-pgp2 transcripts were up-regulated in response to in vitro drug treatment with amiodarone and loperamide, in agreement with the increased polypeptide levels. Finally, in vitro treatment of protoscoleces and metacestodes with trifluoperazine and loperamide was lethal to the parasites. This indicates that both drugs as well as cyclosporine A negatively modulate the E. granulosus Pgp efflux activity, favoring the retention of these drugs in the larval tissue. These events could be associated with the reduction in protoscolex and metacestode viability.

  15. Ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    王建安; 孙勇; 何红

    2003-01-01

    Objective: to evaluate the efficacy and safety of ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation. Methods: The study population consisted of 9 patients with 5 males and 4 females enrolled consecutively who had idiopathic paroxysmal atrial fibrillation(AF). The ultrasound balloon was positioned through a special sheath to the orifice of the target vein by a transseptal procedure. The balloon was inflated with contrast-mixed saline (contrast: saline = 1:4) whose volume was decided by the diameter of the target pulmonary vein. The ablation energy was usually set up at 35 to 40 watts with temperature controlled at 60℃. The duration of each ablation was about 120 seconds which was repeated not over 10 times. Results: The average duration of the total procedure was 132±68 min for our patients. The average fluoroscopy time was 33±17 min. With a mean follow-up of 16±8 months after the procedure, AF was completely eliminated in 4 patients without antiarrhythmic drugs. The episodes of atrial fibrillation were eliminated in 2 patients with low dosage of oral amiodarone (0.1, once daily) which was ineffective before the procedure. The frequency of episodes was similar to that before the procedure in 3 patients. There were no complications such as hemopericardium, air embolism and stenosis of the pulmonary veins by angiography, related to the procedure. Conclusion: Ultrasound ablation of the pulmonary veins is a new approach to treat paroxysmal atrial fibrillation. Before we determined its value, we need to do more researches with bigger sample, randomization and comparison design.

  16. Ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    王建安; 孙勇; 何红

    2003-01-01

    Objective : to evaluate the efficacy and safety of ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation. Methods : The study population consisted of 9 patients with 5 males and 4 females enrolled consecutively who had idiopathic paroxysmal atrial fibrillation(AF) . The ultrasound balloon was positioned through a special sheath to the orifice of the target vein by a transseptal procedure. The balloon was inflated with contrast-mixed saline (contrast: saline = 1:4) whose volume was decided by the diameter of the target pulmonary vein. The ablation energy was usually set up at 35 to 40 watts with temperature controlled at 60℃ . The duration of each ablation was about 120 seconds which was repeated not over 10 times. Results: The average duration of the total procedure was 132± 68 min for our patients. The average fluoroscopy time was 33 ±17 min. With a mean follow-up of 16 ±8 months after the procedure, AF was completely eliminated in 4 patients without antiarrhythmic drugs. The episodes of atrial fibrillation were eliminated in 2 patients with low dosage of oral amiodarone (0.1, once daily) which was ineffective before the procedure. The frequency of episodes was similar to that before the procedure in 3 patients. There were no complications such as hemopericardium, air embolism and stenosis of the pulmonary veins by angiography, related to the procedure. Conclusion : Ultrasound ablation of the pulmonary veins is a new approach to treat paroxysmal atrial fibrillation. Before we determined its value, we need to do more researches with bigger sample, randomization and comparison design.

  17. A New Pharmacogenetic Algorithm to Predict the Most Appropriate Dosage of Acenocoumarol for Stable Anticoagulation in a Mixed Spanish Population.

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    Hoi Y Tong

    Full Text Available There is a strong association between genetic polymorphisms and the acenocoumarol dosage requirements. Genotyping the polymorphisms involved in the pharmacokinetics and pharmacodynamics of acenocoumarol before starting anticoagulant therapy would result in a better quality of life and a more efficient use of healthcare resources. The objective of this study is to develop a new algorithm that includes clinical and genetic variables to predict the most appropriate acenocoumarol dosage for stable anticoagulation in a wide range of patients. We recruited 685 patients from 2 Spanish hospitals and 1 primary healthcare center. We randomly chose 80% of the patients (n = 556, considering an equitable distribution of genotypes to form the generation cohort. The remaining 20% (n = 129 formed the validation cohort. Multiple linear regression was used to generate the algorithm using the acenocoumarol stable dosage as the dependent variable and the clinical and genotypic variables as the independent variables. The variables included in the algorithm were age, weight, amiodarone use, enzyme inducer status, international normalized ratio target range and the presence of CYP2C9*2 (rs1799853, CYP2C9*3 (rs1057910, VKORC1 (rs9923231 and CYP4F2 (rs2108622. The coefficient of determination (R2 explained by the algorithm was 52.8% in the generation cohort and 64% in the validation cohort. The following R2 values were evaluated by pathology: atrial fibrillation, 57.4%; valve replacement, 56.3%; and venous thromboembolic disease, 51.5%. When the patients were classified into 3 dosage groups according to the stable dosage (21 mg/week, the percentage of correctly classified patients was higher in the intermediate group, whereas differences between pharmacogenetic and clinical algorithms increased in the extreme dosage groups. Our algorithm could improve acenocoumarol dosage selection for patients who will begin treatment with this drug, especially in extreme

  18. Anesthesia Approach in Endovascular Aortic Reconstruction

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    Ayşin Alagöl

    2013-03-01

    Full Text Available Introduction: We have analyzed our initial results of our anesthesia techniques in our new-onset endovascular aortic reconstruction cases.Patients and Methods: The perioperative data of 15 elective and emergent endovascular aortic reconstruction cases that were operated in 2010-2011 were collected in a database. The choice of anesthesia was made by the risk factors, surgical team’s preferences, type and location of the aortic pathology and by the predicted operation duration. The data of local and general anesthesia cases were compared.Results: Thirteen (86.7% cases were male and 2 (13.3% female. Eleven patients were in ASA Class III. The demographic parameters, ASA classifications, concurrent diseases were similar in both groups. Thirteen (86.7% cases had infrarenal abdominal aortic aneurysm and 2 (13.3% had Type III aortic dissection. The diastolic arterial pressures were lower in general anesthesia group in 20th and 40th minutes’ measurements just like the mean arterial pressure measurements at the 40th, 100th minutes and during the deployment of the graft. Postoperative mortality occurred in 3 (20.0% patients and they all had general anesthesia and they were operated on emergency basis. Postoperative morbidity occurred in four patients that had general anesthesia (acute renal failure, multi-organ failure and pneumonia. The other patient had atrial fibrillation on the 1st postoperative day and was converted to sinus rhythm with amiodarone infusion.Conclusion: Edovascular aortic reconstruction procedures can safely be performed with both general and local anesthesia less invasively compared to open surgery. General anesthesia may be preferred for the better hemodynamic control.

  19. INVESTIGATION OF SEIZURE ACTIVITY AFTER CYCLIC NUCLEOTIDE PHOSPHODIESTERASE INHIBITION WITH SECOND MESSENGER AND CALCIUM ION CHANNEL INHIBITION IN MICE

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    J Nandhakumar

    2012-03-01

    Full Text Available The role of PDE-4 inhibitor etazolate, was evaluated in the presence of PDE-7 inhibitor, BRL-50481, in animal models of epilepsy. Seizures were induced in the animals by subjecting them to injection of chemical convulsants, Pilocarpine, Kainic acid (KA and maximal electroshock (MES. The combination of etazolate and BRL50481 treated mice showed a significant (P<0.001 quick onset of action, jerky movements and convulsion when compared to gabapentin. The combination of etazolate and sGC inhibitor, methylene blue (MB treated mice showed a significant (P<0.001 delay in onset of action, jerky movements and convulsion when compare to gabapentin as well as against the combination of etazolate with BRL 50481.The present study mainly highlights the individual effects of etazolate and combination with BRL-50481 potentiates (P<0.001 the onset of seizure activity against all models of convulsion. The study mainly comprises the onset of seizures, mortality/recovery, percentage of prevention of seizures (anticonvulsant and total duration of convulsive time. The total convulsive time was prolonged significantly (P<0.05 and P<0.01 in combination of methylene blue with etazolate treated (28.59% and 35.15 % groups, compared to DMSO received group (100% in the MES model. In the same way, the combination of calcium channel modulator (CCM and calcium channel blocker (CCB amiodarone and nifedipine respectively, with etazolate showed a significant (P<0.001 delay in onset of seizures, compared to DMSO and etazolate treated groups in all models of epilepsy. This confirms that both CCM and CCB possess anticonvulsant activity. Finally, the study reveals that identification of new cAMP mediated phosphodiesterases family members offers a potential new therapy for epilepsy management in future.

  20. 抗心律失常药物对蟾酥致小鼠心律失常的影响%Effect of anti-arrhythmia drugs on mouse arrhythmia induced by Bufonis Venenum

    Institute of Scientific and Technical Information of China (English)

    陆文娟; 周婧; 马宏跃; 吕高红; 尤奋强; 丁安伟; 段金廒

    2011-01-01

    -adrenergic receptor antagonist), amiodarone (drugs prolonging the action potential duration) and verapamil (calcium channel blockers) on arrhythmia of mice induced by Bufonis Venenum (Chansu) and isolated mouse hearts lethal dose of Chansu. Arrhythmia of mice were induced by Chansu and then electrocardiograms (ECGs) were recorded. The changes of P-R interval, QRS complex, Q-T interval, T wave amplitude, heart rate (HR) were observed. Moreover, arrhythmia rate, survival rate and arrhythmia score were counted. Isolated mouse hearts were prefused, and the lethal dose of Chansu was recorded. Compared with control group, after pretreatment with phenytoin sodium, broadening of QRS complex and HR were inhibited, and the incidence ofventricular arrhythmia was reduced dramatically, while survival rate was improved; the isolated mouse hearts lethal dose of Chansu was increased significantly. After pretreatment with lidocaine, the prolongation of P-R interval and broadening of QRS complex were inhibited, and the incidences of ventricular arrhythmia were reduced dramatically, while survival rate was improved; the isolated mouse hearts lethal dose of Chansu was increased significantly. After pretreatment with propranolol, prolongation of P-R interval, broadening of QRS complex, prolongation of Q-T interval and HR were inhibited, and the incidences of both supraventricular and ventricular arrhythmias were reduced dramatically, while survival rate was improved. After pretreatment with amiodarone, HR was inhibited, the incidences of ventricular tachycardia were reduced dramatically. Lastly, after pretreatment with verapamil, the prolongation of P-R interval and Q-T interval were inhibited and the incidences of both supraventricular and ventricular arrhythmias were reduced dramatically; the isolated mouse hearts lethal dose of Chansu was reduced significantly. In in vivo experiments, phenytoin sodium was most effective against the mice arrhythmias induced by Chansu while cautious use of verapamil for

  1. Clinical course and treatment of ectopic atrial tachycardia in 144 children%儿童房性心动过速144例临床特征及治疗分析

    Institute of Scientific and Technical Information of China (English)

    戈海延; 李小梅; 张宴; 刘海菊; 江河

    2015-01-01

    EAT from January 2009 to April 2014.The clinical detailed history,12 lead ECG,24-h Holter recording,echocardiography,response to therapy and follow-up were analyzed.Result The onset of EAT occurred at any age with a distribution with positive skewness,57 children ≤ 1 years,22 children > 1-3 years,25 children > 3-6 years and 40 children ≥ 6 years of age.The percentages of the three tachycardia types were 36.1% (n =52) for incessant EAT,52.8% (n =76) for paroxysmal EAT and 11.1% (n =16) for sporadic EAT,respectively.There were 115 patients received drug therapy in our hospital and in 72 cases the EAT was completely controlled.Antiarrhythmic therapy had been discontinued in 35 children with complete control.Normal sinus rhythm was observed by telemetry or Holter within 4 to 90 days and the mean duration of medical therapy was 310 days (range 15 to 608 days) in these children.The combination of sotalol and propafenone showed better effectiveness for control of children with EAT (54%,41/76),compared with single sotalol (36%,24/66) and the combination of amiodarone and metoprolol (30%,7/23) (x2 =6.296,P =0.043).Tachycardia type was able to predict the response to antiarrhythmic drugs for children with EAT,sporadic tachycardia had best control rate on pharmacological therapy compared with paroxysmal tachycardia and incessant tachycardia (94% (15/16) vs.67% (42/63) vs.42% (15/36),x2 =17.925,P =0.000).Acute success of radiofrequency ablation (RFA) in children who showed poor response to antiarrhythmic drugs was achieved in 45 of 49 (92%),ultimate success was achieved in 33 of 49 (67%).The incidence of TIC secondary to EAT was 18.1% (n =26),and left ventricular ejection fraction (LVEF) returned to normal in 23 children after successful control of EAT ((61 ±4)% vs.(43±5)%,t =-10.036,P=0.000).Side effects including abnormal thyroid function (in 3) and abnormal liver function (in 1) occurred in 4 (17%) of 23 children who received amiodarone

  2. Targeted toxicological screening for acidic, neutral and basic substances in postmortem and antemortem whole blood using simple protein precipitation and UPLC-HR-TOF-MS.

    Science.gov (United States)

    Telving, Rasmus; Hasselstrøm, Jørgen Bo; Andreasen, Mette Findal

    2016-09-01

    A broad targeted screening method based on broadband collision-induced dissociation (bbCID) ultra-performance liquid chromatography high-resolution time-of-flight mass spectrometry (UPLC-HR-TOF-MS) was developed and evaluated for toxicological screening of whole blood samples. The acidic, neutral and basic substances covered by the method were identified in postmortem and antemortem whole blood samples from forensic autopsy cases, clinical forensic cases and driving under the influence of drugs (DUID) cases by a reverse target database search. The screening method covered 467 substances. Validation was performed on spiked whole blood samples and authentic postmortem and antemortem whole blood samples. For most of the basic drugs, the established cut-off limits were very low, ranging from 0.25ng/g to 50ng/g. The established cut-off limits for most neutral and acidic drugs, were in the range from 50ng/g to 500ng/g. Sample preparation was performed using simple protein precipitation of 300μL of whole blood with acetonitrile and methanol. Ten microliters of the reconstituted extract were injected and separated within a 13.5min UPLC gradient reverse-phase run. Positive electrospray ionization (ESI) was used to generate the ions in the m/z range of 50-1000. Fragment ions were generated by bbCID. Identification was based on retention time, accurate mass, fragment ion(s) and isotopic pattern. A very sensitive broad toxicological screening method using positive electrospray ionization UPLC-HR-TOF-MS was achieved in one injection. This method covered basic substances, substances traditionally analyzed in negative ESI (e.g., salicylic acid), small highly polar substances such as beta- and gamma-hydroxybutyric acid (BHB and GHB, respectively) and highly non-polar substances such as amiodarone. The new method was shown to combine high sensitivity with a very broad scope that has not previously been reported in toxicological whole blood screening when using only one injection.

  3. 婴儿阵发性室上性心动过速38例药物治疗及临床分析%Clinical Characteristics and Treatment of Infants with Paroxysmal Supraventricular Tachycardia: 38 Cases Report

    Institute of Scientific and Technical Information of China (English)

    王野峰; 黄希勇; 陈智

    2012-01-01

    Objective: To investigate the diagnostic value of ECG types and to evaluate the efficacy of drugs in the treatment of infants with paroxysmal supraventricular tachycardia (PSVT). Methods: Analysis of 38 cases of clinical data and medication of infants with PSVT after admission. Results: Seventeen cases were atrioventricular reentrant tachycardia (AVRT) (44. 7% ) ; twelve cases were atrioventricular nodal reentrant tachycardia (AVNRT) (31.6%); two cases were self-regulation of atrial tachycardia (5.2%); seven cases (18.4% ) were not classified; eleven cases combined organic heart disease (28. 9% ). In treating AVRT patients, the conversion rate of propafenone, ATP and digoxin were 100% , 75. 0% and 37. 5% ; while in treating AVNRT patients, the conversion rate of propafenone, ATP, digoxin, amiodarone were 90.0% , 83.3% , 40.0% and 66.7%. Conclusions: Correct diagnosis of ECG types is valuable for the correct choice of drugs in the treatment of infants with PSVT. Efficacy of drugs is varied with different types of PSVT.%目的:探讨婴儿阵发性室上性心动过速(PSVT)的心电图分型和药物治疗情况,总结药物治疗经验.方法:分析38例婴儿PSVT入院后的临床资料和药物治疗情况.结果:房室折返性心动过速(AVRT) 17例(44.7%),房室结折返性心动过速(AVNRT) 12例(31.6%),自律性房性心动过速2例(5.2%),未分型7例(18.4%),合并器质性心脏病11例(28.9%).AVRT患儿用普罗帕酮转复率为100%,ATP为75.0%,地高辛为37.5%;AVNRT用普罗帕酮转复率为90.0%,ATP为83.3%,地高辛为40.0%,胺碘酮为66.7%.结论:正确的心电图分型对婴儿PSVT治疗药物的选择有指导意义,不同药物对不同类型的PSVT的治疗效果不同.

  4. Emergency Treatment Plan of Paroxysmal Supraventricular Tachycardia and Its Curative Effect Evaluation%阵发性室上性心动过速急诊治疗方案及疗效评估报道

    Institute of Scientific and Technical Information of China (English)

    张俊杰

    2016-01-01

    目的 探讨阵发性室上性心动过速的急诊治疗方案及其疗效. 方法 随机选取阵发性室上性心动过速患者200例,选自2013年1月—2015年1月.按照1:1比例随机分为A、B、C、D四组,分别使用普罗帕酮、胺碘酮、心律平以及异搏定. 观察患者的复律成功率、复律时间以及不良反应. 结果 4组患者的复律成功率均较高,A组的复律成功率为96%,B组的复律成功率为98%,C组的复律成功率为96%,D组的复律成功率为94%. B组复律时间为 (21.96± 3.02)min,明显长于其他3组(P0.05).4组患者均未出现明显的不良反应.结论 对阵发性室上性心动过速患者进行治疗时,应根据患者的具体情况选择治疗方案.%Objective To discuss the emergency treatment plan of paroxysmal supraventricular tachycardia and its effect. Methods 200 cases of patients with paroxysmal supraventricular tachycardia treated from January 2013 to January 2015 were selected and randomly divided into group A, group B, group C and group D with 50 cases in each, the four groups were respectively given propafenone, amiodarone, propafenone and verapamil, the conversion success rates, conversion times and adverse reactions of the patients were observed. Results the conversion success rates of the four groups were high and they were respectively 96% in group A, 98% in group B, 96% in group C and 94% in group D, the conversion time in group B was (21.96±3.02)min, which was significantly longer than that in the other three groups (P0.05),there was no obvious adverse reaction in patients of the four groups. Conclusion We should choose treatment plans according to the specific conditions of patients when treating patients with paroxysmal supraventricular tachycardia.

  5. Sinus node dysfunction in non-medicational treatment of atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Bockeria L. А.

    2012-12-01

    Full Text Available Sinus node dysfunction or sick sinus syndrome (SSS includes clinical conditions such as symptomatic sinus bradycardia, sinus pauses or arrest, sinus node exit block, atrial tachycardias and chronotropic incompetence. Even though SSS incidence increases in an exponential-like manner with age, it can occur at all ages, including in the newborn. The mean age of patients with the syndrome is 68 years, with both genders being affected in approximately equal proportion. This condition occurs in 1 of every 600 cardiac patients over 65. Degenerative fibrosis of the tissues of the node has been suggested to be a common cause of SSS. Although it is still disputed. SSS is frequently associated with atrial fibrillation and flutter, tachy-bradycardia syndrome. Tachy-bradycardia syndrome is defined as sinus bradycardia coupled with atrial flutter/fibrillation or reciprocal atrial tachycardia. This syndrome is common in young patients following a surgical treatment of a congenital heart disease. Patients with chronic or persistent atrial flutter/fibrillation show high rates of cardiovascular disorders and mortality while sinus bradycardia is thought as an independent risk factor of atrial flutter/fibrillation. There are certain restrictions to medical treatment: long-term administration of the same medication (sotalol, amiodarone for atrial flutter/fibrillation can cause symptomatic bradycardia while administration of other medication (a class 1 drug increases the likelihood of ventricular arrythmias or evident bradycardia that enhances the risk of sudden cardiac death. Following atrial fibrillation ablation patients saw a significant improvement in the sinus node function, or saw a better sinus node function disrupted due to remodelling that takes place during atrial fibrillation. The surgical methods applications proved most efficient in non-medicational treatment of atrial fibrillation. In the late 1980s American surgeon J. L. Cox developed a so-called Maze

  6. Comparative Analysis of Methods to Induce Myocardial Infarction in a Closed-Chest Rabbit Model

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    Marc-Antoine Isorni

    2015-01-01

    Full Text Available Objective. To develop a rabbit model of closed-chest catheter-induced myocardial infarction. Background. Limitations of rodent and large animal models justify the search for clinically relevant alternatives. Methods. Microcatheterization of the heart was performed in 47 anesthetized 3-4 kg New Zealand rabbits to test five techniques of myocardial ischemia: free coils (n=4, interlocking coils (n=4, thrombogenic gelatin sponge (n=4, balloon occlusion (n=4, and alcohol injection (n=8. In order to limit ventricular fibrillation, an antiarrhythmic protocol was implemented, with beta-blockers/amiodarone before and xylocaine infusion during the procedure. Clinical, angiographic, and echographic data were gathered. End points included demonstration of vessel occlusion (TIMI flow grades 0 and 1 on the angiogram, impairment of left ventricular function at 2 weeks after procedure (by echocardiography, and pathologically confirmed myocardial infarction. Results. The best arterial access was determined to be through the right carotid artery. The internal mammary guiding catheter 4-Fr was selected as the optimal device for selective intracoronary injection. Free coils deployed prematurely and tended to prolapse into the aorta. Interlocking coils did not deploy completely and failed to provide reliable results. Gelatin sponge was difficult to handle, adhered to the catheter, and could not be clearly visualized by fluoroscopy. Balloon occlusion yielded inconsistent results. Alcohol injection was the most efficient and reproducible method for inducing myocardial infarction (4 out of 6 animals, the extent of which could be fine-tuned by using a coaxial balloon catheter as a microcatheter (0.52 mm to achieve a superselective injection of 0.2 mL of alcohol. This approach resulted in a 20% decrease in LVEF and infarcted myocardium was confirmed histologically. Conclusions. By following a stepwise approach, a minimally invasive, effective, and reproducible

  7. Occurrence and morphological characteristics of cataracts in patients treated with general steroid therapy at the Cantonal Hospital Zenica

    Directory of Open Access Journals (Sweden)

    Jasmin Zvorničanin

    2015-02-01

    Full Text Available Dear Editor, We read with interest the article by Čerim et al. regarding the occurrence and morphological characteristics of cataracts in patients treated with general steroid therapy (1. Similar to the results of previous studies, the authors found that the use of corticosteroids is associated with a higher incidence of cataract development and posterior subcapsular (PSC cataract as most prevalent morphological type (2. Older age and heredity are the most important risk factors associated with different types of cataracts and females are at increased risk of cortical cataract (2,3. Myopia (≤ −1.0 D and elevated intraocular pressure are also associated with an increased risk of nuclear and PSC cataracts (3. The major causal external risk factors influencing cataract formation include: smoking, excessive UV-B exposure, diabetes mellitus (DM and steroidal treatment (2,3. There is also a significant relationship between the risk of cataracts and delivered corticosteroid dose (4. Lower monthly household income, lower education, hypercholesterolemia, hypertension and DM are independent risk factors for the development of any cataract type, while older age and DM are independent risk factors for the development of pure PSC (5. Elevated body mass index (BMI and rapid weight gain may also increase the risk for age related cataract, especially PSC cataract (3,6. Other risk factors for PSC development also include hypertension, the use of amiodarone, thiazide diuretics, aspirin and vitamin E (2. For these reasons, we would kindly ask the authors to perform the correlations for age, gender, BMI, length and regimen of steroid use, cumulative steroid dose, the use of other systemic drugs, DM duration, spherical equivalent and intraocular pressure changes, with cataract occurrence and morphology between the groups. Without this information it would be difficult to hypothesize the direct steroid induced cataractogenesis, especially in the group on the

  8. Effects of n-3 polyunsaturated fatty acids on cardiac ion channels

    Directory of Open Access Journals (Sweden)

    Cristina eMoreno

    2012-07-01

    Full Text Available Dietary n-3 polyunsaturated fatty acids (PUFAs have been reported to exhibit antiarrhythmic properties, attributed to their capability to modulate ion channels. In the present review, we will focus on the effects of PUFAs on cardiac sodium channel (Nav1.5 and two potassium channels (Kv (Kv1.5 and Kv11.1. n-3 marine (docohexaenoic and eicohexapentaenoic acid and plant origin (alpha-linolenic acid PUFAs block Kv1.5 and Kv11.1 channels at physiological concentrations. Also, DHA and EPA decreased Nav1.5 and calcium channels. These effects on Na and Ca channels theoretically should shorten the cardiac APD, whereas the blocking actions of n-3 PUFAs of Kv channels should lengthen the cardiac action potential. Experiments performed in female rabbits fed with a diet rich in n-3 PUFAs show a longer cardiac action potential and effective refractory period. This study was performed to analyze if their antiarrhythmic effects are due to a reduction of triangulation, reverse use-dependence, instability and dispersion of the cardiac action potential (TRIaD as a measure of proarrhythmic effects. Dietary n-3 PUFAs supplementation markedly reduced dofetilide-induced TRIaD and abolished dofetilide-induced torsades de pointes (TdP. Ultrafast sodium channel block by DHA may account for the antiarrhythmic protection of dietary supplements of n-3 PUFAs against dofetilide induced proarrhythmia observed in this animal model. The cardiac effects of n-3 PUFAs resemble those of amiodarone: both block sodium, calcium and potassium channels, have anti-adrenergic properties, can prolong the cardiac action potential, reverse TRIaD and suppress TdP. The main difference is that sodium channel block by n-3 PUFAs has a much faster onset and offset kinetics. Therefore, the electrophysiological profile of n-3 PUFAs appears more desirable: the duration of reduced sodium current (facilitates re-entry is much shorter. The n-3 PUFAs appear as a safer alternative to other antiarrhythmic

  9. Tachyarrhythmias, bradyarrhythmias and acute coronary syndromes

    Directory of Open Access Journals (Sweden)

    Trappe Hans-Joachim

    2010-01-01

    Full Text Available The incidence of bradyarrhythmias in patients with acute coronary syndrome (ACS is 0.3% to 18%. It is caused by sinus node dysfunction (SND, high-degree atrioventricular (AV block, or bundle branch blocks. SND presents as sinus bradycardia or sinus arrest. First-degree AV block occurs in 4% to 13% of patients with ACS and is caused by rhythm disturbances in the atrium, AV node, bundle of His, or the Tawara system. First- or second-degree AV block is seen very frequently within 24 h of the beginning of ACS; these arrhythmias are frequently transient and usually disappear after 72 h. Third-degree AV blocks are also frequently transient in patients with infero-posterior myocardial infarction (MI and permanent in anterior MI patients. Left anterior fascicular block occurs in 5% of ACS; left posterior fascicular block is observed less frequently (incidence < 0.5%. Complete bundle branch block is present in 10% to 15% of ACS patients; right bundle branch block is more common (2/3 than left bundle branch block (1/3. In patients with bradyarrhythmia, intravenous (IV atropine (1-3 mg is helpful in 70% to 80% of ACS patients and will lead to an increased heart rate. The need for pacemaker stimulation (PS is different in patients with inferior MI (IMI and anterior MI (AMI. Whereas bradyarrhythmias are frequently transient in patients with IMI and therefore do not need permanent PS, there is usually a need for permanent PS in patients with AMI. In these patients bradyarrhythmias are mainly caused by septal necrosis. In patients with ACS and ventricular arrhythmias (VTA amiodarone is the drug of choice; this drug is highly effective even in patients with defibrillation-resistant out-of-hospital cardiac arrest. There is general agreement that defibrillation and advanced life support is essential and is the treatment of choice for patients with ventricular flutter/fibrillation. If defibrillation is not available in patients with cardiac arrest due to VTA

  10. Effects of Panax notoginseng saponin Rg1 on cardiac electrophysiological properties and ventricular fibrillation threshold in dogs%三七皂甙Rg1对犬心电生理特性及心室纤颤阈值的影响

    Institute of Scientific and Technical Information of China (English)

    伍卫; 张旭明; 刘品明; 李健明; 王景峰

    1995-01-01

    AIM: To study the effects of Rg1 isolated from saponins of Panac notoginseng on cardiac electrophysiological properties and ventricular fibrillation threshold (VFT). METHODS:Seventeen open-chest dogs were randomly allocated into a Rg1 group (20 mg kg-1, iv) and a control group. The electrophysiological variables and VFT were evaluated by standard electric stimuli and monophasic action potential (MAP) recording. RESULTS: Rg1 prolonged sinus node recovery time (SNRT) by 19. 1 %, AV conduction Wenckebach cycle length (AVWCL) by 7.1%, and ventricular effective refractory period (VERP) by 7.9 %.It prolonged ventricular MAPD30, MAPD50,and MAPD90 by 25.5 %, 24.2 %, and 13.5 %, respectively. VFT was increased by 19.2 %. CONCLUSION: Rg1 prolonged ventricular refractoriness and repolarization, and increased VFT. It was indicated that cardiac electrophysiological effects of Rg1 were similar to those of amiodarone.%目的:研究三七皂甙Rg1对心肌电生理特性及室颤阈值(VFT)的影响.方法:17只正常犬被随机分为生理盐水对照组和Rg1组(20 mgkg-1,iv).麻醉后沿正中开胸,暴露心脏.应用心脏电刺激及单相动作电位(MAP)记录技术,测量心肌电生理参数及VFT.结果:Rg1延长窦房结恢复时间19.1%;延长房室传导文氏阻滞周长7.1%;延长心室有效不应期7.9%;延长心室MAP时程(MAPD),其中MAPD30延长25.5%,MAPD50延长24.2%,MAPD90延长13.5%;提高VFT 19.2%.结论:Rg1延长心室不应性及复极化时程,提高VFT,提示Rg1的作用与胺碘酮的效应类似.

  11. Drugs affecting the eye.

    Science.gov (United States)

    Taylor, F

    1985-08-01

    This discussion reviews drugs that affect the eye, including antihyperglycemic agents; corticosteroids; antirheumatic drugs (quinolines, indomethacin, and allopurinol); psychiatric drugs (phenothiazine, thioridazine, and chlorpromazine); drugs used in cardiology (practolol, amiodarone, and digitalis gylcosides); drugs implicated in optic neuritis and atrophy, drugs with an anticholinergic action; oral contraceptives (OCs); and topical drugs and systemic effects. Refractive changes, either myopic or hypermetropic, can occur as a result of hyperglycemia, and variation in vision is sometimes a presenting symptom in diabetes mellitus. If it causes a change in the refraction, treatment of hyperglycemia almost always produces a temporary hypermetropia. A return to the original refractive state often takes weeks, sometimes months. There is some evidence that patients adequately treated with insulin improve more rapidly than those taking oral medication. Such patients always should be referred for opthalmological evaluation as other factors might be responsible, but it might not be possible to order the appropriate spectacle correction for some time. The most important ocular side effect of the systemic adiministration of corticosteroids is the formation of a posterior subcapsular cataract. Glaucoma also can result from corticosteroids, most often when they are applied topically. Corticosteroids have been implicated in the production of benign intracranial hypertension, which is paradoxical because they also are used in its treatment. The most important side effect of drugs such as chloroquine and hydroxychloroquine is an almost always irreversible maculopathy with resultant loss of central vision. Corneal and retinal changes similar to those caused by the quinolines have been reported with indomethacin, but there is some question about a cause and effect relationship. The National Registry of Drug Induced Ocular Side Effects in the US published 30 case histories of

  12. Ventricular Tachycardia Storm Secondary to Critical Cardiovascular Illness: Clinical Analysis of 37 Patients%心血管危重症继发交感风暴37例临床分析

    Institute of Scientific and Technical Information of China (English)

    谢雷星; 牛敬雪; 李娟; 张波; 盖兢泾; 刘宏斌

    2012-01-01

    Objective: To discuss the cause and therapeutic methods of ventricular tachycardia storm secondary to critical cardiovascular illness. Methods: Clinical data about 37 patients with ventricular tachycardia storm secondary to critical cardiovascular illness admitted to our hospital from 2001 to 2011 were retrospectively analyzed. Results: 37 patients of ventricular tachycardia storm were invo-vled, of which 22 were males and 15 were females with a mean age of 68.25 years. Distribution of causes: myocardial infarction 29, heart failure in 3, 2 cases of dilated cardiomyopathy, electrolyte imbalance in 2 cases, Brugada syndrome in 1. The treatment method includes beta blockers, amiodarone, lidocaine, electrical defibrillation, etc. Among them, 17 cases were dead although anti-arrhythmic drugs and electrical defibrillation were used; other 20 cases were under control. Conclusion: Ventricular tachycardia storm secondary to critical cardiovascular illness is an extremely dangerous state.The application of beta blockers and anti-arrhythmic drugs, combining with positive treatment according to the causes and incentives, can significantly improve the clinical symptoms and prognosis.%目的:探讨心血管危重症继发交感风暴的病因分布特点和治疗方法.方法:回顾性分析我院2001年-2011年37例心血管危重症继发交感风暴临床资料.结果:37例心血管危重症继发交感风暴患者,其中男性22例,女性15例,年龄55-82岁,平均68.25岁.病因分布为:心肌梗死29例,心衰3例,扩张性心肌病2例,电解质紊乱2例,Brugada综合征1例.治疗方法包括β受体阻滞剂、胺碘酮、利多卡因、电除颤等.其中,17例因反复发作室颤,经抗心律失常药物和电除颤治疗无效死亡,余20例病情得到控制.结论:心血管危重症继发交感风暴临床病因多样,病情凶险,应用β受体阻滞剂及抗心律失常药物,同时积极针对病因及诱因治疗,可以改善临床症状和预后.

  13. Bronchiolitis obliterans organising pneumonia. A report of 11 cases and a review of the literature.

    Science.gov (United States)

    Lamont, J; Verbeken, E; Verschakelen, J; Demedts, M

    1998-10-01

    The clinical syndrome "Bronchiolitis Obliterans Organising Pneumonia" (BOOP) has to be considered in patients with a flu-like illness since some weeks, fine crackles, and on chest X-ray bilateral patchy infiltrates. There is no response to antibiotics. BOOP is essentially idiopathic, but associations to other conditions exist. Lung function is often restrictive; biochemistry is not pathognomonic. BAL shows a mixed cellular pattern. The gold standard for pathologic diagnosis is open or thoracoscopic lung biopsy. However, a BOOP pattern or reaction is often seen on histologic specimens without the clinical-radiologic features of the BOOP-entity. Therapy consists of corticosteroids, which have to be prescribed for a long time at a rather high dose. Recurrence is frequent, but prognosis is good. Evolution to respiratory insufficiency and death is rare and may occur in rapidly progressive BOOP. This study reports on 11 cases (6 males/5 females) of clinical-pathological BOOP-syndrome (mean age 58 yrs, range 17-73 yrs), with an unexpectedly high mortality rate of 36% (4 cases). The disease was idiopathic in 7, and was associated with intake of amiodarone (in 1), with past Mycoplasma pneumonia (in 1) and with connective tissue disease (in 2). There was a history of a flu-like syndrome, cough and dyspnea of a mean duration of 4 months (range 1 week to 8 months). Lung function was mostly restrictive or/and obstructive with a diffusing capacity ranging between 47 and 95% predicted; there was hypoxia in about half of the patients. Chest X-ray and computed tomography (CT) scan showed a patchy consolidation with linear opacities (unilateral in 4 patients, bilateral in 5) and/or a ground glass pattern (in 4 patients), and a focal pseudo-tumoral lesion (in 1). Bronchoalveolar lavage showed a variable pattern of mixed, or eosinophilic or neutrophilic alveolitis. Histologic diagnosis was based on open lung biopsy (in 3), on thoracoscopic biopsy (in 2), on transbronchial biopsy (in 2

  14. 系统认识人类心脏整体电活动%Systems approach to understanding electrical activity in the human heart

    Institute of Scientific and Technical Information of China (English)

    黄从新; 陈新

    2010-01-01

    Large amounts of information has been generated at the genetic,molecular,and cellular scales of the cardiovascular systems in the past decade.However,we did not integrate this information within and between scales to the level of the whole heart.Therefore,we really know little about the mechanisms underlying the normal and abnormal electrical activity in the human heart because electrical activity of heart and its alteration occur at the organ level.The study of ionic currents was the major strategy to understand the normal and diseased human cardiac electrical activity in the past years.However,evidence-based medicine has demonstrated that antiarrhythmic drugs (AADs) including flecainide,encainide,moracizine,d-sotalol and amiodarone cannot improve patients'survival.Some AADs which block single ionic channel even increase mortality.On the contrary,other strategies such as non-antiarrhythmic drugs (β-receptor blockers,angiotensin-convening enzyme inhibitors,angiotensin Ⅱ receptor blockers)and catheter ablation Can effectively suppress arrhythmias and improve outcomes,but they do not aim to any ionic channel directly.So,treatment and study of arrhythmias focused only on ionic channels have limitations.Currently,animals such as mice,rats,rabbits and dogs are used extensively in studies of cardiac electrophysiology and arrhythmogenesis.However,species differences in the distribution and kinetics of ionic channels are significant.The limitations of using animal models as means to study electrical activity suggest that we should do our best to improve our understanding of mechanisms underlying the normal and abnormal electrical activity in human heart.Despite great progress in issue,cellular and moleeular scales of the cardiovascular systems.we always troubled by a question:why there are significant difference between genotype and phenotype.Fortunately,recent advances in genomics,pmteomics,metabolomics,and genetic engineering have pmvided information and means to

  15. 光敏性药疹68例临床分析%Clinical analysis of 68 patients with photosensitization drug eruption

    Institute of Scientific and Technical Information of China (English)

    朱敏刚; 魏盛; 王音; 胡晓波; 刘卫

    2015-01-01

    目的::明确光敏性药疹的临床特征及相关药物。方法:对我院门诊诊断为光敏性药疹患者的临床资料进行回顾性分析。结果:68例患者中,噻嗪类药物所致37例,喹诺酮类19例,多西环素3例,维胺酯、辛伐他丁及秋水仙碱各2例,氯丙嗪、地尔硫卓及乙胺碘呋酮各1例。皮损仅局限于曝光部位的62例,主要表现为水肿性红斑;皮损同时累及非曝光部位的有6例,表现为湿疹样皮损等多形性损害。患者停用可疑药物及避光,口服抗组胺药、烟酰胺或中小剂量糖皮质激素,外用炉甘石洗剂或糖皮质激素乳膏。65例患者皮损于4周内基本消退。结论:噻嗪类利尿剂及喹诺酮类是引起光敏性药疹最常见的药物。%Objective:To determine the types of drugs which caused photosensitization drug eruption and the clinical features of the patients. Methods: The data of patients with photosensitization drug eruption was analyzed retrospectively. Results: Out of 68 patients, 37 patients were caused by thiazine diuretics, 19 by quinolones, 3 by doxycycline, 2 by viaminate, 2 by Simvastatin, 2 by colchicine, 1 by chlorpromazine, 1 by diltiazem and 1 by amiodarone. The lesions were located on exposed area only and mainly manifested as edem-atous erythema in 62 patients. The lesions were located on both exposed and unexposed areas and manifested as various lesions in 6 patients. All patients stopped the suspicious drugs, kept away from the sun exposure and were given oral antihistamines, nicotinamide, low-medium doses of glucocorticoid and topical calamine lotion and corticosteroids cream. Six five patients were cured after the treatment of 4 weeks. Conclusion:Thia-zine diuretics and quinolones are the most common drugs inducing the photosensitization drug eruption in our patients.

  16. Mode of death on Chagas heart disease: comparison with other etiologies. a subanalysis of the REMADHE prospective trial.

    Directory of Open Access Journals (Sweden)

    Silvia M Ayub-Ferreira

    Full Text Available Sudden death has been considered the main cause of death in patients with Chagas heart disease. Nevertheless, this information comes from a period before the introduction of drugs that changed the natural history of heart failure. We sought to study the mode of death of patients with heart failure caused by Chagas heart disease, comparing with non-Chagas cardiomyopathy.We examined the REMADHE trial and grouped patients according to etiology (Chagas vs non-Chagas and mode of death. The primary end-point was all-cause, heart failure and sudden death mortality; 342 patients were analyzed and 185 (54.1% died. Death occurred in 56.4% Chagas patients and 53.7% non-Chagas patients. The cumulative incidence of all-cause mortality and heart failure mortality was significantly higher in Chagas patients compared to non-Chagas. There was no difference in the cumulative incidence of sudden death mortality between the two groups. In the Cox regression model, Chagas etiology (HR 2.76; CI 1.34-5.69; p = 0.006, LVEDD (left ventricular end diastolic diameter (HR 1.07; CI 1.04-1.10; p<0.001, creatinine clearance (HR 0.98; CI 0.97-0.99; p = 0.006 and use of amiodarone (HR 3.05; CI 1.47-6.34; p = 0.003 were independently associated with heart failure mortality. LVEDD (HR 1.04; CI 1.01-1.07; p = 0.005 and use of beta-blocker (HR 0.52; CI 0.34-0.94; p = 0.014 were independently associated with sudden death mortality.In severe Chagas heart disease, progressive heart failure is the most important mode of death. These data challenge the current understanding of Chagas heart disease and may have implications in the selection of treatment choices, considering the mode of death.ClinicalTrials.gov NCT00505050 (REMADHE.

  17. 疏血通注射液联合尿激酶对急性心肌梗死进行静脉溶栓的临床观察%Clinical Observation on Urokinase Combined with Shuxuetong Injection for Acute Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    邝志斌

    2011-01-01

    Objective To study the efficacy of Shuxuetong injection combined with urokinase for acute myocardial infarction. Methods Fifty patients (pts) with acute ST - segment elevation myocardial infarction were randomly divided into control group (n = 25) and combined treatment group (n = 25). All pts were routinely given aspirin, clopidogrel,metoprolol,simvastatin,nitroglycerin, low molecular heparin, amiodarone. Urokinase was used in control group on the basis of conventional therapy. Shuxuetong injection with urokinase were used in combined treatment group. Results The recanalization rate of coronary artery was 80% in combined treatment group, which was significantly higher than that in control group(64% ,P0. 05). Conclusion Shuxuetong injection combined with urokinase for treatment of acute myocardial infarction was safe and effective.%目的 观察疏血通注射液联合尿激酶在急性心肌梗死进行静脉溶栓的疗效.方法 选择50例急性ST段抬高型心肌梗死患者,随机分为对照组与治疗组,各25例.两组据病情常规给予阿司匹林、氯吡格雷、美托洛尔、辛伐他汀、硝酸甘油、低分子肝素、胺碘酮等治疗.对照组在常规治疗基础上加用尿激酶,治疗组在对照组基础上加用疏血通注射液静脉溶栓治疗.观察两组冠状动脉再通率.结果 治疗组冠状动脉再通率为80%,高于对照组的64%(P<0.05);凝血指标纤维蛋白原较对照组显著降低(P<0.05),出血率及病死率两组比较无统计学意义(P>0.05).结论 疏血通注射液联合尿激酶对急性心肌梗死的静脉溶栓治疗安全有效,能增加冠状动脉的再通率.

  18. Appropriateness of administration of nasogastric medication and preliminary intervention

    Directory of Open Access Journals (Sweden)

    Zhou Q

    2012-11-01

    Full Text Available Ling-Ling Zhu,1 Ling-Cheng Xu,2 Hui-Qin Wang,3 Jing-Fen Jin,3 Hua-Fen Wang,3 Quan Zhou21Cadre Department, 2Department of Pharmacy, 3Division of Nursing, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, ChinaAbstract: A utilization study was performed in a 2200-bed tertiary care teaching hospital. Data mining was performed on all nasogastric medication prescriptions for patients hospitalized in 2011. Nurses were interviewed by questionnaire. A PDCA (Plan-Do-Check-Act cycle was used for continuous quality improvement. The proportion of patients with nasogastric tubes (NGT was 3.2%. A large number of medical orders (n  6261 involved nasogastric medications with a package insert particularly noting that they should not be crushed or opened (group 1 or medications without a specific formulation recommendation in the package insert but having evidence discouraging NGT dosing (group 2. Of the nasogastrically administered sustained-release or controlled-release formulations, a sustained-release sodium valproate tablet formulation was the most prescribed drug and a sustained-release 2.5 mg felodipine tablet was prescribed with the highest proportion of NGT dosing [NGT/(NGT  oral  12.3%]. Among the nasogastrically administered enteric-coated formulations, a myrtol-standardized enteric-coated capsule formulation was the most prescribed drug and a pantoprazole tablet formulation was prescribed with the highest proportion of NGT dosing [NGT/(NGT  oral  19.3%]. Proportions of NGT dosing for amiodarone and carbamazepine (group 2 were 4.8% and 6.3%, respectively. The percentage of nurses with adequate knowledge about pharmaceutical dosage formulations was 60%. The rate of answering correctly as to whether medications in group 1 could be crushed or opened was only 30%. Awareness of evidence discouraging NGT dosing of medications in group 2 was zero. Most nurses (90% left physicians and

  19. Anterior Pituitary Hypofunction with Long QT Syndrome Episodes of Torsades De Pointes Ventricular Tachycardia : Report of One Case%腺垂体功能减退症伴长QT综合征发作尖端扭转性室速一例

    Institute of Scientific and Technical Information of China (English)

    韩贤珍; 张竞涛; 安雅莉; 谭慧琼

    2011-01-01

    Patients with men 63 years of age, due to a sudden syncope emergency admissions, morbidity when in the outer court head MR1 shows: empty sells, ECG shows: long QT with torsade de pointes ventricular tachycardia after intravenous administration of amiodarone, give terminating ventricular tachycardia, then transferred to the hospital, with no obvious predisposing factors during hair two times. Auxiliary examination: dynamic electrocardiogram shows: QT570-640ms sinus bradycardia in heartbeat, junctional escape rhythm; hypopituitarism. Implanted ICD absolutely suitable for patients, because of personal factors give DDD pacemaker implantation, and combined with propranoioi regulation of ventricular rate in 60-70 / mm. Follow-up for half a year without recurrence. The clinical course is empty sclla syndrome ESS and pituitary (unction reduction alter TDP. Without other trigger factors, similar to those reported in rare, we suggested that the two may be related, specifically whether there is any association or causation need further medical certificates.%患者男性63岁,因突发晕厥急诊入院,发病时在外院颅脑MRI示:空泡蝶鞍,ECG示:长QT伴尖端扭转型室速,给与胺碘酮静脉用药后终止室速,后转入笔者医院,期间无明显诱发因素再发两次.辅助检查:动态心电图示:QT570-640ms窦性心动过缓,交界区逸搏心律;腺垂体功能低下.有植入ICD的绝对适应征,因患者个人因素给予植入DDD起搏器,并合用心得安调节心室率在60-70次/min,随访半年无再发.该个案临床过程表现为空泡蝶鞍综合征ESS并垂体功能低减后出现TDP,无其它引发因素,类似报道罕见,我们认为二者可能相关,具体是否存在关联或者因果关系尚需进一步医学证明.

  20. Examining variations in prescribing safety in UK general practice: cross sectional study using the Clinical Practice Research Datalink

    Science.gov (United States)

    Kontopantelis, Evangelos; Akbarov, Artur; Rodgers, Sarah; Avery, Anthony J; Ashcroft, Darren M

    2015-01-01

    Study question What is the prevalence of different types of potentially hazardous prescribing in general practice in the United Kingdom, and what is the variation between practices? Methods A cross sectional study included all adult patients potentially at risk of a prescribing or monitoring error defined by a combination of diagnoses and prescriptions in 526 general practices contributing to the Clinical Practice Research Datalink (CPRD) up to 1 April 2013. Primary outcomes were the prevalence of potentially hazardous prescriptions of anticoagulants, anti-platelets, NSAIDs, β blockers, glitazones, metformin, digoxin, antipsychotics, combined hormonal contraceptives, and oestrogens and monitoring by blood test less frequently than recommended for patients with repeated prescriptions of angiotensin converting enzyme inhibitors and loop diuretics, amiodarone, methotrexate, lithium, or warfarin. Study answer and limitations 49 927 of 949 552 patients at risk triggered at least one prescribing indicator (5.26%, 95% confidence interval 5.21% to 5.30%) and 21 501 of 182 721 (11.8%, 11.6% to 11.9%) triggered at least one monitoring indicator. The prevalence of different types of potentially hazardous prescribing ranged from almost zero to 10.2%, and for inadequate monitoring ranged from 10.4% to 41.9%. Older patients and those prescribed multiple repeat medications had significantly higher risks of triggering a prescribing indicator whereas younger patients with fewer repeat prescriptions had significantly higher risk of triggering a monitoring indicator. There was high variation between practices for some indicators. Though prescribing safety indicators describe prescribing patterns that can increase the risk of harm to the patient and should generally be avoided, there will always be exceptions where the indicator is clinically justified. Furthermore there is the possibility that some information is not captured by CPRD for some practices—for example, INR results in

  1. Assessment of statin-associated muscle toxicity in Japan: a cohort study conducted using claims database and laboratory information

    Science.gov (United States)

    Chang, Chia-Hsien; Kusama, Makiko; Ono, Shunsuke; Sugiyama, Yuichi; Orii, Takao; Akazawa, Manabu

    2013-01-01

    Objective To estimate the incidence of muscle toxicity in patients receiving statin therapy by examining study populations, drug exposure status and outcome definitions. Design A retrospective cohort study. Setting 16 medical facilities in Japan providing information on laboratory tests performed in and claims received by their facilities between 1 April 2004 and 31 December 2010. Participants A database representing a cohort of 35 903 adult statin (atorvastatin, fluvastatin, pitavastatin, pravastatin, rosuvastatin and simvastatin) users was studied. Use of interacting drugs (fibrates, triazoles, macrolides, amiodarone and ciclosporin) by these patients was determined. Main outcome measure Statin-associated muscle toxicity (the ‘event’) was identified based on a diagnosis of muscle-related disorders (myopathy or rhabdomyolysis) and/or abnormal elevation of creatine kinase (CK) concentrations. Events were excluded if the patients had CK elevation-related conditions other than muscle toxicity. Incidence rates for muscle toxicity were determined per 1000 person-years, with 95% CI determined by Poisson regression. Results A total of 18 036 patients accounted for 42 193 person-years of statin therapy, and 43 events were identified. The incidence of muscle toxicity in the patients treated with statins was 1.02 (95% CI 0.76 to 1.37)/1000 person-years. The estimates varied when outcome definitions were modified from 0.09/1000 person-years, which met both diagnosis and CK 10× greater than the upper limit of normal range (ULN) criteria, to 2.06/1000 person-years, which met diagnosis or CK 5× ULN criterion. The incidence of muscle toxicity was also influenced by the statin therapies selected, but no significant differences were observed. Among 2430 patients (13.5%) received interacting drugs with statins, only three muscle toxicity cases were observed (incidence: 1.69/1000 person-years). Conclusions This database study suggested that statin use is generally well

  2. Time-to-Onset Analysis of Drug-Induced Long QT Syndrome Based on a Spontaneous Reporting System for Adverse Drug Events

    Science.gov (United States)

    Sasaoka, Sayaka; Matsui, Toshinobu; Hane, Yuuki; Abe, Junko; Ueda, Natsumi; Motooka, Yumi; Hatahira, Haruna; Fukuda, Akiho; Naganuma, Misa; Hasegawa, Shiori; Kinosada, Yasutomi

    2016-01-01

    Long QT syndrome (LQTS) is a disorder of the heart’s electrical activity that infrequently causes severe ventricular arrhythmias such as a type of ventricular tachycardia called torsade de pointes (TdP) and ventricular fibrillation, which can be fatal. There have been no previous reports on the time-to-onset for LQTS based on data from spontaneous reporting systems. The aim of this study was to assess the time-to-onset of LQTS according to drug treatment. We analyzed the association between 113 drugs in 37 therapeutic categories and LQTS including TdP using data obtained from the Japanese Adverse Drug Event Report database. For signal detection, we used the reporting odds ratio (ROR). Furthermore, we analyzed the time-to-onset data and assessed the hazard type using the Weibull shape parameter. The RORs (95% confidence interval) for bepridil, amiodarone, pilsicainide, nilotinib, disopyramide, arsenic trioxide, clarithromycin, cibenzoline, donepezil, famotidine, sulpiride, and nifekalant were 174.4 (148.6–204.6), 17.3 (14.7–20.4), 52.0 (43.4–62.4), 13.9 (11.5–16.7), 69.3 (55.3–86.8), 54.2 (43.2–68.0), 4.7 (3.8–5.8), 19.9 (15.9–25.0), 8.1 (6.5–10.1), 3.2 (2.5–4.1), 7.1 (5.5–9.2), and 254.8 (168.5–385.4), respectively. The medians and quartiles of time-to-onset for aprindine (oral) and bepridil were 20.0 (11.0–35.8) and 18.0 (6.0–43.0) days, respectively. The lower 95% confidence interval of the shape parameter β of bepridil was over 1 and the hazard was considered to increase over time.Our study indicated that the pattern of LQTS onset might differ among drugs. Based on these results, careful long-term observation is recommended, especially for specific drugs such as bepridil and aprindine. This information may be useful for the prevention of sudden death following LQTS and for efficient therapeutic planning. PMID:27723808

  3. Effect of sophocarpine on aconitine induced rat arrhythmic model and its mechanism%槐果碱抗乌头碱诱发大鼠心律失常及其作用机制

    Institute of Scientific and Technical Information of China (English)

    陈雯雯; 罗章源; 陈颖敏; 徐瑾; 陈曙霞; 何奔

    2011-01-01

    AIM To study the antiarrhythmic effect of sophocarpine and its mechanism. METHODS A rapid cardiac arrhythmic SD rat model induced by aconitune was used, dividing into 3 groups such as model group, sophocarpine group (5 mg·kg-1, iv) and amiodarone group (2.5μg·kg-1, iv). Continuous EKG monitoring and printing were applied to keep track of the appearing time of ventricular premature beat, ventricular tachycardia, ventricular flutter, ventricular fibrillation and cardiac arrest, which could be changed into total consumption dose of aconitine so as to be compared among groups, then the antiarrhythmia effect of sophocarpine could be evaluated. Capillary grass microelectrode was used to record action potential of guinea pig papillary muscles in vitro. Sophocarpine of different concentrations (1、5、10 μmol·L-1) were added to the perfusion sulotion separately in order to investigate how they would affect action potential duration (APD) , effective refractory period (ERP), maximal depolarization velocity (Vmax), action potential amplitude (APA) and resting potential (RP). RESULTS The appearance of ventricular premature beat, ventricular tachycardia, ventricular flutter, ventricular fibrillation and cardiac arrest were all delayed in the sophocarpine group and the amiodarone group in comparison with the model group (P 0.05). Sophocarpine (1、5、10 μmol·L-1) prolonged APD50, APD90, APD100 and ERP while Vmax declined (P 0.05). CONCLUSION Sophocarpine has significant antiarrhythmic effect on the aconitine induced , arrhythmia rat mode, which is possibly due to prolongation of APD and ERP.%目的 研究槐果碱的抗心律失常作用及其机制.方法采用乌头碱诱发的快速型心律失常的SD大鼠,分为模型组、槐果碱组(5 mg· kg-1,iv)与胺碘酮组(2.5 μg· kg-1,iv)3组.心电图连续示波观察,电脑实时显示并存储,记录室性早搏、室性心动过速、心室扑动-心室颤动、心脏停搏出现时间,换算成乌

  4. 老年阵发性室上速食道调搏与药物复律的比较%Comparison of Cardioversion between by Transesophageal Atrial Pacing and Drug in Elderly Patients with Paroxysmal Supraventricular Tachycardia

    Institute of Scientific and Technical Information of China (English)

    胡司淦; 徐玮; 王本芳; 蔡鑫

    2013-01-01

    目的 对比观察老年阵发性室上性心动过速(paroxysmal supraventricular tachycardia,PSVT)患者通过食道心房调搏(transesophageal atrial pacing,TEAP)与药物复律的效果.方法 45例老年PSVT患者心动过速发作时分别应用TEAP和药物终止PSVT发作,观察心动过速的终止方式、终止时间及并发症的发生情况.TEAP终止PSVT发作采用超速刺激,药物复律采用ATP、心律平及可达龙.结果 TEAP组患者心动过速终止时间(2~30 s)少于药物组(5 s~10h).TEAP组PSVT终止率(100%)高于药物组终止率(94.7%),无统计学意义(P>0.05).药物组患者窦性停搏、低血压并发症高于TEAP组(P<0.05).复律后早搏及胸痛等并发症两组无统计学意义(P>0.05).结论 老年PSVT患者特别是合并器质性心脏病患者首选TEAP术终止心动过速发作.通过TEAP电生理检查能明确心律失常类型,具有安全性高、创伤小及快速终止优点.%Objective To compare the efficacy of cardioveision in elderly patients with paroxysmal supraventricular tachycar-dia(PSVT) by transesophageal atrial pacing (TEAP) and drug. Methods 45 elderly patients with PSVT were applied respectively TEAP and drug to terminate tachycardia, the tachycardia termination mode, termination time and complications were observed. TEAP terminated PSVT using overdrive stimulation. Pharmacologic cardioversion using ATP,propafenone and amiodarone. Results The time of tachycardia termination in TEAP group(2 -30 seconds) was less than that in drug group(5 second - 10 hours). PSVT termination rate in group of TEAP( 100% ) were higher than that in drug group termination rate(94. 7% ) ,P > 0.05. The sinus arrest and hypotension complications in drug group were higher than those in TEAP group ( P < 0. 05 ). Premature beat,chest pain and other complications in the two groups were not statistically significant(P >0.05). Conclusion The TEAP was preferred to terminate tachycardia in elderly

  5. Isolamento das veias pulmonares em pacientes com fibrilação atrial permanente secundária a valvopatia mitral Isolation of the pulmonary veins in patients with permanent atrial fibrillation secondary to mitral valve disease

    Directory of Open Access Journals (Sweden)

    Gustavo G. Lima

    2004-04-01

    atrial appendage, and a perpendicular incision originating in the inferior margin of the circumferential incision isolating the pulmonary veins down to the mitral valve. Early arrhythmias were aggressively treated with cardioversion. RESULTS: The mean follow-up was 23.9±17 months, and 3 patients died in the postoperative period. Ten patients required electrical cardioversion in the postoperative period; 87% had sinus rhythm in the last medical visit, and 33% were using amiodarone. CONCLUSION: Isolation of the pulmonary veins associated with mitral valve surgery is an effective and safe technique for maintaining sinus rhythm in patients with permanent atrial fibrillation.

  6. Medicamentos que podem induzir prolongamento do intervalo QT utilizados por idosos em domicílio

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    Josiane Macêdo Martins

    2015-10-01

    cardiac death. The objective of this study was to identify drugs used by elderly at home which may induce QTi prolongation. This is a quantitative, retrospective, descriptive, exploratory study conducted in a teaching hospital. A total of 190 elderly with information on the use of medications at home available in medical records were included in the study. The median age was 69.5 years, and 99 (52.1 % were female. The median number of medications used per patient at home was 4.0. A variety of 159 drugs were identified including 23(14.5% that may induce QTi prolongation. Among the 39 elderly (20.5% using drugs that may induce QTi prolongation, the most frequent were: amiodarone, amitriptyline, nortriptyline, citalopram and fluoxetine. Hypertension was the most frequent risk factor for QTi prolongation. The use of these drugs and the presence of risk factors place the elderly at increased risk for developing torsade de pointes. The identification of drugs that may induce QTi prolongation, drug-drug interactions and clinical conditions that may lead to this adverse effect reinforces the need for actions to ensure the drug safety in the elderly population and to avoid serious adverse events.Keywords: QT interval prolongation. Drugs. Elderly. Torsades de pointes.

  7. AL Amyloidosis

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    Desport Estelle

    2012-08-01

    /or immunofluorescence. Due to the systemic nature of the disease, non-invasive biopsies such as abdominal fat aspiration should be considered before taking biopsies from involved organs, in order to reduce the risk of bleeding complications. Differential diagnosis Systemic AL amyloidosis should be distinguished from other diseases related to deposition of monoclonal LC, and from other forms of systemic amyloidosis. When pathological studies have failed to identify the nature of amyloid deposits, genetic studies should be performed to diagnose hereditary amyloidosis. Management Treatment of AL amyloidosis is based on chemotherapy, aimed at controlling the underlying plasma clone that produces amyloidogenic LC. The hematological response should be carefully checked by serial measurements of serum free LC. The association of an alkylating agent with high-dose dexamethasone has proven to be effective in two thirds of patients and is considered as the current reference treatment. New agents used in the treatment of multiple myeloma are under investigation and appear to increase hematological response rates. Symptomatic measures and supportive care is necessary in patients with organ failure. Noticeably, usual treatments for cardiac failure (i.e. calcium inhibitors, β-blockers, angiotensin converting enzyme inhibitors are inefficient or even dangerous in patients with amyloid heart disease, that should be managed using diuretics. Amiodarone and pace maker implantation should be considered in patients with rhythm or conduction abnormalities. In selected cases, heart and kidney transplantation may be associated with prolonged patient and graft survival. Prognosis Survival in AL amyloidosis depends on the spectrum of organ involvement (amyloid heart disease being the main prognosis factor, the severity of individual organs involved and haematological response to treatment.

  8. 误诊为重症心肌炎患儿的左室特发性室速1例%A case analysis of idiopathic left ventricular tachycardia misdiagnosed as serious myocarditis

    Institute of Scientific and Technical Information of China (English)

    李凌蔚; 赵鹏军

    2011-01-01

    .Electrophysiologic study showed that ventricular tachycardia originated in the left posterior branch. When it was difficult to distinguish ILVT from paroxysmal supraventricular tachycardia ( PSVT ), esophageal ECG could be used to find atrioventricular dissociation so as to confirm the diagnosis. Nourishing myocardium, treating arrhythmia, inhibiting inflammatory reaction by megavitamin, interferon, gammaglobulin and hormone, improving heart function with milrinone and treating arrhythmia with amiodarone should be the major treatments. Conclusion ILVT can be diagnosed by repeated examining of enzymes, troponin and electrocardiogram and be treated with radiofrequency catheter ablation.

  9. The Cause Analysis and Countermeasures of Frequent Shocks in Patients with Implantable Cardioverter Defibrillator%埋藏式心脏除颤器患者频繁电击原因分析及对策

    Institute of Scientific and Technical Information of China (English)

    吴冬燕; 邢彩耐; 卢凤民; 付乃宽; 许静

    2014-01-01

    Objective To investigate the cause and countermeasures of frequent shocks in patients with implantable cardioverter defibrillators (ICD). Methods Eighty ICD patients with heart failure and malignant ventricular arrhythmias were followed up, including sixty-two male and eighteen female patients. There were 35 patients with single-chamber ICD, 23 with dual-chamber ICD and 22 with three-chamber ICD. Patients in this study were followed up for 1-6 years to analyze the reasons for ICD discharge. According to the specific circumstances, patients were treated. Results Twenty-three pa-tients in 80 patients suffered from shock treatment. Ten patients (12.5%) experienced frequent shocks. The causes of fre-quent shock included repeated episodes of ventricular tachycardia, invalid shock due to increased defibrillation threshold (DF) and false identification of the frequent episodes of paroxysmal ventricular tachycardia or arrhythmias. The management included the identification process adjustment of ventricular tachycardia and supraventricular tachycardia, increased num-bers of beats of ventricular tachycardia judgment and increase the basic pacing rate. The anti-arrhythmic drugs should be combinedly used, especially metoprolol and amiodarone. The ICD shock was significantly reduced after parameter optimiza-tion and anti-arrhythmic therapy. Conclusion The ICD shocks were effectively reduced with rational use of anti-arrhyth-mic drugs and valid ICD programming.%目的:探讨植入埋藏式心脏除颤器(ICD)的患者出现频繁放电的原因及处理方法。方法随访80例因心力衰竭或恶性室性心律失常植入ICD的患者,男62例,女18例,其中单腔ICD 35例,双腔ICD 23例,三腔ICD (CRTD)22例,随访1~6年,了解ICD的放电原因,并根据具体情况进行治疗。结果80例患者中有23例患者遭受电击,其中10例为频繁电击(24 h内电击≥3次或1年内电击≥5次),均为心脏猝死二级预防患者。

  10. Tratamento cirúrgico da fibrilação atrial: procedimento do "labirinto": experiência inicial Surgical treatment of atrial fibrillation with "maze" procedure: initial experience

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    Adib D Jatene

    1992-06-01

    complicações infecciosas. Os pacientes restantes obtiveram alta hospitalar sem drogas antiarrítmicas. Em um período de um a dez meses (M = 5,4, os pacientes estão assintomáticos e o Holter mostra presença de ritmo atrial irregular permanente (com FC média de 70 a 80 bpm com condução AV preservada; o ecodoppler mostra presença de contração atrial eficiente. Não houve recorrências de FA e nenhum dos pacientes. Em conclusão, podemos admitir que, a curto prazo, a técnica do "labirinto" na FA em reumáticos restaurou a contração atrial organizada e controlou a FC. Assim, pode contribuir para redução de fenômenos trombo-embólicos. Maior número de pacientes deve ser observado durante tempo prolongado para avaliação da eficácia do procedimento.The "maze" procedure for surgical treatment of chronic atrial fibrillation (AF described by Cox was performed in 9 patients from July 91 to May 92; 7 were female and the ages range from 37 to 63y (51,4y. Eight patients had surgical rheumatic valve disfunction (mitral stenosis in 6; mitral double disfunction in 2 being 1 with associated tricuspid regurgitation and 1 had recurrent paroxicistic AF with no valve disfunction. Surgical treatment was performed following the technique described by Cox and the surgery was completed with 6 mitral comissurotomies and 2 mitral valve replacements. Three patients had left atrial thrombosis. There were no immediate deaths and 1 patient died in the 45th day with infeccious complications. The first patient required reoperation for bleeding review. Second and 3rd patients presented transitory atrial tachycardia in 3rd and 5th day, controlled with intravenous amiodarone. No other complications were observed. In a mean follow up period of 5,4m (1 to 10 m, all patients were in regular atrial rhythm without antiarrhythmic drugs. Effective atrial contraction was demonstrated by ECHO in all patients and no one returned to AF. In conclusion, this initial follow up showed good results in

  11. Creatinina sérica elevada en el paciente hipotiroideo: miopatía o verdadera nefropatía? Propuesta de clasificación Elevated Serum Creatinine in Hypothyroidism: Myopathy or Real Nephropathy ? Classification Proposal

    Directory of Open Access Journals (Sweden)

    Carmen Lidia Guerrero-Lobo

    2009-03-01

    rabdomyolysis or acute renal failure with increased CK since it may be secondary to hypothyroid myopathy. 2. Serum creatinine should be requested in hypothyroid patients who discontinue levothyroxine for any reason or are using amiodarone. 3 Proteinuria within the nephrotic range in a hypothyroid patient who has discontinued levothiroxine will have a different response to treatment depending of the cause (if it is autoimmune it will respond to glucorticoids and if is not, will respond to levothyroxine.

  12. Perioperative nursing of modified maze procedure using bipolar radiofrequency ablation accompanied with valve replacement for surgical treatment of permanent atrial fibrillation%心脏瓣膜置换术同期双极射频消融治疗永久性心房颤动的围手术期护理

    Institute of Scientific and Technical Information of China (English)

    洪慧; 陈晓玲; 石开虎

    2013-01-01

    surgery in addition to routine care,rhythm and heart rate monitoring were paid attention to,maintenance of cardiac function,observation of drainage,maintenance of electrolyte balance,observation of pacemaker,observation of amiodarone medication and nursing,as well as health guidance and psychological care were implemented.Results The surgery of 55 patients was successfully completed.The day after surgery,atrial fibrillation in 48 cases turned into sinus rhythm.In all patients,2 of them had suffered Ⅲ degree atrioventricular block after surgery and permanent pacemakers were applicated.There were no cardiac perforation and non-hospital mortality.The average length of stay was(12.5±2.1) d.The mean follow-up was(8.6±3.0) months.87.3% of patients maintained sinus rhythm,9.1% in AF rhythm,3.6% in paced rhythm.Conclusions Modified maze procedure using bipolar radiofrequency ablation is a simple,safe and effective surgical procedure for the treatment of permanent atrial fibrillation.High quality of perioperative nursing is to improve the success rate of surgery and the key to reduce mortality.

  13. 多极标测在心房颤动消融术后持续性房性心动过速中的应用体会%Application of multielectrode activation mapping and radiofrequency catheter ablation in patients with sustained atrial tachycardia after atrial fibrillation ablation

    Institute of Scientific and Technical Information of China (English)

    詹贤章; 张黔桓; 蒙霏霭; 薛玉梅; 吴书林; 杨平珍; 方咸宏; 廖洪涛; 梁远红; 魏薇; 邓海

    2012-01-01

    .Radiofrequency catheter ablation was performed at the critical reentry isthmus or the focal origin by constructing three-dimensional model of atrium.Results Twenty-eight types of AT were presented in 18 patients.The average cycle lengths of AT were (260.7±57.6)ms.The mean multielectrode mapping points were (368.6± 152.4).The mean multielectrode mapping time was (11.1 ±3.6)min.Twenty-seven types of activation sequences of AT were mapped,including 13 types of local or microreentrant AT,1 type of small reentry AT around tWo lesion" gaps" of right pulmonary vein,and 13 types of macroreentry AT (around mitral annulus 10,around the pulmonary vein and left atrial roof,2,double reentry 1).Acute successful ablation was obtained in 25 types of AT(89%).The mean procedure time was (122.6±35.0)min,The mean exposure time was (16.0±5.9) min.The complications related with mapping and catheter ablation were not detected.During (11.2±6.6) months of follow-up,4 cases recurred,and 2 of them could maintain sinus rhythm by taking amiodarone.Conclusions Multielectrode activation mapping using EnSite NavX/Velocity mapping system can easily and effectively achieve high density mapping of AT,which can help for the judgment of AT mechanism and the selection of ablation strategy,and improve the successful ablation rate in complex sustained AT after AF ablation.

  14. Aspectos clínicos e terapêuticos da insuficiência cardíaca por doença de Chagas Clinical and therapeutics aspects of heart failure due to Chagas disease

    Directory of Open Access Journals (Sweden)

    Julio Cesar Vieira Braga

    2006-04-01

    included in the study. Chagasic cardiomyopathy was the most common etiology (48% of the cases. Other etiologies included hypertensive cardiomyopathy in 19% of the patients, idiopathic dilated in 11% and ischemic in 9%. Patients with HF secondary to chagasic cardiomyopathy were more frequently from non-white ethnic groups (88 vs. 75%; p = 0.002, had a family history of Chagas disease (57 vs. 21%; p = 0.001, had the disease for a longer length of time (71 vs. 56 months; p = 0.034, had lower levels of education (4.4 ± 4.1 vs. 5.7 ± 4.2 years of study; p = 0.004, had a lower heart rate (69 ± 12 vs. 73 ± 13; p = 0.03 and a lower systolic blood pressure (121 ± 25 vs. 129 ± 28 mmHg; p = 0.006. There was also a higher incidence of the use of amiodarone (22 vs. 13%; p = 0.036 and artificial pacemakers (15 vs. 1%; p = 0.001. There was a lower usage of beta-blockers (39 vs. 59%; p = 0.001. CONCLUSION: In this sample of HF outpatients, in a state with a high prevalence of Chagas disease, chagasic cardiomyopathy was the most common etiology and they presented some unique clinical and therapeutic characteristics in comparison to other heart failure patients.

  15. Knowledge about Ultraviolet Radiation Hazards and Tanning Behavior of Cosmetology and Medical Students.

    Science.gov (United States)

    Zuba, Ewelina Bogumiła; Francuzik, Wojciech; Malicki, Przemysław; Osmola-Mańkowska, Agnieszka; Jenerowicz, Dorota

    2016-04-01

    the term Fitzpatrick's skin phototype. We emphasize this because patients with phototype 1 and 2 are more susceptible to the development of skin cancers (10) and ignorance in this matter may be dangerous. UV rays may promote drug-induced photosensitivity reactions such as phototoxicity and photoallergy (1), with the most common causes being: non-steroidal anti-inflammatory agents (ketoprofen, ibuprofen, piroxicam, diclofenac), cardiovascular drugs (furosemid, amiodarone, thiazides), antibiotics (tetracyclines, ciprofloxacine, sulfonamides), psoralens, and oral contraceptives (11). Our study found deficient knowledge about drugs which may trigger photosensitivity reactions. Cosmetology students reported significantly more risky tanning behavior but did better in knowledge checking questions, which may be explained by their personal interest in this subject or by educational focus due to their major. We suggest that better knowledge about sunbathing in general is due to increased interest in this matter (not solely due to formal education) and this interest derives from a positive attitude towards a tanned appearance. It has been proven that sunbathing shows signs of addictive behavior (12). Tanorexia as a term was more widely known among cosmetology students, which may illustrate that although students knew about the addictive properties of tanning, they were sure that this did not apply to them. Many studies showed that increased knowledge did not translate into safer tanning habits (13,14). Our study agrees with those findings. Our study demonstrated that medical and cosmetology student knowledge about sunbeds and risk of UV radiation is deficient. However, cosmetology students demonstrated better knowledge than medical students. Future cosmetologists may be better information providers about sun risk and its prevention. On the other hand, students of the cosmetology faculty tended to tan more often and longer and engage in more risky behavior despite being aware of

  16. Three dimensional voltage map scar-related ventricular tachycardias due to myocardial infarction under sinus rhythm%窦性心律下通过三维电压标测心肌梗死后瘢痕性室性心动过速

    Institute of Scientific and Technical Information of China (English)

    贾玉和; 任岚; 方丕华; 唐闽; 毛克修; 赵允梓; 楚建民; 张澍

    2012-01-01

    目的 介绍一种不需行拖带标测,而在窦性心律下可标测和消融心肌梗死后瘢痕性室性心动过速(室速)的方法.方法 两例男性患者,均在心肌梗死和冠状动脉再通治疗后出现室速.经胺碘酮治疗后出现甲状腺功能异常而停药.其中例1为前壁心肌梗死合并心尖部室壁瘤,在发作室速时心功能恶化伴顽固咳嗽;例2为下后壁心肌梗死,其临床室速有两种形态,室性早搏(室早)有多种形态.该两种情况占心肌梗死后室速的大部分,均不太适合常规的拖带标测.首先在窦性心律时在Carto系统指导下建立左心室的三维电解剖图,通过调整瘢痕区电压标准,使梗死边缘区三层结构清楚显示后,沿边缘区行起搏标测,通过特征电位和测量刺激至QRS间距来判定峡部区,然后以峡部区为中心,以垂直于边缘区的方向行连续线性消融,直至室速不能被诱发视为消融终点.结果 两例在消融前均可反复诱发室速,在经过几条垂直线消融后室速均不能被诱发,随访3个月室速也未复发.心功能和生活质量明显改善.但例1出现室壁瘤附壁血栓.结论 对大多数心肌梗死后瘢痕性室速患者,均可在窦性心律下标测到其关键峡部区,并以此为中心点沿着垂直于边缘区方向行线性消融,以室速不能被诱发做为急性期终点同样能得到较好的远期成功率,但术后1个月需保持华法林抗凝.%Objective To introduce an initial experience of mapping scar-related ventricular tachycardias (VTs)after myocardial infarction using three dimensional voltage mapping under sinus rhythm without induction of ventricular tachycardia.Methods Two males with ventricular tachycardias ( VTs ) due to myocardial infarction received percutaneous catheter intervention(PCI) and stent implantation.Both of them had abnormal thyroid function due to amiodarone administration and finally quitted it.Case one with remote anterior wall

  17. 辛伐他汀和阿托伐他汀与CYP3A4酶抑制剂/诱导剂在心内科患者中联用情况调查%Investigation of the co-administration of simvastatin or atorvastatin with cytochrome P4503A4 inhibitors or inducers in cardiology ward

    Institute of Scientific and Technical Information of China (English)

    钟雪; 张亚同; 纪立伟; 胡欣; 程刚

    2013-01-01

    patients were prescribed simvastatin or atorvastatin with CYP3A4 inhibitors, among which the patients used simvastatin accounted for 30%and atorvastatin accounted for 36%. The average duration of concomitant medication use were (7.04 ± 0.29) days. The CYP3A4 inhibitors that usually combined with simvastatin or atorvastatin were amlodipine, diltiazem, ranitidine, amiodarone, and ginkgo;while the CYP3A4 inducers were carbamazepine, prednisolone acetate tablets. The combination of simvastatin or atorvastatin with CYP3A4 inhibitors was more frequently than that with CYP3A4 inducers. There was no significant difference (P>0.05) when comparing the biochemical indicators of patients who used statins combined with inhibitors or not. Conclusion:The co-prescription of simvastatin or atorvastatin with CYP3A4 inhibitors is common in the hospital. Strategies should be taken to avoid co-administration of simvastatin or atorvastatin with CYP3A4 inhibitors or inducers. If it must be used, drug dosage should be limited according to the direction of drug. We should pay attention to the drug interactions with potential adverse effects, and follow-up patients' condition at regular intervals.

  18. 儿童长 QT 间期综合征伴晕厥11例治疗及随访分析%Treatment and follow-up study of long QT syndrome with syncope in 11 children

    Institute of Scientific and Technical Information of China (English)

    王野峰; 陈智; 肖云彬; 姚震亚; 王成

    2016-01-01

    Objective To assess the clinical features and treatment of children with long QT syndrome (LQTS)and syncope.Methods Eleven cases of children with LQTS and syncope between January 2009 and July 2014 in Hunan Children′s Hospital were retrospectively analyzed for clinical features,treatment and long term follow -up.Results There were 11 cases of children with LQTS aged 4.0 -14.5(9.16 ±2.71)years,8 male and 3 female, with syncope more than once.The range of QTc was 460 -521(483.72 ±22.90)ms.For 3 cases of acquired LQTS,1 case was parathyroid hypothyroidism causing hypocalcemia,1 case was myocarditis complicated with third degree atrio-ventricular block,and 1 case showed atrial flutter receiving amiodarone post congenital cardiac surgery.All patients re-covered after the inducement removed and primary illness cured.For 8 cases of congenital LQTS,3 cases of LQTS un-derwent genetic test (1 case of KCNQ1 gene mutation,2 cases of KCNH2 gene mutation).One case died after frequent torsade de pointes (Tdp)and ventricular fibrillation during hospitalization,the remaining 7 patients were given oral pro-pranolol,potassium chloride sustained -release tablets after discharge.Follow -up time was 8 to 75 months,an average of (45.73 ±24.42)months.One case died suddenly at home after 25 months of follow -up.The remaining 6 cases of children with congenital LQTS could withstand general activities without syncope,in which 4 cases had normal QTc by electrocardiography(ECG),and the findings in 2 cases did not change compared with those previously.The QTc re-turned to normal in children with acquired LQTS in the follow -up review.Conclusions Children with congenital LQTS should receive early genetic screening and genotyping for rational use of drugs.For children with higher risk of sudden death,drug therapy combined with implantable cardioverter defibrillator should be considered.For acquired LQTS,it should be better to remove the inducement and treat primary disease actively

  19. Clinical analysis of fulminant myocarditis in children%儿童暴发性心肌炎临床分析

    Institute of Scientific and Technical Information of China (English)

    于霞; 袁越; 王勤; 邵魏; 崔烺; 王颖

    2014-01-01

    Objective To investigate clinical characteristics of children with fulminant myocarditis . Methods The 50 cases of fulminant myocarditis were retrospectively analyzed .The children′s gender, age, clini-cal manifestations , treatment and prognosis were summarized .Results Among fifty cases of fulminant myocarditis in children,16 cases(32.0%) had digestive tract symptoms, 14 cases (28.0%) had cardiovascular symptom, 8 cases (16.0%) had nervous system symptoms .Asperger syndrome was the primary symptom in 26.0%of chil-dren;46 cases (92.0%) had abnormal electrocardiogram;positive rate of myocardial enzyme index and heart col-or doppler flow imaging were 48.0%(24 cases) and 50.0%(25 cases);32 cases were given immunoglobulin in-fusion;44 cases had prednisolone; 28 cases with Ⅲ degree atrioventricular block had temporary pacemaker in-stalled based on the comprehensive treatment .4 cases were given final permanent pacemaker installation .6 cases had lidocaine;7 cases had amiodarone;8 cases were given synchronous cardioerter .17 tachycardia was termina-ted;one case had temporary pacemaker installed after converting sinus rhythm;2 cases with ventricular fibrillation died.Conclusions Most of children with fulminant myocarditis have diverse symptoms and most are not typical ;misdiagnosis rate is high .Comprehensive analysis of the results of electrocardiogram ,echocardiography and myocar-dial enzymology markers may improve the diagnosis of fulminant myocarditis and may also indicate the severity and prognosis.%目的:探讨儿童暴发性心肌炎的临床特征。方法对北京儿童医院2007年1月至2013年5月收治的50例暴发性心肌炎患儿的病历资料进行回顾性分析,对其性别、年龄、临床表现及治疗、预后等进行总结。结果50例暴发性心肌炎患儿中,存在消化道症状16例(32.0%),心血管系统症状14例(28.0%),神经系统症状8例(16.0%),26.0%(13例)的患儿以阿

  20. Effect of beta blocker in treatment of paroxysmal atrial fibrillation:a meta-analysis%β受体阻滞剂治疗阵发性心房颤动疗效及安全性的Meta分析

    Institute of Scientific and Technical Information of China (English)

    张淑娟; 赵庆彦; 代子玄; 王晓占; 郭宗文; 赵红宜

    2015-01-01

    Objective To assess the efficacy and safety of beta blockers in the treatment of paroxysmal atrial fibrilla-tion.Method From 2001 January to 2014 September, computer retrieval of controlled trials in the Cochrane library, PubMed database, Wanfang Data, Chinese academic periodical full-text database, VIP database ( VIP) , the clinical randomized con-trolled trials of beta blocker therapy in patients with paroxysmal atrial fibrillation ( RCT) were collected, 2 reviewers according to the inclusion and exclusion criteria, extracted the data independently, cross check and evaluate the quality of methodology, use RevMan 5 software to perform the Meta-analysis.Result 26 studies of 3368 cases were included.(1) combined with the application of beta blocker therapy in patients with paroxysmal atrial fibrillation was better than amiodarone (OR=1.97, 95%CI 1.49~2.61, P 0.05), the overall induced gastrointestinal adverse reaction rate was lower than the control group (OR=0.48, 95%CI, 0.35~0.66, P =0.05) and ACEI (OR=0.62, 95%CI 0.37~1.04, P >=0.05) showed no significant difference;the overall adverse reaction induced by arrhythmia rate the treatment group was lower than that of control group (OR=0 .60, 95%CI, 0.46~0.79, P <0.05).Conclusion Beta blockers has good clinical efficacy in the treatment of paroxysmal atrial fibrillation with low incidence rate of adverse reaction.Limited with the quality of the included studies, the evaluation of the treatment of paroxysmal atrial fibrillation efficacy and safety need more high quality randomized controlled double-blind trial.%目的:系统评价β受体阻滞剂治疗阵发性心房颤动的有效性及安全性。方法计算机检索2001年1月—2014年9月Cochrane图书馆临床对照试验数据库、Pubmed、万方数据、中国学术期刊全文数据库、维普数据库( VIP)等,收集β受体阻滞剂治疗阵发性房颤的临床随机对照试验( RCT),由2名评价者按纳入、排除标准独立选择

  1. Three steps to manage recurrent ventricular fibrillation during aortic valve replacement in patients with valvular aortic stenosis%三阶段法处理主动脉瓣狭窄患者瓣膜置换术中顽固性心室颤动

    Institute of Scientific and Technical Information of China (English)

    潘志浩; 郭建荣

    2010-01-01

    Objective To study rational method for managing recurrent ventricular fibrillation during aortic valve replacement in patients with valvular aortic stenosis.Methods One hundred consecutive patients with valvular aortic stenosis who scheduled to receive aortic valve replacement were enrolled into the study.Three steps method was applied when ventricular fibrillation occurred after aortic unclamping.The first step was to correct disturbance of internal environment,intravenous lidocaine (100mg) and defibrillation (20-30 W/s); the second step was to inject norepinephrine to maintain mean arterial pressure 70-90 mm Hg (1mm Hg =0.133 kPa),then repeated defibrillation; the third step was infusion of magenisum sulphate (1g) and/or amiodarone (150 mg),then repeated defibrillation.Preoperative left ventricular mass index,mean arterial pressure,nasopharyneal temperature,serum potassium level and hematocrit after aortic unclamping were collected and compared.ResultsAfter aortic unelamping,56 patients recovered spontaneous rhythm without defibrillation,after the first step,16 patients could be defibrillated successfully,other 10 patients recovered spontaneous rhythm after the second step,still other 18 patients remained unresponse untill the third step.Patients who recovered spontaneous rhythm without defibrillation or needed the first step management had significant lower left ventricular ragas index when comparing with patients who entered the second step and third step management respectively [(184±43),(178±51)g/m~2 vs(237±61),(242±46) g/m~2,P<0.05 ].Patients who needed the second step or third step management also had significant higher mean arterial pressure than the other patients.Conclusion Three steps method can be used to manage recurrent ventricular fibrillation during aortic valve replacement in patients with valvular aortic stenosis.%目的 研究主动脉瓣狭窄患者瓣膜置换术中顽周性心室颤动的处理.方法 100例因主动脉瓣狭窄行主

  2. Slow ventricular tachycardia in patients with implantable cardioverter defibrillator%植入植入型心律转复除颤器后慢频率室性心动过速的治疗策略

    Institute of Scientific and Technical Information of China (English)

    孙国建; 何浪; 陈宇宁; 欣明花; 付蕾; 钟诚; 沈法荣

    2016-01-01

    Objective This study aims to assess the incidence of slow ventricular tachycardia ( VT ) and its treatment strategies in implantable cardioverter defibrillator( ICD) patients. Methods All 353 patients with including single and dual-chamber ICD or cardiac resyncronization therapy defibrillator( CRT-D) were en-rolled in this study in Zhejiang Greentown Cardiovascular Hospital from January 2008 to December 2014. Pa-tients had a 3-zone detection configuration: monitoring non treatment(ventricular rate 120 to 180 bpm),anti-tachyarrhythmia pacing(ATP)-low energy shock zone(ventricular rate 180 to 200 bpm),and a ventricular fi-brillation zone.When VT burden was more than 10% and the ventricular rate was less than 160 bpm it needed to optimize the parameters to treat the slow VT. Patients were divided into group A ATP-low energy cardioverter groups(ATP1time-5 J-10 J-maximum energy shock);group B ATP-high energy(ATP 3 times-20 J-the largest energy). Results VT occurred in 102(29%)patients,slow VT occurred in 46(13.1%)patients.Parameters optimization was carried for slow VTs in 27(7. 6%)patients.One time ATP therapy success rate was 67% in group A,ATP+5 J success rate was 79%,ATP+5 J+10 J was 92%. Group B 3 times ATP success rate was 71%,ATP 3 times+20 J was 89%. Conclusion The slow VT had a high incidence in patients with ICD,espe-cially in patients who took up large doses of amiodarone andβreceptor blockers.For patients with heavier bur-den of slow VTs,ATP and small energy electric shock therapy may have greater benefit.%目的:探讨慢频率室性心动过速(室速)在植入植入型心律转复除颤器( ICD)患者中的发生率及治疗策略。方法入选浙江绿城心血管病医院心内科自2008年1月至2014年12月植入的除颤器[单、双腔ICD及心脏再同步治疗除颤器( CRT-D)]患者353例。所有一级预防和二级预防患者按既定不同方案设置参数。术后室速发作负荷≥10%且频率<160次/min定义为需优化参数治

  3. Administração inadvertida de 4 mg de morfina por via subaracnóidea: relato de caso Administración inadvertida de 4 mg de morfina por vía subaracnoidea: relato de caso Accidental subarachnoid administration of 4 mg of morphine: case report

    Directory of Open Access Journals (Sweden)

    Bruno Salomé de Morais

    2008-04-01

    sus potenciales efectos adversos.BACKGROUND AND OBJECTIVES: The subarachnoid administration of morphine is a well-established anesthetic technique of postoperative analgesia due to its efficacy, safety and low cost. The objective of this paper was to report the accidental subarachnoid administration of 4 mg of morphine complicated by atrial fibrillation after administration of naloxone. CASE REPORT: A 45-year old male patient with 75 kg, 1.72 m, physical status ASA II, hypertensive, was scheduled for reconstruction of the anterior cruciate ligament of the left knee. After spinal anesthesia, it was noticed that the vial of morphine had been changed resulting in the accidental subarachnoid administration of 4 mg of morphine (0.4 mL of the 10 mg vial. Respiratory rate varied from 12 to 16 bpm and the patient remained hemodynamically stable without intraoperative complaints. Thirty minutes after admission to the post-anesthesia recovery unit the patient developed vomiting and diaphoresis being treated with 0.4 mg of naloxone followed by continuous infusion of 0.2 mg.h-1 until the symptoms had subsided. Continuous naloxone infusion was maintained in the Intensive Care Unit (ICU, where blood pressure, heart rate, respiratory rate and oxygen saturation were monitored as well as the presence of nausea, pruritus, vomiting, sedation, pain and urinary retention. Two hours after arriving at the ICU the patient developed acute atrial fibrillation without hemodynamic instability. Sinus rhythm was reestablished after the administration of 150 mg of amiodarone and discontinuation of the naloxone infusion. During the following 18 hours the patient remained hemodynamically stable and did not experience any other intercurrence until his discharge from the hospital. CONCLUSIONS: The present report is an alert for the risk of inadvertently switching of drugs during anesthesia, stressing the importance of referring patients being treated for opiate overdose to the ICU, due to the potential

  4. Status of β-blocker use and heart rate control in Chinese patients with stable coronary artery disease%中国稳定性冠心病患者心率控制与β受体阻滞剂使用状况分析

    Institute of Scientific and Technical Information of China (English)

    孙艺红; 余金明; 胡大一

    2016-01-01

    .6 ±10.3 ) years old with 75.6% ( 1 983 ) male patients, 55.0%(1 443) patients had HR≥70 bpm.Mean HR measure by electrocardiogram(ECG) was (69.4 ±10.2)bpm, 50.9%(1 334 cases) patients had myocardial infarction (MI) history.A total of 21.9%(575 cases) patients had anginal symptoms; coronary angiography was performed in 88.8%(2 327 cases) of the patients.76.2%(1 997 cases) patients were treated with BB (any molecule and any dose ), 2.7%(70 cases) with digoxin or derivatives, 3.9%(103 cases) with verapamil or diltiazem, and 1.8%(47 cases) with amiodarone or dronedarone and 0.1%(2 cases) received ivabradine.BB use was similar among 3 HR groups(P>0.05).The independent risk factors associated with HR≥70 bpm were diabetes (OR=1.31), current smoker(OR=1.57), chronic heart failure(CHF) with NYHAⅢ(OR=2.13) and increased diastolic blood pressure ( OR=1.30 ).Conversely , high physical activity ( OR=0.61 ) , former smoker (OR=0.76) and history of percutaneous coronary intervention (PCI, OR=0.80) were associated with lower risk of HR≥70 bpm ( all P<0.05).The independent risk factors associated with non-BB use were older age (OR=1.11, 95%CI 1.01-1.47, P=0.005), lower diastolic blood pressure (OR=1.47, 95%CI 1.32-1.68, P=0.012), no history of MI (OR=1.86,95%CI 1.43-2.44, P<0.001) or PCI (OR=1.94, 95%CI 1.55 -3.73, P <0.001), asthma/chronic obstructive pulmonary disease (OR =1.32, 95%CI 1.15-1.99, P<0.001).Conclusions A total of 76.2%Chinese SCAD patients received BB medication but more than half of them did not reach the optimal HR.Clinical characteristics including diabetes , current smoker , CHF, increased diastolic blood pressure and no PCI were associated with poorly controlled HR(≥70 bpm).More efforts including adjusting the type and dose of heart rate lowering drugs are needed to achieve optimal HR control in Chinese SCAD patients.Clinical Trail Registry International Standard Randomized Controlled Trial ,ISRCTN43070564.