Dronedarone for the Treatment of Atrial Arrhythmias in Adults With Congenital Heart Disease

IF 0.8 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Mahdi S. Agha, Peter R. Ermis, Wayne J. Franklin, Dhaval R. Parekh, Angeline D. Opina, Jeffrey J. Kim, Christina Y. Miyake, Santiago O. Valdes, Wilson W. Lam
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引用次数: 0

Abstract

Background:

Atrial tachyarrhythmias are common and difficult to treat in adults with congenital heart disease. Dronedarone has proven effective in patients without congenital heart disease, but data are limited about its use in adults with congenital heart disease of moderate to great complexity.

Methods:

A single-center, retrospective chart review of 21 adults with congenital heart disease of moderate to great complexity who were treated with dronedarone for atrial tachyarrhythmias was performed.

Results:

The median (IQR) age at dronedarone initiation was 35 (27.5-39) years. Eleven patients (52%) were male. Ten patients (48%) had New York Heart Association class I disease, 10 (48%) had class II disease, and 1 (5%) had class III disease. Ejection fraction at initiation was greater than 55% in 11 patients (52%), 35% to 55% in 9 patients (43%), and less than 35% in 1 patient (5%). Prior treatments included β-blockers (71%), sotalol (38%), amiodarone (24%), digoxin (24%), and catheter ablation (38%). Rhythm control was complete in 5 patients (24%), partial in 6 (29%), and inadequate in 10 (48%). Two patients (10%) experienced adverse events, including nausea in 1 (5%) and cardiac arrest in 1 (5%), which occurred 48 months after initiation of treatment. There were no deaths during the follow-up period. The median (IQR) follow-up time for patients with complete or partial rhythm control was 20 (1-54) months.

Conclusion:

Dronedarone can be effective for adult patients with congenital heart disease and atrial arrhythmias for whom more established therapies have failed, and with close monitoring it can be safely tolerated.

治疗先天性心脏病成人房性心律失常的决奈达隆
背景:房性快速性心律失常在患有先天性心脏病的成人中很常见,而且难以治疗。方法:对 21 名患有中度至高度复杂性先天性心脏病并接受决奈达隆治疗的成人房性快速性心律失常患者进行了单中心回顾性病历审查。11名患者(52%)为男性。10名患者(48%)患有纽约心脏协会Ⅰ级疾病,10名患者(48%)患有Ⅱ级疾病,1名患者(5%)患有Ⅲ级疾病。开始治疗时,11 名患者(52%)的射血分数大于 55%,9 名患者(43%)的射血分数在 35% 至 55% 之间,1 名患者(5%)的射血分数小于 35%。既往治疗包括β受体阻滞剂(71%)、索他洛尔(38%)、胺碘酮(24%)、地高辛(24%)和导管消融(38%)。5 名患者(24%)完全控制了节律,6 名患者(29%)部分控制了节律,10 名患者(48%)节律控制不足。两名患者(10%)出现了不良反应,其中一名患者(5%)出现恶心,一名患者(5%)在开始治疗 48 个月后出现心脏骤停。随访期间无死亡病例。结论:决奈达隆对先天性心脏病和房性心律失常的成年患者很有效,这些患者已接受过多种成熟疗法,但疗效不佳。
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来源期刊
Texas Heart Institute journal
Texas Heart Institute journal 医学-心血管系统
CiteScore
1.10
自引率
11.10%
发文量
131
审稿时长
2 months
期刊介绍: For more than 45 years, the Texas Heart Institute Journal has been published by the Texas Heart Institute as part of its medical education program. Our bimonthly peer-reviewed journal enjoys a global audience of physicians, scientists, and healthcare professionals who are contributing to the prevention, diagnosis, and treatment of cardiovascular disease. The Journal was printed under the name of Cardiovascular Diseases from 1974 through 1981 (ISSN 0093-3546). The name was changed to Texas Heart Institute Journal in 1982 and was printed through 2013 (ISSN 0730-2347). In 2014, the Journal moved to online-only publication. It is indexed by Index Medicus/MEDLINE and by other indexing and abstracting services worldwide. Our full archive is available at PubMed Central. The Journal invites authors to submit these article types for review: -Clinical Investigations- Laboratory Investigations- Reviews- Techniques- Coronary Anomalies- History of Medicine- Case Reports/Case Series (Submission Fee: $70.00 USD)- Images in Cardiovascular Medicine (Submission Fee: $35.00 USD)- Guest Editorials- Peabody’s Corner- Letters to the Editor
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