PDF(Pubmed)
Abstract：
Left ventricular assist devices (LVADs) are widely used as end-stage therapy in patients with advanced heart failure, whereas implantation increases the risks of development of sustained ventricular tachycardia at the later postimplantation stage. Therefore, this study aimed to evaluate the clinical efficacy of orally administered amiodarone and propranolol in 3 patients with ventricular tachycardia (VT) after LVAD implantation who were resistant to initial anti-antiarrhythmic drugs. This retrospective cohort study consisted of the initial evaluation of the clinical data of 14 adult patients who underwent implantation of LVAD between January 2019 and March 2021. A total of 3 patients with resistant VT were finally included. In all cases, the patients were initially administered amiodarone in the different doses intravenously to stabilize the critical condition, whereas its oral form along with that of propranolol was used as maintenance therapy in the first 2 cases. In the third case, amiodarone was withdrawn because of the risk of development of hyperthyroidism, while oral propranolol was used in the treatment. The assessment in the 16-month follow-up period after discharge did not show presence of non-sustained and sustained VT in all 3 cases. In the ventricular arrhythmia-free group, the total mortality rate within the follow-up period was 11.1 ± 7.78 months in the 3 patients. We suggest that maintenance oral therapy of propranolol and amiodarone can significantly decrease the risks of complications in patients with VT after implantation of ventricular assist device in the long term.
摘要：
左心室辅助装置（LVAD）被广泛用作晚期心力衰竭患者的终末期治疗，而植入会增加植入后后期发生持续性室性心动过速的风险。因此,本研究旨在评估口服胺碘酮和普萘洛尔治疗3例LVAD植入术后室性心动过速(VT)患者的临床疗效,这些患者对初始抗心律失常药物耐药.这项回顾性队列研究包括对2019年1月至2021年3月期间接受LVAD植入的14例成年患者的临床数据的初步评估。最终纳入3例难治性VT患者。在所有情况下,患者最初静脉注射不同剂量的胺碘酮以稳定病情，而其口服形式与普萘洛尔一起用作前2例的维持治疗。在第三种情况下，胺碘酮因甲状腺功能亢进的风险而被停用，而口服普萘洛尔用于治疗。出院后16个月随访期的评估未显示所有3例患者均存在非持续性和持续性VT。在无室性心律失常组中,3例患者随访期间总死亡率为11.1±7.78个月.我们建议普萘洛尔和胺碘酮的维持口服治疗可以显着降低长期植入心室辅助装置后室性心动过速患者并发症的风险。
