Effects of Antiarrhythmic Drugs on Inappropriate Shocks in Patients With Implantable Cardioverter Defibrillators
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概要
- 論文の詳細を見る
Background Patients with atrial fibrillation (AF) or congestive heart failure (CHF) are more vulnerable to inappropriate shocks from implantable cardioverter-defibrillators (ICDs), but the effect of antiarrhythmic drugs in these patients remains unknown. Methods and Results A total of 55 patients with AF and/or CHF (New York Heart Association functional class ≥III) who had ICDs were divided into 3 groups [amiodarone (n=24), sotalol (n=12), β-blocker (n=19)] and the cumulative rates of inappropriate shocks were compared. The baseline characteristics of the 3 groups were not significantly different. The 4-year event rate of inappropriate shocks was 27.3% in the amiodarone group, 54.3% in the sotalol group, and 70.6% in the β-blocker group (amiodarone vs β-blocker: log-rank p=0.003; sotalol vs β-blocker: log-rank p=0.16; amiodarone vs sotalol: log-rank p=0.29). Amiodarone reduced the risk of inappropriate shocks significantly as compared with β-blockers (hazard ratio (HR) 0.17; 95% confidence interval (CI) 0.05-0.64; p=0.008), whereas sotalol did not (HR 0.57; 95%CI 0.19-1.68; p=0.3). Amiodarone was discontinued in 4 patients (16.7%) because of pulmonary toxicity and the dose was reduced in 4 patients (16.7%) because of a thyroid function abnormality. Conclusions Amiodarone is more effective than sotalol or β-blockers in preventing inappropriate ICD shocks in patients with AF or CHF, but it has a significant risk of drug-related adverse effects.
- 社団法人日本循環器学会の論文
- 2007-12-20
著者
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CHOI Kee-Joon
Asan Medical Center, Department of Internal Medicine, University of Ulsan College of Medicine
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Kim Hyung
Department of Internal Medicine, Seoul National University College of Medicine, Cardiovascular Labor
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LEE Chang
Department of Oral Biology, Yonsei University College of Dentistry
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Kim Jun
Department of Internal Medicine, Chonnam University Medical School
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Kim Hyung
Department Of Biochemistry Ewha Womans University School Of Medicine
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Kim You-ho
Asan Medical Center Department Of Internal Medicine University Of Ulsan College Of Medicine
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Choi Kee-joon
Asan Medical Center Department Of Internal Medicine University Of Ulsan College Of Medicine
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Nam Gi-byoung
Asan Medical Center Department Of Internal Medicine University Of Ulsan College Of Medicine
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Park Kyoung-min
Sanggye Paik Hospital Department Of Internal Medicine College Of Medicine Inje University
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Nam Gi-Byoung
Department of Internal Medicine, University of Ulsan College of Medicine
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Park Hyun-Gu
Department of Internal Medicine, University of Ulsan College of Medicine
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Park Kyoung-Min
Department of Internal Medicine, University of Ulsan College of Medicine
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Choi Kee-Joon
Department of Internal Medicine, University of Ulsan College of Medicine
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Kim You-Ho
Department of Internal Medicine, University of Ulsan College of Medicine
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Lee Chang
Department Of Animal Science Utsunomiya University
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Lee Chang
Department Of Internal Medicine University Of Ulsan College Of Medicine
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Park Hyun-gu
Department Of Internal Medicine University Of Ulsan College Of Medicine
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Kim Jun
Department Of Ceramic Engineering Yonsei University
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Kim Jun
Pusan National University Yangsan Hospital Department Of Internal Medicine Pusan National University
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Kim Jun
Department Of Bioengineering University Of California Los Angeles
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Kim Hyung
Department Of Internal Medicine University Of Ulsan College Of Medicine
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Kim You-ho
Department Of Internal Medicine Asan Medical Center University Of Ulsan College Of Medicine
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Nam Gi-byoung
Department Of Internal Medicine Asan Medical Center University Of Ulsan College Of Medicine
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Choi Kee-joon
Department Of Internal Medicine Asan Medical Center University Of Ulsan College Of Medicine
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Lee Chang
Departlnent Of Biology College Of Natural Sciences Kyungpook National University Korea
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KIM Jun
Department of Advanced Material Science and Engineering, Yonsei University
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Kim You-Ho
Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center
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Nam Gi-Byoung
Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center
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Choi Kee-Joon
Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center
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