Clinical observation of the effect of amiodarone in the treatment of ventricular arrhythmias following acute myocardial infarction
胺碘酮治疗急性心肌梗死后室性心律失常临床效果观察

摘要

目的 探讨胺碘酮治疗急性心肌梗死后室性心律失常的临床效果，评估其在控制节律异常等方面的综合价值。方法 选取2024年1月至2025年1月期间我院收治的急性心肌梗死合并室性心律失常患者97例，依据随机数字表法分为对照组48例和实验组49例。对照组接受标准化常规治疗，实验组在此基础上联合静脉和口服胺碘酮。比较两组患者的心律恢复时间等指标。结果 实验组在1小时内心律恢复率为46.94%，高于对照组的18.75%；治疗后72小时内心律失常控制率达93.88%，亦优于对照组的66.67%。QT间期延长增幅超过60ms者实验组为8.16%，未见致命性节律事件。实验组不良反应发生率为24.49%，略高于对照组，但均为可控轻中度事件。院期间严重室性心律失常再发率实验组为6.12%，远低于对照组的20.83%，差异具有统计学意义（P<0.05）。结论 胺碘酮干预可提升急性心肌梗死后室性心律失常的节律控制效率及心律稳定性，具备快速起效可控风险等多重优势，适合早期临床干预使用。

Abstract

Objective To investigate the clinical effect of amiodarone in the treatment of ventricular arrhythmias after acute myocardial infarction, and to evaluate its comprehensive value in controlling rhythm abnormalities.
Methods A total of 97 patients with acute myocardial infarction and ventricular arrhythmia admitted to our hospital from January 2024 to January 2025 were selected and divided into 48 cases in the control group and 49 cases in the experimental group according to the random number table method. The control group received standardized conventional treatment, and the experimental group combined with intravenous and oral amiodarone on this basis. The two groups of patients were compared with the heart rhythm recovery time and other indicators.
Results The heart rhythm recovery rate of the experimental group was 46.94% within 1 hour, which was higher than that of the control group(18.75%).The arrhythmia control rate was93.88%within 72 hours after treatment, which was better than that of the control group(66.67%).The increase of QT prolongation was 8.16% in the experimental group with more than 60 ms, and no fatal rhythm events were observed. The incidence of adverse reactions in the experimental group was 24.49%, which was slightly higher than that in the control group, but all were controllable mild to moderate events. The recurrence rate of severe ventricular arrhythmias during hospitalization was 6.12% in the experimental group, which was much lower than that of the control group (20.83%),and the difference was statistically significant (P<0.05).
Conclusion   Amiodarone intervention can improve the rhythm control efficiency and rhythm stability of ventricular arrhythmias after acute myocardial infarction, and has multiple advantages such as rapid onset and controllable risk, making it suitable for early clinical intervention.