作者分析顽固性心房颤动(房颤)患者口服胺碘酮的复律效果及其预报因子。方法:经奎尼丁、普鲁卡因酰胺、双异苯丙胺治疗无效的症状性房颤患者68(男37、女31)例,平均年龄59(25～75)岁,包括冠心病15例、风心病13例、高血压症12例、孤立性房颤9例、病态窦房结综合征7例、特发性扩张性心肌病6例、二尖瓣替换术后3例及肥厚性心肌病和慢性阻塞性肺部病变各2例。胺碘酮口服剂量:初次为800mg/day,一周后减至400mg/day。根据药效及不良作用,维持剂量为200～400mg/day,使血药浓度保持在1.0～2.5mg/L。治疗4～6周后,28例未恢复正常窦性心律,接受电复律术。胺碘酮治疗4周以上且血药浓度≥1.0mg/L,方可评价疗效。治疗有效的标准为:心房颤动停止发作;或者临床复发率减少75%以上且发作可自行终止,症状能耐受。阵发性房颤或房颤持续时间不足1年者(54例)为组Ⅰ,房颤持续时间超过1年者(14例)为组Ⅱ。服胺碘酮后随访3～56(平均21)个月。结果:54例长期口服胺碘酮治疗有效,总有效 The authors analyzed the effect and its predictors of the effect of oral administration of amiodarone in patients with refractory atrial fibrillation (AF). Methods: Sixty-eight patients (37 males and 31 females) with symptomatic atrial fibrillation who were treated with quinidine, procainamide and diisopropylamine, mean age 59 (25-75) years old, included 15 patients with coronary heart disease, 13 cases of rheumatic heart disease, 12 cases of hypertension, 9 cases of isolated atrial fibrillation, 7 cases of sick sinus syndrome, 6 cases of idiopathic dilated cardiomyopathy, 3 cases of mitral valve replacement and hypertrophic cardiomyopathy And chronic obstructive pulmonary disease in 2 cases. Amiodarone Oral dose: initial 800mg / day, reduced to 400mg / day one week later. According to the efficacy and adverse effects, to maintain the dose of 200 ~ 400mg / day, so that blood concentration remained at 1.0 ~ 2.5mg / L. After 4 to 6 weeks of treatment, 28 patients did not return to normal sinus rhythm and received electrical cardioversion. Amiodarone treatment for more than 4 weeks and blood concentration ≥ 1.0mg / L, before evaluation of efficacy. Effective treatment criteria are: atrial fibrillation to stop seizures; or clinical recurrence rate decreased by more than 75% and the onset can be terminated on their own, the symptoms can tolerate. Paroxysmal atrial fibrillation or atrial fibrillation duration less than 1 year (54 cases) for the group Ⅰ, atrial fibrillation for more than 1 year (14 cases) for the group Ⅱ. After taking amiodarone 3 to 56 years (average 21) months. Results: 54 cases of long-term oral amiodarone treatment is effective, always effective