心房颤动:目前认识和治疗建议

发布时间：2018-01-01 18:27

本文关键词：心房颤动:目前认识和治疗建议　出处：《中华心律失常学杂志》2001年02期 　论文类型：期刊论文

【摘要】：心房颤动 (房颤 )是临床最常见的持续性心律失常。尽管房颤本身并不直接危及生命 ,房颤时快速的心室率可引起血流动力学恶化 ,产生明显症状 ,尤其使患者有发生脑血管栓塞的危险。大多数房颤发生在器质性心脏病尤其二尖瓣病变的患者。发生在无可察觉的心血管病和其它病因的孤立性房颤也不少见 ,约占 30 %。除了病因治疗外 ,房颤的处理有 3个策略 ,包括 (1)转复和维持窦性心律 ;(2 )控制心室率 ;和 (3)预防栓塞性事件 ,尤其脑卒中。有些患者需要 1个以上的治疗策略。尽管有一些前瞻性随机对照试验的资料有助于临床医师作出治疗决策 ,但只有抗凝治疗能裨益患者有较多的证据。但是 ,由于种族差异 ,在白种人群中进行的随机临床试验所获得的资料是否适合中国人尚难定论。本文就房颤的目前认识和治疗方法提出建议 ,供广大临床医师参考 ,包括 (1)控制心室率的病例选择及具体方法 ;(2 )药物和非药物方法转复窦性心律 ;(3)抗心律失常药维持窦性心律 ;(4)经胸和心内直流电转复心律 ;(5 )心脏起搏预防房颤复发 ;(6 ) Cox迷宫手术预防房颤复发 ;和 (7)导管射频消融治疗房颤
[Abstract]:Atrial fibrillation (AF) is the most common persistent arrhythmia. Although AF itself does not directly endanger life, rapid ventricular rate during atrial fibrillation can cause hemodynamic deterioration and produce obvious symptoms. Most atrial fibrillation occurs in patients with organic heart disease, especially in patients with mitral valve disease. Isolated atrial fibrillation that occurs in undetectable cardiovascular diseases and other causes is not uncommon. . In addition to etiological treatment, there are three strategies for the management of atrial fibrillation, including 1) recovery and maintenance of sinus rhythm; 2) controlling ventricular rate; Some patients need more than one treatment strategy, although there are some prospective randomized controlled trials that help clinicians make treatment decisions. But only anticoagulant therapy can benefit patients with more evidence. However, due to ethnic differences. It is still difficult to determine whether the data obtained from random clinical trials in white people is suitable for Chinese. This article gives some suggestions on the current understanding and treatment of atrial fibrillation for the reference of the majority of clinicians. Including 1) case selection and specific methods for controlling ventricular rate; 2) conversion of sinus rhythm by drug and non-drug methods; Antiarrhythmic drugs maintain sinus rhythm; 4) transthoracic and intracardiac direct current cardioconversion; 5) cardiac pacing to prevent the recurrence of atrial fibrillation; 6) Cox labyrinth operation to prevent the recurrence of atrial fibrillation; Radiofrequency catheter ablation for atrial fibrillation
【作者单位】：中华医学会心电生理和起搏分会!100037北京阜外医院内中华医学会心电生理和起搏分会!100037北京阜外医院内中华医学会心电生理和起搏分会!100037北京阜外医院内中华医学会心电生理和起搏分会!100037北京阜外医院内中华医学会心电生理和起搏分会!100037北京阜外医院内
【分类号】：R541.75
【正文快照】： 心房颤动 ( atrial fibrillation,AF,房颤 )是临床最常见的持续性心律失常 ,大多发生于器质性心脏病患者 ,少数患者无可发现的心脏病[1,2 ] ,且其发生率随年龄增高 [3 ]。房颤是缺血性脑卒中的主要原因之一 ,尤其老年人 [4 ,5]。房颤很容易由心电图作出诊断。房颤时快速心室

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