[European Society of Cardiology (ESC) guidelines on atrial fibrillation 2024 : What is new and what is important?]

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Herz Pub Date : 2025-02-01 Epub Date: 2024-11-27 DOI:10.1007/s00059-024-05287-6

Robert Hättasch, Verena Tscholl, Gerhard Hindricks, Nikolaos Dagres

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Abstract

The 2024 guidelines of the European Society of Cardiology (ESC) on atrial fibrillation (AF) present current and comprehensive recommendations for the diagnosis, prevention and treatment of AF. They are based on the AF-CARE treatment pathway, which includes modification of cardiovascular risk factors, stroke prevention, symptom management and continuous re-evaluation. Accordingly, all patients with newly diagnosed AF should undergo transthoracic echocardiography. Sodium-glucose cotransporter 2 (SGLT2) inhibitors are recommended for the treatment of heart failure across all clinical and echocardiographic levels of left ventricular ejection fraction (LVEF). The CHA2DS2-VASc score has been simplified to the CHA2DS2-VA score for the risk assessment of thromboembolism. For rate or rhythm control pharmacotherapy with beta-blockers, digitalis, amiodarone and flecainide are still the most important drugs. Pulmonary vein isolation is now also recommended as a first-line treatment for paroxysmal AF. Re-evaluation of risk factors and treatment of comorbidities is also emphasized. Overall the guidelines represent a further development and update based on recent studies. They remain practical and provide clear and detailed recommendations for action that are globally recognized in the clinical practice.

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[欧洲心脏病学会（ESC）心房颤动指南 2024 ：什么是新的，什么是重要的？］

欧洲心脏病学会（ESC）关于心房颤动（AF）的 2024 年指南为心房颤动的诊断、预防和治疗提供了最新、最全面的建议。该指南以 AF-CARE 治疗路径为基础，其中包括心血管风险因素的调整、中风的预防、症状管理和持续的再评估。因此，所有新确诊的房颤患者都应接受经胸超声心动图检查。钠-葡萄糖共转运体 2（SGLT2）抑制剂被推荐用于治疗所有临床和超声心动图左室射血分数（LVEF）水平的心力衰竭。用于血栓栓塞风险评估的 CHA2DS2-VASc 评分已简化为 CHA2DS2-VA 评分。在控制心率或心律方面，β-受体阻滞剂、洋地黄、胺碘酮和非卡因仍是最重要的药物。目前还建议将肺静脉隔离作为阵发性房颤的一线治疗方法。重新评估风险因素和治疗合并症也得到了强调。总体而言，该指南是在近期研究基础上的进一步发展和更新。这些指南依然实用，并提供了全球临床实践中公认的明确而详细的行动建议。

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来源期刊

Herz 医学-心血管系统

CiteScore

3.00

自引率

5.90%

发文量

审稿时长

4-8 weeks

期刊介绍： Herz is the high-level journal for further education for all physicians interested in cardiology. The individual issues of the journal each deal with specific topics and comprise review articles in English and German written by competent and esteemed authors. They provide up-to-date and comprehensive information concerning the speciality dealt with in the issue. Due to the fact that all relevant aspects of the pertinent topic of an issue are considered, an overview of the current status and progress in cardiology is presented. Reviews and original articles round off the spectrum of information provided.