心房颤动:频率与节律控制。

HCA healthcare journal of medicine Pub Date : 2023-10-30 eCollection Date: 2023-01-01 DOI:10.36518/2689-0216.1564
Carlos E Vargas, Mina Bhatnagar, Haris Ahmed, Michael G Flynn, Thomas Alexander
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引用次数: 0

摘要

房颤(AF)仍然是世界上最常见的心律失常,预计到2030年仅在美国就会影响大约1200万人。血栓栓塞事件仍然是AF的一个可怕的并发症,应该使用CHA2DS2-VASc评分系统进行治疗和风险分层。房颤的其他并发症范围广泛,从生活质量受损到全因死亡率增加。心率控制策略包括控制心室率,已被证明对无症状房颤患者是一种安全有效的策略。对于患有导致生活质量受损或运动能力下降的症状的患者,使用抗心律失常药物或导管消融来控制心律可能是合适的选择。在比较过去十年的多项研究时,比较速率与节律控制的死亡率效益仍然是模棱两可的。
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Atrial Fibrillation: Rate Versus Rhythm Control.

Description Atrial fibrillation (AF) remains the most common arrhythmia worldwide and is expected to affect approximately 12 million individuals in the United States alone by 2030. Thromboembolic events remain a feared complication of AF and should be treated and risk-stratified utilizing the CHA2DS2-VASc scoring system. Other complications of AF span a wide spectrum from impaired quality of life (QoL) to an increase in all-cause mortality. Rate control strategies consist of controlling the ventricular rate and have been shown to be a safe and effective strategy for asymptomatic AF patients. In patients who are plagued with symptoms leading to impaired QoL or a decrease in exercise capacity, rhythm control with antiarrhythmic drugs or catheter ablation may be suitable options. Mortality benefits when comparing rate versus rhythm control remain equivocal when comparing multiple studies over the past decade.

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