心律控制的时代:房颤抗心律失常药物的流行病学和临床影响综述

C. Dye, Jamario Skeete, Asad Khan, Michael Dunleavy, Michael Dietrich, A. Volgman, Parikshit S. Sharma, Henry Huang
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引用次数: 0

摘要

心房颤动被描述为一种全球流行病,在过去50年中发病率增加了三倍。随着心房颤动患病率的持续增长,已经设计了多项具有里程碑意义的试验来确定治疗心房颤动的最佳方法。初步试验表明,心率控制并不劣于节律控制,然而,随着心房颤动节律控制的疗效提高,节律控制也显示出了益处。由于这种增加心律控制的趋势,越来越多的患者接受了抗心律失常药物治疗。本文将综述抗心律失常药物应用的流行病学和临床影响。随着我们进入节奏控制时代,需要提高对这些药物可能发生的监测和潜在不良事件的认识。提供者必须平衡对心律控制的日益重视与药物间相互作用和不同合并症可能发生的不良反应对患者的总体临床影响。如果心律控制的临床势头持续下去,将需要进行真实世界的数据分析,以评估抗心律失常药物的使用、风险和益处的临床影响。
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The Era of Rhythm Control: A Review of the Epidemiology and Clinical Impact of Anti-Arrhythmic Medications in Atrial Fibrillation
Atrial fibrillation has been described as a global epidemic with a three-fold increase in prevalence in the last 50 years. As the prevalence of atrial fibrillation continues to grow, multiple landmark trials have been designed to determine the best method to treat atrial fibrillation. Initial trials have stated that rate control was not inferior to rhythm control, however, as the efficacy of rhythm control of atrial fibrillation has improved, a benefit in rhythm control has been shown. Because of this trend towards increased rhythm control, more patients have been placed on anti-arrhythmic medications. This paper will review the epidemiology and clinical impact of the utilization of anti-arrhythmic medications. As we enter the era of rhythm control, increased awareness is needed regarding the monitoring and potential adverse events that can occur with these medications. Providers must balance the increased emphasis on rhythm control with the overall clinical impact on their patients due to drug-to-drug interactions and adverse effects that can occur with different co-morbidities. If the clinical momentum towards rhythm control continues, real-world data analysis will be needed to evaluate the clinical impact of the use, risk, and benefits of anti-arrhythmic medications.
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