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2023 ACC/AHA/ACCP/HRS 指南:心房颤动的诊断与管理——美国心脏病学会/美国心脏协会联合临床实践指南委员会的报告。

2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.

机构信息

ACC/AHA Joint Committee on Clinical Practice Guidelines liaison.

ACC/AHA Joint Committee on Performance Measures liaison.

出版信息

Circulation. 2024 Jan 2;149(1):e1-e156. doi: 10.1161/CIR.0000000000001193. Epub 2023 Nov 30.

Abstract

AIM

The "2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation" provides recommendations to guide clinicians in the treatment of patients with atrial fibrillation.

METHODS

A comprehensive literature search was conducted from May 12, 2022, to November 3, 2022, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Library, the Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline. Additional relevant studies, published through November 2022, during the guideline writing process, were also considered by the writing committee and added to the evidence tables, where appropriate.

STRUCTURE

Atrial fibrillation is the most sustained common arrhythmia, and its incidence and prevalence are increasing in the United States and globally. Recommendations from the "2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation" and the "2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation" have been updated with new evidence to guide clinicians. In addition, new recommendations addressing atrial fibrillation and thromboembolic risk assessment, anticoagulation, left atrial appendage occlusion, atrial fibrillation catheter or surgical ablation, and risk factor modification and atrial fibrillation prevention have been developed.

摘要

目的

《2023 ACC/AHA/ACCP/HRS 心房颤动诊断与管理指南》提供了指导临床医生治疗心房颤动患者的建议。

方法

从 2022 年 5 月 12 日至 2022 年 11 月 3 日,进行了全面的文献检索,涵盖了在 PubMed、EMBASE、Cochrane 图书馆、美国医疗保健研究与质量局和其他与本指南相关的选定数据库中发表的关于人类受试者的研究、综述和其他证据。在指南编写过程中,编写委员会还考虑了 2022 年 11 月之前发表的与指南相关的其他相关研究,并在适当的情况下将其添加到证据表中。

结构

心房颤动是最常见的持续性心律失常,其在美国和全球的发病率和患病率都在增加。对 2014 年 AHA/ACC/HRS 心房颤动患者管理指南和 2019 年 AHA/ACC/HRS 对 2014 年 AHA/ACC/HRS 心房颤动患者管理指南的重点更新的建议进行了更新,以提供新的证据指导临床医生。此外,还制定了新的建议,涉及心房颤动和血栓栓塞风险评估、抗凝治疗、左心耳封堵、心房颤动导管或手术消融以及危险因素修正和心房颤动预防。

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