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心房颤动:通过心率和节律管理实现更好的症状控制。

Atrial fibrillation: better symptom control with rate and rhythm management.

作者信息

Gupta Dhiraj, Rienstra Michiel, van Gelder Isabelle C, Fauchier Laurent

机构信息

Liverpool Heart & Chest Hospital, Thomas Drive, Liverpool, United Kingdom.

Liverpool Centre for Cardiovascular Science, University of Liverpool, United Kingdom.

出版信息

Lancet Reg Health Eur. 2024 Feb 1;37:100801. doi: 10.1016/j.lanepe.2023.100801. eCollection 2024 Feb.

Abstract

Atrial fibrillation (AF) is often associated with limiting symptoms, and with significant impairment in quality of life. As such, treatment strategies aimed at symptom control form an important pillar of AF management. Such treatments include a wide variety of drugs and interventions, including, increasingly, catheter ablation. These strategies can be utilised either singly or in combination, to improve and restore quality of life for patients, and this review covers the current evidence base underpinning their use. In this Review, we discuss the pros and cons of rate vs. rhythm control, while offering practical tips to non-specialists on how to utilise various treatments and counsel patients about all relevant treatment options. These include antiarrhythmic and rate control medications, as well as interventions such as cardioversion, catheter ablation, and pace-and-ablate.

摘要

心房颤动(AF)常伴有症状受限以及生活质量的显著下降。因此,旨在控制症状的治疗策略构成了房颤管理的重要支柱。此类治疗包括多种药物和干预措施,其中越来越多地采用导管消融术。这些策略可以单独使用或联合使用,以改善和恢复患者的生活质量,本综述涵盖了支持其使用的当前证据基础。在本综述中,我们讨论了心率控制与节律控制的利弊,同时为非专科医生提供实用建议,说明如何使用各种治疗方法以及就所有相关治疗选择向患者提供咨询。这些治疗方法包括抗心律失常药物和心率控制药物,以及诸如心脏复律、导管消融和起搏消融等干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fd6/10866934/7bbde5ea7498/gr1.jpg

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