心房颤动处理策略上的一些新认识

Some New Understandings in Treatment with Atrial Fibrillation

阐述近年来对心房颤动部分处理方法的新进展。心室率控制:质疑静息中或剧烈活动时严格控制心室率,引用RACE2研究,提出宽松的心率控制,其预后与严格控制的相仿。药物转复房颤:首选为胺碘酮,决奈达龙已获FDA批准用于非永久性房颤,伊布利特近年提出在射频消融过程中应用,可使心房碎裂波区缩小,消融易成功。其他新药尚无临床确切疗效。消融技术提出用冷冻球囊,于隔离肺静脉与心房后应用。副作用少,疗效显著。抗凝治疗:仍推荐用华法林。Xa抑制剂已获重视。不少新型制剂仍需临床观察,以判定其与其他药物的相互影响等。

This paper is to expound new progression in atrial fibrillation processing in recent years.Ventricular rate control： RACEⅡ research proposed that it is similar between lenient heart rate controlling and strictly controlling in prognosis.So strictly controlling the ventricular rate is questioning.Drug converting atrial fibrillation： first choice for Amiodarone,Dronedarone has been approved by FDA for the nonpermanent AF,Ibutilide in recent years is put forward in radiofrequency ablation,CFAE narrowing can make ablation is easy to succeed.Other drugs there had been no clinical exactly curative effect.Anticoagulation： still recommended for Warfarin.Xa inhibitor has been seriously consideration.Many new preparations still need clinical observation,to determine the interaction with other drugs,etc.