Background Atrial fibrillation (AF) is a common arrhythmia associated with increased cardiovascular morbidity and mortality This study was undertaken to analyze the epidemiological factors and evaluate the current sta...Background Atrial fibrillation (AF) is a common arrhythmia associated with increased cardiovascular morbidity and mortality This study was undertaken to analyze the epidemiological factors and evaluate the current status of treatment in patients with AF in China's Mainland Methods Retrospective analysis of hospital records were taken from patients with primary diagnosis of AF, discharged from January 1999 to December 2001 A total of 9297 cases (mean age 65 5 years) with AF were enrolled from 40 hospitals in major parts of China Results The percentage of hospital admissions with AF was gradually increased comparing to those of total cardiovascular admission during three years, with the average of 7 9% The cases distribution progressively rose with age The causes and associated conditions of AF: advanced age 58 1%, hypertension 40 3%, coronary heart disease 34 8%, heart failure 33 1%, rheumatic valvular disease 23 9%, idiopathic AF 7 4%, cardiomyopathy 5 4%, diabetes 4 1% The most common coexistence among these variables was advanced age with hypertension Permanent AF almost accounted for half of these cases (49 5%), paroxysmal and persistent AF were 33 7% and 16 7%, respectively Paroxysmal AF was mainly treated with rhythm control (56 4%) However, 82 8% of patients with chronic AF had therapeutic strategy of rate control In patients with persistent AF, the cardioversion had been attempted in cases more than 50%, with only 31 1% of these patients who could maintain stabilized sinus rhythm The prevalence of stroke in this group was 17 5% In nonvalvular AF patients the risk factors that significantly associated with stroke included advanced age, history of hypertension, coronary heart disease and type of AF Sixty four point five percent of these patients received antithrombotic therapy with dominated use of antiplatelet agents The long term prevention with anticoagulants only accounted for 6 6% In this investigation patients with antiplatelets as well as patients with anticoagulants showed significant lower stroke rate in comparison with those managed neither However, the difference between antiplatelets and anticoagulants in terms of stroke rate was not significant Conclusions Most epidemiological factors of AF from this group showed highly in accordance with those from the reports from other countries, such as age distribution, causes and associated conditions, type of AF, dominantly with approach of rate control Both antiplatelet and anticoagulant treatments significantly reduced stroke rate But there was no significant difference between these two kinds of treatments in reducing stroke rate展开更多
目的评价心脏再同步化治疗(CRT)慢性心力衰竭(心衰)合并持续性心房颤动(房颤)患者的临床疗效。方法选择慢性心衰患者23例,其中13例窦性心律患者及4例房颤患者(房颤CRT患者)接受双心室起搏治疗,另6例房颤患者(药物治疗患者)继续服用抗心...目的评价心脏再同步化治疗(CRT)慢性心力衰竭(心衰)合并持续性心房颤动(房颤)患者的临床疗效。方法选择慢性心衰患者23例,其中13例窦性心律患者及4例房颤患者(房颤CRT患者)接受双心室起搏治疗,另6例房颤患者(药物治疗患者)继续服用抗心衰药物治疗。术后3个月进行随访,观察患者的心功能分级(NYHA),6 min步行距离,超声心动图测定各房室腔内径大小、LVEF、二尖瓣反流以及速度向量成像超声评价同步性参数的变化。结果 17例患者三腔起搏器置入术均取得成功。术后3个月随访,房颤CRT患者心功能分级[(3.00±0.00)级vs(2.25±0.50)级]、左心房内径[(52.75±3.50)mm vs (45.25±3.50)mm,P<0.05]、LVEF[(36.25±4.79)% vs (42.00±5.16)%]及二尖瓣反流(3.25±0.50 vs 1.50±0.58,P<0.01)较术前均有明显改善,速度向量成像超声结果显示,室内不同步较术前有明显改善。与药物治疗患者比较,房颤CRT患者LVEF、左心房内径、二尖瓣反流明显改善。结论对于慢性心衰合并持续性房颤患者,在有效控制心室率的基础上行CRT明显优于药物保守治疗,与窦性心律患者一样可以改善心功能。展开更多
文摘Background Atrial fibrillation (AF) is a common arrhythmia associated with increased cardiovascular morbidity and mortality This study was undertaken to analyze the epidemiological factors and evaluate the current status of treatment in patients with AF in China's Mainland Methods Retrospective analysis of hospital records were taken from patients with primary diagnosis of AF, discharged from January 1999 to December 2001 A total of 9297 cases (mean age 65 5 years) with AF were enrolled from 40 hospitals in major parts of China Results The percentage of hospital admissions with AF was gradually increased comparing to those of total cardiovascular admission during three years, with the average of 7 9% The cases distribution progressively rose with age The causes and associated conditions of AF: advanced age 58 1%, hypertension 40 3%, coronary heart disease 34 8%, heart failure 33 1%, rheumatic valvular disease 23 9%, idiopathic AF 7 4%, cardiomyopathy 5 4%, diabetes 4 1% The most common coexistence among these variables was advanced age with hypertension Permanent AF almost accounted for half of these cases (49 5%), paroxysmal and persistent AF were 33 7% and 16 7%, respectively Paroxysmal AF was mainly treated with rhythm control (56 4%) However, 82 8% of patients with chronic AF had therapeutic strategy of rate control In patients with persistent AF, the cardioversion had been attempted in cases more than 50%, with only 31 1% of these patients who could maintain stabilized sinus rhythm The prevalence of stroke in this group was 17 5% In nonvalvular AF patients the risk factors that significantly associated with stroke included advanced age, history of hypertension, coronary heart disease and type of AF Sixty four point five percent of these patients received antithrombotic therapy with dominated use of antiplatelet agents The long term prevention with anticoagulants only accounted for 6 6% In this investigation patients with antiplatelets as well as patients with anticoagulants showed significant lower stroke rate in comparison with those managed neither However, the difference between antiplatelets and anticoagulants in terms of stroke rate was not significant Conclusions Most epidemiological factors of AF from this group showed highly in accordance with those from the reports from other countries, such as age distribution, causes and associated conditions, type of AF, dominantly with approach of rate control Both antiplatelet and anticoagulant treatments significantly reduced stroke rate But there was no significant difference between these two kinds of treatments in reducing stroke rate
文摘目的评价心脏再同步化治疗(CRT)慢性心力衰竭(心衰)合并持续性心房颤动(房颤)患者的临床疗效。方法选择慢性心衰患者23例,其中13例窦性心律患者及4例房颤患者(房颤CRT患者)接受双心室起搏治疗,另6例房颤患者(药物治疗患者)继续服用抗心衰药物治疗。术后3个月进行随访,观察患者的心功能分级(NYHA),6 min步行距离,超声心动图测定各房室腔内径大小、LVEF、二尖瓣反流以及速度向量成像超声评价同步性参数的变化。结果 17例患者三腔起搏器置入术均取得成功。术后3个月随访,房颤CRT患者心功能分级[(3.00±0.00)级vs(2.25±0.50)级]、左心房内径[(52.75±3.50)mm vs (45.25±3.50)mm,P<0.05]、LVEF[(36.25±4.79)% vs (42.00±5.16)%]及二尖瓣反流(3.25±0.50 vs 1.50±0.58,P<0.01)较术前均有明显改善,速度向量成像超声结果显示,室内不同步较术前有明显改善。与药物治疗患者比较,房颤CRT患者LVEF、左心房内径、二尖瓣反流明显改善。结论对于慢性心衰合并持续性房颤患者,在有效控制心室率的基础上行CRT明显优于药物保守治疗,与窦性心律患者一样可以改善心功能。
