Mehta Nirav N, Greenspon Arnold J
Jefferson Medical College of Thomas Jefferson University, Philadelphia, USA.
Geriatrics. 2003 Apr;58(4):39-44; quiz 45.
Atrial fibrillation (AF) is the most common sustained arrhythmia encountered in primary care practice. Because the prevalence increases with age and the overall population is steadily aging, physicians of all specialties will be faced with managing more AF patients. AF independently increases mortality as well as the risk of stroke, subsequent coronary events, and congestive heart failure. Stroke prevention is particularly important in older patients, since they are at highest risk for these events. In addition, because of an increased risk of proarrhythmia, older adults should be managed cautiously with antiarrhythmic drugs. Data are now emerging on the optimal management of older patients with persistent AF. For each patient, physicians will have to answer the question: is rhythm control better than rate control?
心房颤动（AF）是基层医疗实践中最常见的持续性心律失常。由于其患病率随年龄增长而增加，且总体人口正在稳步老龄化，所有专科的医生都将面临管理更多房颤患者的情况。房颤会独立增加死亡率以及中风、随后的冠状动脉事件和充血性心力衰竭的风险。预防中风在老年患者中尤为重要，因为他们发生这些事件的风险最高。此外，由于心律失常风险增加，老年人使用抗心律失常药物时应谨慎。目前关于老年持续性房颤患者的最佳管理的数据正在不断涌现。对于每位患者，医生都必须回答这个问题：节律控制是否优于心率控制？
