Artang Ramin, Vidaillet Humberto
Marshfield Clinic and St Joseph's Hospital, Marshfield, Wisconsin 54449-5777, USA.
J Interv Card Electrophysiol. 2004;10 Suppl 1:33-44. doi: 10.1023/B:JICE.0000011344.01006.a1.
Decision-making regarding thromboembolism prophylaxis in atrial fibrillation remains a major clinical challenge. While evidence of the beneficial effect of anticoagulation for patients participating in clinical trials is well established, only half of eligible individuals in the general population are currently treated with warfarin. Using an evidence-based approach, this review covers major therapeutic approaches in practice today and many of those expected to be released in the near future. Pharmacologic agents evaluated include warfarin, aspirin, other antiplatelets agents, direct thrombin inhibitors and antiarrhythmic drugs. Nonpharmacologic treatments reviewed include surgical and catheter ablation, pacing, left atrial appendage ligation and occlusion methods, and atrial defibrillators.
心房颤动患者血栓栓塞预防的决策仍然是一项重大的临床挑战。虽然抗凝治疗对参与临床试验患者的有益效果已有充分证据，但目前普通人群中只有一半符合条件的个体接受华法林治疗。本综述采用循证医学方法，涵盖了当今临床实践中的主要治疗方法以及许多预计在不久的将来推出的方法。评估的药物制剂包括华法林、阿司匹林、其他抗血小板药物、直接凝血酶抑制剂和抗心律失常药物。综述的非药物治疗方法包括外科手术和导管消融、起搏、左心耳结扎和封堵方法以及心房除颤器。
