Van Lieshout J, Boode B S P, Assendelft W J J
Nederlands Huisartsen Genootschap, afd. Richtlijnontwikkeling en Wetenschapsbeleid, Postbus 3231. 3502 GE Utrecht.
Ned Tijdschr Geneeskd. 2004 Jul 17;148(29):1435-9.
The practice guideline 'Atrial fibrillation' from the Dutch College of General Practitioners provides the general practitioner with guidelines for the diagnosis and management of patients with atrial fibrillation. Atrial fibrillation can be detected by observation of the cardiac rhythm during every measurement of the blood pressure. The diagnosis 'atrial fibrillation' must be made on the basis of an ECG. Atrial fibrillation must not be looked upon as an isolated phenomenon: possible comorbidity (cerebral infarction ('transient ischaemic attack'; TIA), hypertension, diabetes mellitus, heart failure, coronary heart disease, hyperthyroidism) should be taken into consideration in the evaluation. Particular attention should be given to determining whether heart failure is also present. An important goal of treatment is the prevention of thromboembolic complications. Cardioversion is not generally recommended. The symptoms may be an indication that an attempt should be made to restore sinus rhythm. This constitutes one of the indications for referral for specialised treatment.
荷兰全科医生学院的“心房颤动”实践指南为全科医生提供了心房颤动患者诊断和管理的指导方针。每次测量血压时观察心律即可检测出心房颤动。“心房颤动”的诊断必须基于心电图。心房颤动不应被视为孤立现象:在评估时应考虑可能的合并症(脑梗死(“短暂性脑缺血发作”;TIA)、高血压、糖尿病、心力衰竭、冠心病、甲状腺功能亢进)。应特别注意确定是否也存在心力衰竭。治疗的一个重要目标是预防血栓栓塞并发症。一般不建议进行心脏复律。症状可能表明应尝试恢复窦性心律。这是转诊进行专科治疗的指征之一。