Lopez Carmen M, House-Fancher Mary Ann
Interventional Cardiology Group, The Heart and Vascular Cardiology Group, Tampa, FL, USA.
J Cardiovasc Nurs. 2005 Mar-Apr;20(2):133-40. doi: 10.1097/00005082-200503000-00009.
Atrial fibrillation is the cardiac arrhythmia encountered most often in clinical practice. It is triggered by many conditions such as thyroid dysfunction, cardiac disease, alcohol, and pulmonary disease. Patients with chronic obstructive pulmonary disease (COPD) are susceptible to many insults that can lead to an acute deterioration superimposed on chronic disease. Changes in blood gases, abnormalities in pulmonary functions, and hemodynamic changes resulting from pulmonary hypertension can lead to the development of atrial fibrillation. Atrial fibrillation and COPD frequently coexist and complicate treatment of both conditions. The treatment of COPD exacerbation may include beta-adrenergic agonist and theophylline, which can precipitate atrial fibrillation with rapid ventricular response. Pharmacologic and electrical cardioversion may be ineffective in the management of atrial fibrillation in patients with COPD until respiratory decompensation has been corrected. This article focuses on the management of atrial fibrillation in patients with COPD.
心房颤动是临床实践中最常遇到的心律失常。它由许多情况引发，如甲状腺功能障碍、心脏病、酒精和肺部疾病。慢性阻塞性肺疾病（COPD）患者易受多种损伤，这些损伤可导致在慢性疾病基础上叠加急性恶化。血气变化、肺功能异常以及肺动脉高压引起的血流动力学变化可导致心房颤动的发生。心房颤动和COPD常并存，使两种疾病的治疗都变得复杂。COPD加重期的治疗可能包括β-肾上腺素能激动剂和茶碱，这可能会诱发伴有快速心室反应的心房颤动。在慢性阻塞性肺疾病患者中，在呼吸失代偿得到纠正之前，药物和电复律可能对心房颤动的治疗无效。本文重点关注慢性阻塞性肺疾病患者心房颤动的管理。
