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J Cardiovasc Electrophysiol. 2010 Aug 1;21(8):946-58. doi: 10.1111/j.1540-8167.2010.01770.x. Epub 2010 Apr 8.
The Atrial Fibrillation (AF) Exchange Group, an international multidisciplinary group concerned with the management of AF, was convened to review recent advances in the field and the potential impact on treatment strategies.
Issues discussed included epidemiology and the impact of the rising incidence of AF on health care systems, developments in pharmacological and surgical interventions in the management of arrhythmias and thromboprophylaxis, the potential to affect treatment strategies, and barriers to implementing them.
The incidence of AF and the associated burden on health care systems are increasing with aging populations, prevalence of comorbidities and more effective treatment of cardiovascular diseases. Advances in available medical treatments, in particular dronedarone and dabigatran, with other products in development, offer the possibility of changes in treatment paradigms and a greater emphasis on reducing hospitalizations and improvement in long-term outcomes instead of a symptom/safety-driven approach in which the priority is symptom suppression without provoking drug toxicity. Developments in catheter ablation techniques may mean that, in experienced centers, ablation may be offered as first-line treatment in selected patient populations. Barriers to optimal treatment include underdiagnosis, lack of recognition as a serious condition and as a risk factor for stroke, limited access to care, inadequate implementation of guidelines, and poor adherence to treatment.
The focus of the management of AF may be changing as a consequence of new treatments based on the outcome improvements they offer. However, the benefits will not be fully realized if guidelines and guidance are not observed in routine clinical practice.
心房颤动（AF）交换小组，一个关注 AF 管理的国际多学科小组，聚集在一起审查该领域的最新进展及其对治疗策略的潜在影响。
讨论的问题包括流行病学以及 AF 的发病率上升对医疗保健系统的影响、心律失常和血栓预防的药物和手术干预的发展、对治疗策略产生影响的潜力以及实施这些策略的障碍。
随着人口老龄化、合并症的流行以及心血管疾病的更有效治疗，AF 的发病率及其对医疗保健系统的负担正在增加。现有治疗方法的进展，特别是多非利特和达比加群，以及其他正在开发的产品，为改变治疗模式提供了可能性，并更加重视减少住院治疗和改善长期结果，而不是以症状/安全性为导向的方法，这种方法的重点是抑制症状而不引起药物毒性。导管消融技术的发展可能意味着，在有经验的中心，消融可能作为某些患者群体的一线治疗方法提供。优化治疗的障碍包括诊断不足、对严重疾病和中风风险因素的认识不足、获得护理的机会有限、指南实施不足以及对治疗的依从性差。
由于新的治疗方法提供了更好的结果，AF 的管理重点可能正在发生变化。然而，如果在常规临床实践中不遵守指南和指导，这些益处将无法完全实现。
