Department of Neurology, University of California, San Francisco, USA.
Curr Atheroscler Rep. 2011 Aug;13(4):338-43. doi: 10.1007/s11883-011-0180-5.
Identifying atrial fibrillation (AF) as the cause of stroke is important because it may trigger a change from therapy with antiplatelet agents to proven superior therapy with anticoagulants. Ischemic stroke due to chronic AF is readily diagnosed, but if patients with intermittent AF remain in sinus rhythm throughout their hospitalization, they will likely be discharged on inferior treatment. Numerous monitoring techniques can identify intermittent AF, and the available evidence suggests that prolonging the duration of monitoring increases the likelihood of detecting AF, which supports the use of monitoring beyond the currently recommended 24 h. Further research is required to definitively establish the utility of cardiac monitoring and identify the optimum method and duration. The promise of new drugs to replace warfarin in the near future reinforces the importance of this line of research. Even using current therapeutics, optimizing the diagnosis of AF remains a key component of quality care for patients with ischemic stroke.
确定房颤（AF）是中风的病因很重要，因为这可能会促使治疗策略从抗血小板药物转为疗效更为确切的抗凝治疗。由慢性 AF 导致的缺血性中风很容易诊断，但如果间歇性 AF 患者在整个住院期间保持窦性心律，他们很可能会接受较差的治疗。许多监测技术可以识别间歇性 AF，现有证据表明延长监测时间会增加检测到 AF 的可能性，这支持在目前推荐的 24 小时之外进行监测。需要进一步的研究来明确心脏监测的效用，并确定最佳的方法和时间。在不久的将来，新型药物替代华法林的前景进一步强调了这方面研究的重要性。即使使用现有的治疗方法，优化 AF 的诊断仍然是缺血性中风患者高质量护理的关键组成部分。
