Kumagai Koichiro
Fukuoka Sanno Hospital, Heart Rhythm Center.
Nihon Rinsho. 2013 Jan;71(1):86-90.
Upstream therapy to prevent atrial remodeling associated with hypertension, heart failure, or inflammation may deter the development of new AF or rate of recurrence or progression to permanent AF. Treatments with ACEI, ARB, and statins are usually referred to as upstream therapies for AF. There is a sustained reduction in new-onset AF in patients with significant underlying heart disease treated with ACEI or ARB, but evidence is less robust in patients with moderate structural heart disease and recurrent AF. Evidence in support of the use of statins for prevention of AF, except for post-operative AF, is insufficient to produce any robust recommendation. There is as yet no consensus regarding the intensity and duration of treatment and type of statins.
预防与高血压、心力衰竭或炎症相关的心房重构的上游治疗，可能会阻止新发房颤的发生、复发率或进展为永久性房颤。使用ACEI、ARB和他汀类药物的治疗通常被称为房颤的上游治疗。在患有严重基础心脏病的患者中，使用ACEI或ARB治疗可使新发房颤持续减少，但在中度结构性心脏病和复发性房颤患者中，证据则不那么确凿。除了术后房颤外，支持使用他汀类药物预防房颤的证据不足，无法给出有力的推荐。关于治疗强度、持续时间和他汀类药物类型，目前尚无共识。
