Ferguson Caleb, Inglis Sally C, Newton Phillip J, Middleton Sandy, Macdonald Peter S, Davidson Patricia M
Centre for Cardiovascular and Chronic Care, Faculty Health, University of Technology, Sydney, Australia.
Centre for Cardiovascular and Chronic Care, Faculty Health, University of Technology, Sydney, Australia.
Aust Crit Care. 2014 May;27(2):92-8. doi: 10.1016/j.aucc.2013.08.002. Epub 2013 Sep 18.
Atrial fibrillation (AF) is a common arrhythmia and a risk factor for stroke and other, adverse events. Internationally there have been recent advancements in the therapies available for, stroke prevention in AF. Nurses will care for individuals with AF across a variety of primary and acute, care settings and should be familiar with evidence based therapies.
This paper provides a review of the epidemiology of AF and stroke, stroke and bleeding risk, assessment tools and evidence based treatments for the prevention of stroke in AF including the use of, novel anti-thrombin agents.
A review of key databases was conducted from 2002 to 2012 using the key search terms 'atrial, fibrillation' 'anticoagulation' 'risk assessment' and 'clinical management'. The following electronic, databases were searched: CINAHL, Medline, Scopus, the Cochrane Library and Google Scholar., Reference lists were manually hand searched. Key clinical guidelines from National Institute for, Clinical Excellence (NICE, UK), American Heart Association (AHA, USA), American College of Cardiology, (ACC, USA) and the European Society of Cardiology (ESC) and key government policy documents were, also included. Articles were included in the review if they addressed nursing management with a focus, on Australia.
Many treatment options exist for AF. Best practice guidelines make a variety of, recommendations which include cardioversion, ablation, pulmonary vein isolation, pharmacological, agents for rate or rhythm control approaches, and antithrombotic therapy (including anticoagulation, and antiplatelet therapy). Treatment should be patient centred and individualised based upon, persistency of the rhythm, causal nature, risk and co-morbid conditions.
AF is a common and burdensome condition where treatment is complex and not without, risk. Nurses will encounter individuals with AF across a variety of primary and acute care areas, understanding the risk of AF and appropriate therapies is important across all care settings. Treatment, must be individually tailored to the needs of the patient and balanced with the best available evidence.
心房颤动（AF）是一种常见的心律失常，也是中风和其他不良事件的危险因素。国际上，用于心房颤动中风预防的治疗方法最近有了进展。护士将在各种初级和急性护理环境中照顾心房颤动患者，并且应该熟悉基于证据的治疗方法。
本文综述了心房颤动和中风的流行病学、中风和出血风险、评估工具以及用于心房颤动中风预防的基于证据的治疗方法，包括新型抗凝血酶药物的使用。
使用关键词“心房颤动”“抗凝”“风险评估”和“临床管理”，对2002年至2012年的主要数据库进行了综述。搜索了以下电子数据库：CINAHL、Medline、Scopus、Cochrane图书馆和谷歌学术。还手动搜索了参考文献列表。纳入了英国国家卫生与临床优化研究所（NICE）、美国心脏协会（AHA）、美国心脏病学会（ACC）和欧洲心脏病学会（ESC）的关键临床指南以及关键政府政策文件。如果文章涉及以澳大利亚为重点的护理管理，则纳入综述。
心房颤动有多种治疗选择。最佳实践指南提出了各种建议，包括心脏复律、消融、肺静脉隔离、控制心率或心律的药物治疗以及抗血栓治疗（包括抗凝和抗血小板治疗）。治疗应以患者为中心，并根据心律的持续性、病因、风险和合并症进行个体化。
心房颤动是一种常见且负担沉重的疾病，治疗复杂且并非没有风险。护士将在各种初级和急性护理领域遇到心房颤动患者，在所有护理环境中了解心房颤动的风险和适当的治疗方法很重要。治疗必须根据患者的需求进行个体化定制，并与最佳现有证据相平衡。
