Antz M, Willems S, Hoffmann B A
Klinik für Kardiologie, Klinikum Oldenburg, Herzzentrum, Rahel-Straus-Str. 10, 26133, Oldenburg, Deutschland,
Herz. 2015 Feb;40(1):45-9. doi: 10.1007/s00059-014-4196-9.
In addition to treatment with drugs to control the rate and rhythm, the method of catheter ablation is a cornerstone in the treatment of atrial fibrillation. Another crucial part in treating patients with atrial fibrillation is an adequate oral anticoagulation. Apart from the vitamin K antagonists (VKA) phenprocoumon and warfarin, the direct oral anticoagulants (DOAC) apixaban, dabigatran and rivaroxaban have been approved for oral anticoagulation of patients with atrial fibrillation. As a result there are different potential treatment possibilities for pre-interventional, peri-interventional and post-interventional anticoagulation in the setting of catheter ablation for atrial fibrillation. Due to increasing clinical experience with DOAC and the increasing number of atrial fibrillation ablations worldwide, peri-interventional treatment strategies are continuously changing. Therefore, the current article discusses current standards and gives practical guidance.
除了使用药物控制心率和节律外,导管消融术是治疗心房颤动的基石。治疗心房颤动患者的另一个关键部分是充分的口服抗凝治疗。除了维生素K拮抗剂(VKA)苯丙香豆素和华法林外,直接口服抗凝剂(DOAC)阿哌沙班、达比加群和利伐沙班已被批准用于心房颤动患者的口服抗凝治疗。因此,在心房颤动导管消融术中,对于介入前、介入中和介入后的抗凝治疗有不同的潜在治疗方案。由于DOAC的临床经验不断增加以及全球范围内心房颤动消融术数量的增加,介入期间的治疗策略也在不断变化。因此,本文讨论了当前的标准并提供了实用指南。