Rolf Sascha, Kornej Jelena, Dagres Nikolaos, Hindricks Gerhard
Department of Electrophysiology, University of Leipzig-Heart Center, Leipzig, Germany.
Second University Department of Cardiology, University of Athens, Attikon University Hospital, Athens, Greece.
Heart. 2015 Jun;101(11):842-6. doi: 10.1136/heartjnl-2013-305152. Epub 2015 Mar 19.
Atrial fibrillation (AF) is a global healthcare problem of growing prevalence and major significance. The consequences of AF include an increased rate of death, stroke and heart failure. Theoretically, a therapeutic strategy aiming at restoration and maintenance of sinus rhythm should offset the prognosis impairment associated with AF. However, these expectations were disproven in large randomised controlled trials comparing conventional antiarrhythmic drugs for rhythm control with conventional rate control. These apparently contradictory findings suggest that rhythm control strategies require better therapeutic instruments. These improvements may involve drugs and/or interventions with optimised risk-benefit profile and which also appreciate the specific atrial pathology and the patient's comorbidities. This article addresses important aspects of rhythm control strategies, which may have the potential of a beneficial contribution to the prognosis of AF patients.
心房颤动（AF）是一个在全球范围内患病率不断上升且具有重大意义的医疗保健问题。AF的后果包括死亡率、中风和心力衰竭发生率增加。从理论上讲，旨在恢复和维持窦性心律的治疗策略应能抵消与AF相关的预后损害。然而，在比较用于节律控制的传统抗心律失常药物与传统心率控制的大型随机对照试验中，这些期望被证明是错误的。这些明显矛盾的发现表明，节律控制策略需要更好的治疗手段。这些改进可能涉及具有优化风险效益比的药物和/或干预措施，同时也要考虑到特定的心房病理状况和患者的合并症。本文探讨了节律控制策略的重要方面，这些方面可能对AF患者的预后有潜在的有益贡献。
