Carpenter Alexander, Frontera Antonio, Bond Richard, Duncan Edward, Thomas Glyn
Bristol Heart Institute, University Hospitals Bristol NHS Trust, United Kingdom.
Bristol Heart Institute, University Hospitals Bristol NHS Trust, United Kingdom.
Int J Cardiol. 2015 Dec 15;201:415-21. doi: 10.1016/j.ijcard.2015.08.108. Epub 2015 Aug 10.
Vagal atrial fibrillation (AF) remains an under-recognised entity, affecting younger patients often with structurally normal hearts. Although there remains no universal definition or diagnostic criteria, in this review we describe recognised triggers and associated features, including a well-established association with athletic training. We explore potential mechanisms, including the role of the autonomic nervous system and ganglionated plexi in initiating and maintaining arrhythmia. We discuss the limited evidence base addressing the question of progression to persistent AF, and debate the merits of anti-arrhythmic treatment, as well as uncertainty regarding the risk of stroke. Differences in suggested pharmacological therapy are highlighted and as is the emerging promise of radiofrequency catheter ablation as a therapeutic option. As we recognise the emerging burden of vagal AF, we hope to explore the important similarities and differences crucial to developing our understanding of the disorder, and highlight some significant questions which remain unanswered.
迷走神经介导的心房颤动（AF）仍是一个未被充分认识的疾病实体，常影响心脏结构正常的年轻患者。尽管目前尚无统一的定义或诊断标准，但在本综述中，我们描述了已被认可的触发因素和相关特征，包括与运动训练的明确关联。我们探讨了潜在机制，包括自主神经系统和神经节丛在心律失常的起始和维持中的作用。我们讨论了关于进展为持续性房颤问题的有限证据基础，并对抗心律失常治疗的利弊以及中风风险的不确定性进行了辩论。文中强调了建议的药物治疗差异，以及射频导管消融作为一种治疗选择的新前景。鉴于我们认识到迷走神经介导的房颤负担日益加重，我们希望探讨对于深入理解该疾病至关重要的重要异同点，并突出一些仍未得到解答的重大问题。
