Giudici Michael C, Bhave Prashant D
Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA.
Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA.
Cardiol Clin. 2017 May;35(2):297-300. doi: 10.1016/j.ccl.2016.12.011.
The relationship of stroke and atrial fibrillation seems to become more complex as we gain more knowledge of the issue. Recent studies have questioned the temporal relationship between the two, which also questions causation. Left atrial appendage closure is an attractive, but unproven technology when compared with the 50-year experience with warfarin. In a patient who is on warfarin and having no issues with bleeding, medication intolerance, or lack of efficacy, it is difficult to justify stopping the drug and placing a closure device as sole therapy to prevent a stroke.
随着我们对中风与心房颤动之间关系的了解不断深入，这一关系似乎变得愈发复杂。近期的研究对两者之间的时间关系提出了质疑，这也对因果关系提出了疑问。与华法林50年的使用经验相比，左心耳封堵术是一项有吸引力但尚未得到证实的技术。对于正在服用华法林且不存在出血、药物不耐受或疗效不佳问题的患者，很难证明停用该药并置入封堵装置作为预防中风的唯一治疗方法是合理的。
