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心房颤动与心力衰竭:流行病学、病理生理学、预后和管理。

Atrial Fibrillation and Heart Failure: Epidemiology, Pathophysiology, Prognosis, and Management.

机构信息

Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.

Department of Cardiology, Royal Melbourne Hospital, Department of Medicine, University of Melbourne, Melbourne, Australia.

出版信息

Card Electrophysiol Clin. 2021 Mar;13(1):47-62. doi: 10.1016/j.ccep.2020.11.004.

Abstract

Atrial fibrillation (AF) and heart failure (HF) have similar risk factors, frequently coexist, and potentiate each other in a vicious cycle. Evidence suggests the presence of AF in both HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF) increases the risk of all-cause mortality and stroke, particularly when AF is incident. Catheter ablation may be an effective strategy in controlling symptoms and improving quality of life in AF-HFrEF. Strong data guiding management of AF-HFpEF are lacking largely due to its challenging diagnosis. Improving outcomes associated with these coexistent conditions requires further careful investigation.

摘要

心房颤动(AF)和心力衰竭(HF)有相似的危险因素,常同时存在,并在恶性循环中相互加剧。有证据表明,射血分数降低的心力衰竭(HFrEF)和射血分数保留的心力衰竭(HFpEF)中存在 AF 会增加全因死亡率和中风的风险,尤其是当 AF 是新发时。导管消融可能是控制 AF-HFrEF 症状和改善生活质量的有效策略。由于其诊断具有挑战性,因此缺乏指导 AF-HFpEF 管理的有力数据。进一步仔细研究这些共存病症相关的预后,可以改善治疗效果。

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