Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.
Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Medical University of Silesia, Silesian Centre for Heart Diseases, Zabrze, Poland.
Expert Rev Cardiovasc Ther. 2021 Apr;19(4):277-287. doi: 10.1080/14779072.2021.1902307. Epub 2021 Apr 13.
: An integral aspect of atrial fibrillation (AF) management involves better symptom control, incorporating a rate control, rhythm control, or a combination strategy. The 2020 ESC Guidelines suggest that rhythm control strategy should be recommended for symptomatic patients, to mitigate their symptoms and improve the quality of life. However, adequately powered randomized control trials and prospective 'real-world' registries are needed to fully assess the impact of early rhythm control strategies on clinical outcomes in patients with AF.: In this narrative review, we discuss clinical outcomes following rhythm management approach among patients with AF, considering the effectiveness of an early intervention strategy.: Patients involvement and shared decision-making are crucial when deciding the optimal management strategy among patients with AF. For those with newly diagnosed symptomatic AF, an early invasive approach such as catheter ablation may have a role in preventing AF progression and subsequent pathophysiological changes.
房颤(AF)管理的一个重要方面涉及更好地控制症状,包括控制心率、控制节律或采用联合策略。2020 年 ESC 指南建议,对于有症状的患者,应推荐节律控制策略,以减轻其症状并改善生活质量。然而,需要进行充分的、有影响力的随机对照试验和前瞻性“真实世界”注册研究,以全面评估 AF 患者早期节律控制策略对临床结局的影响。在这篇叙述性综述中,我们讨论了 AF 患者节律管理方法后的临床结局,同时考虑了早期干预策略的有效性。患者的参与和共同决策在决定 AF 患者的最佳管理策略时至关重要。对于新诊断为有症状的 AF 患者,导管消融等早期介入方法可能在预防 AF 进展和随后的病理生理变化方面发挥作用。