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导管消融治疗心房颤动优于药物治疗:一项专题综述。

Catheter ablation superiority over the pharmacological treatments in atrial fibrillation: a dedicated review.

作者信息

Alrumayh Abdullah, Alobaida Muath

机构信息

Department of Basic Sciences, King Saud University, Riyadh, Saudi Arabia.

出版信息

Ann Med. 2021 Dec;53(1):551-557. doi: 10.1080/07853890.2021.1905873.

Abstract

Atrial fibrillation globally affects roughly 33.5 million people, making it the most common heart rhythm disorder. It is a crucial arrhythmia, as it is linked with a variety of negative outcomes such as strokes, heart failure and cardiovascular mortality. Atrial fibrillation can reduce quality of life because of the potential symptoms, for instance exercise intolerance, fatigue, and palpitation. There are different types of treatments aiming to prevent atrial fibrillation and improve quality of life. Currently, the primary treatment for atrial fibrillation is pharmacology therapy, however, these still show limited effectiveness, which has led to research on other alternative strategies. Catheter ablation is considered the second line treatment for atrial fibrillation when the standard treatment has failed. Moreover, catheter ablation continues to show significant results when compared to standard therapy. Hence, this review will argue that catheter ablation can show superiority over current pharmacological treatments in different aspects. It will discuss the most influential aspects of the treatment of atrial fibrillation, which are recurrence and burden of atrial fibrillation, quality of life, atrial fibrillation in the setting of heart failure and mortality and whether catheter ablation can be the first line treatment for patients with atrial fibrillation.

摘要

全球约有3350万人受心房颤动影响,使其成为最常见的心律失常。它是一种关键的心律失常,因为它与多种负面后果相关,如中风、心力衰竭和心血管疾病死亡率。由于可能出现的症状,如实运动耐量下降、疲劳和心悸,心房颤动会降低生活质量。有不同类型的治疗方法旨在预防心房颤动并提高生活质量。目前,心房颤动的主要治疗方法是药物治疗,然而,这些治疗方法的效果仍然有限,这导致了对其他替代策略的研究。当标准治疗失败时,导管消融被认为是心房颤动的二线治疗方法。此外,与标准治疗相比,导管消融仍显示出显著效果。因此,本综述将论证导管消融在不同方面可显示出优于当前药物治疗的优势。它将讨论心房颤动治疗中最具影响力的方面,即心房颤动的复发和负担、生活质量、心力衰竭情况下的心房颤动以及死亡率,以及导管消融是否可以成为心房颤动患者的一线治疗方法。

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