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早期心房颤动的检测与全面管理的转变。

Early atrial fibrillation detection and the transition to comprehensive management.

机构信息

Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, 6202 AZ Maastricht, The Netherlands.

Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands.

出版信息

Europace. 2021 Apr 10;23(23 Suppl 2):ii46-ii51. doi: 10.1093/europace/euaa424.

Abstract

Current atrial fibrillation (AF) guidelines recommend screening for AF in individuals above 65 years or with other characteristics suggestive of increased stroke risk. Several mobile health (mHealth) approaches are available to identify AF. Although most wearables or ECG machines include algorithms to detect AF, an ECG confirmation of AF is necessary to establish a suspected diagnosis of AF. Early detection of AF is important to allow early initiation of AF management, and early rhythm control therapy lowered risk of adverse cardiovascular outcomes among patients with early AF aged >75 or with a CHA2DS2-VASc score ≥2 and cardiovascular conditions in the EAST-AFNET 4 study. Strategies for early AF detection should be always linked to a comprehensive work-up infrastructure organized within an integrated care pathway to allow early initiation and guidance of AF treatment in newly detected AF patients. In this review article, we summarize strategies and mHealth approaches for early AF detection and the transition to early AF management including AF symptoms evaluation and assessment of AF progression as well as AF risk factors.

摘要

目前的心房颤动(AF)指南建议在年龄超过 65 岁或具有其他增加中风风险特征的个体中筛查 AF。有几种移动医疗(mHealth)方法可用于识别 AF。尽管大多数可穿戴设备或心电图机都包含用于检测 AF 的算法,但需要进行心电图确认以确定 AF 的疑似诊断。早期发现 AF 很重要,这样可以尽早开始 AF 管理,并且在 EAST-AFNET 4 研究中,年龄 >75 岁或 CHA2DS2-VASc 评分≥2 且有心血管疾病的早期 AF 患者中,早期节律控制治疗降低了不良心血管结局的风险。早期 AF 检测策略应始终与综合护理途径内组织的全面检查基础设施相关联,以允许在新发现的 AF 患者中尽早开始和指导 AF 治疗。在这篇综述文章中,我们总结了早期 AF 检测和早期 AF 管理的策略和 mHealth 方法,包括 AF 症状评估和 AF 进展评估以及 AF 风险因素。

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