Department of Pharmacy, WVU Medicine, 1 Medical Center Drive, Morgantown, WV, 26505, USA.
Department of Internal Medicine, West Virginia University School of Medicine, Morgantown, WV, USA.
Am J Cardiovasc Drugs. 2022 Sep;22(5):475-496. doi: 10.1007/s40256-022-00529-6. Epub 2022 Mar 30.
Atrial fibrillation (AF) is an increasingly common arrhythmia encountered in clinical practice that leads to a substantial increase in utilization of healthcare services and a decrease in the quality of life of patients. The prevalence of AF will continue to increase as the population ages and develops cardiac comorbidities; thus, prompt and effective treatment is important to help mitigate systemic resource utilization. Treatment of AF involves two tenets: prevention of stroke and systemic embolism and symptom control with either a rate or a rhythm control strategy. Historically, due to the safe nature of medications like beta-blockers and non-dihydropyridine calcium channel blockers, used in rate control, it has been the initial strategy used for symptom control in AF. Newer data suggest that a rhythm control strategy with antiarrhythmic medications with or without catheter ablation may lead to a reduction in major adverse cardiovascular events, particularly in patients newly diagnosed with AF. Modulation of factors that promote AF or its complications is another important aspect of the overall holistic management of AF. This review provides a comprehensive focus on the management of patients with AF and an in-depth review of pharmacotherapy of AF in the rate and rhythm control strategies.
心房颤动（AF）是临床实践中越来越常见的心律失常，导致医疗服务利用的大量增加和患者生活质量的下降。随着人口老龄化和心脏合并症的发展，AF 的患病率将继续增加；因此，及时有效的治疗对于帮助减轻系统资源利用至关重要。AF 的治疗包括两个原则：预防中风和全身性栓塞，以及通过控制心率或节律的策略来控制症状。历史上，由于β受体阻滞剂和非二氢吡啶类钙通道阻滞剂等药物在控制心率方面的安全性，它们一直是 AF 症状控制的初始策略。新的数据表明，使用抗心律失常药物进行节律控制策略，或联合导管消融，可能会减少主要不良心血管事件，特别是在新诊断为 AF 的患者中。调节促进 AF 或其并发症的因素是 AF 整体综合管理的另一个重要方面。这篇综述全面关注 AF 患者的管理，并深入探讨 AF 的药物治疗在控制心率和节律的策略中的作用。
