Gunawardene Melanie, Hartmann Jens, Willems Stephan
Klinik für Kardiologie und internistische Intensivmedizin, Asklepios Klinik St. Georg, Lohmühlenstr. 5, 20099, Hamburg, Deutschland.
Herzschrittmacherther Elektrophysiol. 2023 Jun;34(2):122-130. doi: 10.1007/s00399-023-00933-8. Epub 2023 Mar 13.
Atrial fibrillation (AF) is the most common cardiac arrhythmia affecting millions of people worldwide and poses a significant burden to the health care system. AF screening of the general population or of a specific higher-risk population could not only lead to earlier detection of AF but also to a prompt initiation of an adequate therapy to prevent complications such as stroke or death and consecutively to a potential reduction of health care costs, especially in asymptomatic AF patients. To conduct screening programs, accessible new technology devices such as "wearables", smartwatches, and implantable event recorders provide an innovative solution. However, as data regarding screening are inconclusive, routine AF screening of the population is currently not recommended by the European Society of Cardiology. Recently published studies have indicated that anticoagulation and early rhythm control of asymptomatic AF could avoid occurrence of clinical endpoints. This article reports on the scientific results of the current literature as well as gaps of evidence and discusses possible treatment options of asymptomatic AF.
心房颤动(AF)是影响全球数百万人的最常见心律失常,给医疗保健系统带来了沉重负担。对普通人群或特定高风险人群进行AF筛查,不仅可以更早地检测出AF,还能促使及时启动适当治疗,以预防中风或死亡等并发症,并进而有可能降低医疗保健成本,尤其是对于无症状AF患者。为开展筛查项目,诸如“可穿戴设备”、智能手表和植入式事件记录仪等易于获取的新技术设备提供了创新解决方案。然而,由于有关筛查的数据尚无定论,欧洲心脏病学会目前不建议对人群进行常规AF筛查。最近发表的研究表明,无症状AF的抗凝治疗和早期节律控制可避免临床终点事件的发生。本文报告了当前文献的科学结果以及证据空白,并讨论了无症状AF可能的治疗选择。