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心房颤动的处理方法:基层医疗的必备知识。

Approach to atrial fibrillation: Essentials for primary care.

机构信息

Assistant Professor in the Department of Family and Community Medicine at the University of Toronto in Ontario and served as a Canadian Cardiovascular Society (CCS) atrial fibrillation guideline panel member.

Associate Professor of Medicine at the University of British Columbia in Vancouver, Adjunct Professor at the University of Montréal in Quebec, and Co-chair of the CCS atrial fibrillation guideline panel.

出版信息

Can Fam Physician. 2023 Apr;69(4):245-256. doi: 10.46747/cfp.6904245.

Abstract

OBJECTIVE

To support family physicians in preventing atrial fibrillation (AF) in patients at risk and in identifying and managing those with established AF; and to summarize key recommendations for ideal screening and care of patients.

SOURCES OF INFORMATION

The 2020 Canadian Cardiovascular Society and Canadian Heart Rhythm Society comprehensive guidelines for the management of AF, based on current evidence and clinical experience related to AF.

MAIN MESSAGE

Atrial fibrillation, which is estimated to affect at least 500,000 Canadians, is associated with high risks of stroke, heart failure, and death. Primary care clinicians occupy a central role in the management of this chronic condition, focusing on the challenges of preventing AF and identifying, diagnosing, treating, and following patients with AF. Evidence-based guidelines that provide optimal management strategies have been published by the Canadian Cardiovascular Society and Canadian Heart Rhythm Society to assist in these tasks. Messages critical to primary care are offered to support effective knowledge translation.

CONCLUSION

Most patients with AF can be managed effectively in primary care. Family physicians not only play an important role in ensuring patients with AF receive timely diagnoses, but they are also key to providing initial and ongoing care, especially in patients with comorbid conditions.

摘要

目的

为家庭医生预防高危人群的心房颤动(AF)、识别和管理已确诊的 AF 提供支持;总结理想的患者筛查和护理的关键建议。

信息来源

基于与 AF 相关的当前证据和临床经验,2020 年加拿大心血管学会和加拿大心律学会制定了 AF 综合管理指南。

主要信息

心房颤动估计影响至少 50 万加拿大人,与中风、心力衰竭和死亡的高风险相关。初级保健临床医生在这种慢性疾病的管理中占据核心地位,重点关注预防 AF 以及识别、诊断、治疗和随访 AF 患者的挑战。加拿大心血管学会和加拿大心律学会发布了循证指南,提供最佳管理策略,以协助完成这些任务。为支持有效的知识转化,提供了对初级保健至关重要的信息。

结论

大多数 AF 患者可以在初级保健中得到有效管理。家庭医生不仅在确保 AF 患者及时诊断方面发挥着重要作用,而且在提供初始和持续护理方面也至关重要,尤其是在患有合并症的患者中。

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Early Rhythm-Control Therapy in Patients with Atrial Fibrillation.心房颤动患者的早期节律控制治疗。
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Antithrombotic Therapy for Atrial Fibrillation with Stable Coronary Disease.心房颤动合并稳定性冠心病的抗栓治疗。
N Engl J Med. 2019 Sep 19;381(12):1103-1113. doi: 10.1056/NEJMoa1904143. Epub 2019 Sep 2.
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Long-Term Incidence of Atrial Fibrillation and Stroke Among Cross-Country Skiers.长距离滑雪者的房颤和中风长期发病率。
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