Trohman Richard G, Huang Henry D, Sharma Parikshit S
Section of Electrophysiology, Division of Cardiology, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States.
Front Cardiovasc Med. 2023 Jun 15;10:1060030. doi: 10.3389/fcvm.2023.1060030. eCollection 2023.
Atrial fibrillation (AF), is the most common sustained cardiac arrhythmia. It was once thought to be benign as long as the ventricular rate was controlled, however, AF is associated with significant cardiac morbidity and mortality. Increasing life expectancy driven by improved health care and decreased fertility rates has, in most of the world, resulted in the population aged ≥65 years growing more rapidly than the overall population. As the population ages, projections suggest that the burden of AF may increase more than 60% by 2050. Although considerable progress has been made in the treatment and management of AF, primary prevention, secondary prevention, and prevention of thromboembolic complications remain a work in progress. This narrative review was facilitated by a MEDLINE search to identify peer-reviewed clinical trials, randomized controlled trials, meta-analyses, and other clinically relevant studies. The search was limited to English-language reports published between 1950 and 2021. Google and Google scholar as well as bibliographies of identified articles were reviewed for additional references. In these two manuscripts, we discuss the current strategies available to prevent AF, then compare noninvasive and invasive treatment strategies to diminish AF recurrence. In addition, we examine the pharmacological, percutaneous device and surgical approaches to prevent stroke as well as other types of thromboembolic events.
心房颤动（AF）是最常见的持续性心律失常。它曾被认为只要心室率得到控制就是良性的，然而，AF与显著的心脏发病率和死亡率相关。在世界上大多数地区，医疗保健改善和生育率下降导致预期寿命增加，使得65岁及以上人口的增长速度超过了总人口。随着人口老龄化，预测表明到2050年AF的负担可能增加60%以上。尽管在AF的治疗和管理方面已经取得了相当大的进展，但一级预防、二级预防以及血栓栓塞并发症的预防仍在进行中。本叙述性综述通过MEDLINE检索来确定同行评审的临床试验、随机对照试验、荟萃分析和其他临床相关研究。检索仅限于1950年至2021年发表的英文报告。还查阅了谷歌和谷歌学术以及已识别文章的参考文献列表以获取更多参考文献。在这两篇手稿中，我们讨论了目前可用于预防AF的策略，然后比较了减少AF复发的非侵入性和侵入性治疗策略。此外，我们研究了预防中风以及其他类型血栓栓塞事件的药物、经皮装置和手术方法。
