Maisano Anna, Vitolo Marco, Imberti Jacopo Francesco, Bonini Niccolò, Albini Alessandro, Valenti Anna Chiara, Sgreccia Daria, Mantovani Marta, Malavasi Vincenzo Livio, Boriani Giuseppe
Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy.
Clinical and Experimental Medicine PhD Program, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41124 Modena, Italy.
Rev Cardiovasc Med. 2022 May 16;23(5):176. doi: 10.31083/j.rcm2305176. eCollection 2022 May.
Atrial fibrillation (AF) is the most common arrhythmia in the setting of critically ill patients. Pneumonia, and in particular community-acquired pneumonia, is one of the most common causes of illness and hospital admission worldwide. This article aims to review the association between AF and acute diseases, with specific attention to pneumonia, from the pathophysiology to its clinical significance. Even though the relationship between pneumonia and AF has been known for years, it was once considered a transient bystander. In recent years there has been growing knowledge on the clinical significance of this arrhythmia in acute clinical settings, in which it holds a prognostic role which is not so different as compared to that of the so-called "primary" AF. AF is a distinct entity even in the setting of pneumonia, and acute critical illnesses in general, and it should therefore be managed with a guidelines-oriented approach, including prescription of anticoagulants in patients at thromboembolic risk, always considering patients' individuality. More data on the significance of the arrhythmia in this setting will help clinicians to give patients the best possible care.
心房颤动（AF）是危重症患者中最常见的心律失常。肺炎，尤其是社区获得性肺炎，是全球范围内最常见的疾病和住院原因之一。本文旨在综述AF与急性疾病之间的关联，特别关注肺炎，内容涵盖从病理生理学到临床意义。尽管肺炎与AF之间的关系已为人所知多年，但它曾一度被视为短暂的旁观者。近年来，人们对这种心律失常在急性临床环境中的临床意义有了越来越多的认识，在这种环境中，它具有与所谓“原发性”AF相似的预后作用。即使在肺炎以及一般的急性危重症情况下，AF也是一种独特的病症，因此应以遵循指南的方法进行管理，包括对有血栓栓塞风险的患者开具抗凝药物，同时始终考虑患者的个体情况。关于这种情况下心律失常意义的更多数据将有助于临床医生为患者提供尽可能最佳的治疗。
