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非风湿性心房颤动管理的最新进展:全面综述

Recent Advances in the Management of Non-rheumatic Atrial Fibrillation: A Comprehensive Review.

作者信息

Kadam Abhinav, Kotak Palash S, Khurana Kashish, Toshniwal Saket S, Daiya Varun, Raut Sarang S, Kumar Sunil, Acharya Sourya

机构信息

Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Jul 31;16(7):e65835. doi: 10.7759/cureus.65835. eCollection 2024 Jul.

Abstract

Atrial fibrillation (AF) is a prevalent cardiac arrhythmia characterized by irregular atrial electrical activity, posing significant challenges to patient management and healthcare systems worldwide. Non-rheumatic AF, distinct from AF due to rheumatic heart disease, encompasses a spectrum of etiologies, including hypertension, coronary artery disease, and structural heart abnormalities. This review examines the latest advancements in managing non-rheumatic AF, encompassing diagnostic approaches, pharmacological therapies, and innovative non-pharmacological interventions. Diagnostic strategies ranging from traditional electrocardiography to advanced imaging modalities are explored alongside emerging biomarkers and wearable technologies facilitating early detection and management. Pharmacological management options, including novel anticoagulants and rhythm control agents, are evaluated in light of current guidelines and recent clinical trials. Non-pharmacological interventions, such as catheter ablation and device-based therapies, are discussed regarding their evolving techniques and outcomes. Special considerations for diverse patient populations, including elderly individuals and athletes, are addressed, emphasizing personalized approaches to optimize therapeutic outcomes. The review concludes with insights into future directions for AF management, highlighting promising avenues in gene therapy, regenerative medicine, and precision medicine approaches. By synthesizing recent research findings and clinical innovations, this review provides a comprehensive overview of the dynamic landscape of non-rheumatic AF management, offering insights for clinicians, researchers, and healthcare stakeholders.

摘要

心房颤动(AF)是一种常见的心律失常,其特征为心房电活动不规则,给全球患者管理和医疗系统带来了重大挑战。非风湿性AF与风湿性心脏病所致的AF不同,包括一系列病因,如高血压、冠状动脉疾病和心脏结构异常。本综述探讨了非风湿性AF管理的最新进展,涵盖诊断方法、药物治疗和创新的非药物干预措施。从传统心电图到先进成像模式的诊断策略与新兴生物标志物和可穿戴技术一同被探讨,这些技术有助于早期检测和管理。根据当前指南和近期临床试验评估了药物管理选项,包括新型抗凝剂和节律控制药物。讨论了非药物干预措施,如导管消融和基于设备的治疗方法,涉及它们不断发展的技术和疗效。还讨论了包括老年人和运动员在内的不同患者群体的特殊考虑因素,强调采用个性化方法以优化治疗效果。综述最后对AF管理的未来方向进行了展望,突出了基因治疗、再生医学和精准医学方法等有前景的途径。通过综合近期研究结果和临床创新,本综述全面概述了非风湿性AF管理的动态格局,为临床医生、研究人员和医疗保健利益相关者提供了见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f0e/11363501/fd2b47bbff76/cureus-0016-00000065835-i01.jpg

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