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2024 年欧洲心脏病学会心房颤动诊断和管理指南:临床医生视角。

The 2024 European Society of Cardiology Guidelines for Diagnosis and Management of Atrial Fibrillation: A Viewpoint from a Practicing Clinician's Perspective.

机构信息

Medical Faculty, University of Belgrade, Belgrade, Serbia.

Intensive Care for Arrhythmias, Cardiology Clinic, University Clinical Centre of Serbia, Belgrade, Serbia.

出版信息

Thromb Haemost. 2024 Dec;124(12):1087-1094. doi: 10.1055/a-2434-9244. Epub 2024 Oct 7.

Abstract

Atrial fibrillation (AF) is a complex disease requiring a multidomain and (usually) long-term management, thus posing a significant burden to patients with AF, practitioners, and health care system. Unlike cardiovascular conditions with a narrow referral pathway (e.g., acute coronary syndrome), AF may be first detected by a wide range of specialties (often noncardiology) or a general practitioner. Since timely initiated optimal management is essential for the prevention of AF-related complications, a concise and simple guidance is essential for practitioners managing AF patients, regardless of their specialty. Guideline-adherent management of patients with AF has been shown to translate to improved patient outcomes compared with guideline-nonadherent treatment. To facilitate guideline implementation in routine clinical practice, a good guideline document on AF should introduce only evidence-based new recommendations, while avoiding arbitrary changes, which may be confusing to practitioners. Herein, we discuss the main changes in the 2024 European Society of Cardiology (ESC) AF Guidelines relative to the previous 2020 ESC document. Whether the updates and new recommendations issued by the new guidelines will translate in high adherence in clinical practice (and hence improved prognosis of patients with AF) will need to be addressed in upcoming years.

摘要

心房颤动(AF)是一种复杂的疾病,需要多领域和(通常)长期管理,因此给 AF 患者、医生和医疗保健系统带来了巨大的负担。与心血管疾病狭窄的转诊途径不同(例如急性冠状动脉综合征),AF 可能首先由广泛的专业领域(通常是非心脏病学)或全科医生发现。由于及时启动最佳管理对于预防 AF 相关并发症至关重要,因此无论其专业领域如何,管理 AF 患者的医生都需要一个简洁明了的指南。与不遵循指南的治疗相比,遵循指南管理 AF 患者已被证明可改善患者的预后。为了在常规临床实践中促进指南的实施,一份好的 AF 指南文件应仅介绍基于证据的新建议,同时避免任意更改,因为这可能会让医生感到困惑。在此,我们讨论了 2024 年欧洲心脏病学会(ESC)AF 指南与 2020 年 ESC 指南相比的主要变化。新指南发布的更新和新建议是否会在临床实践中得到高度遵循(从而改善 AF 患者的预后),这将需要在未来几年内解决。

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