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心房颤动管理的进展:普通内科医生指南。

Advances in Atrial Fibrillation Management: A Guide for General Internists.

作者信息

Pham Hoang Nhat, Ibrahim Ramzi, Truong Hong Hieu, Sainbayar Enkhtsogt, Tran Viet Nghi, Abdelnabi Mahmoud, Kanaan Christopher, Sridharan Aadhavi

机构信息

Department of Medicine, University of Arizona, Tucson, AZ 85719, USA.

Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA.

出版信息

J Clin Med. 2024 Dec 23;13(24):7846. doi: 10.3390/jcm13247846.

Abstract

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, impacting approximately 6.1 million adults in the United States, with projections to increase two-fold by 2030. AF significantly increases the risk of stroke and other adverse cardiovascular events, leading to increased morbidity and mortality. The 2023 ACC/AHA/ACCP/HRS guidelines present a paradigm shift in AF management, moving from a duration-based classification to a more comprehensive, patient-centered approach. This includes a novel AF classification system that emphasizes early detection and intervention, including risk factors and lifestyle modification tailored to each patient's risk profile. Moreover, the recommendations advocate for a multidisciplinary care model, ensuring coordinated management involving primary care providers and specialists. Primary care providers play a crucial role in initiating risk factor management and lifestyle interventions, even before the development of AF. This review aims to thoroughly examine the guidelines for the diagnosis and management of AF and equip general internists with the necessary insights to navigate the evolving landscape of AF care effectively.

摘要

心房颤动(AF)是最常见的持续性心律失常,在美国约有610万成年人受其影响,预计到2030年将增加一倍。AF显著增加中风和其他不良心血管事件的风险,导致发病率和死亡率上升。2023年美国心脏病学会(ACC)/美国心脏协会(AHA)/美国胸科医师学会(ACCP)/美国心律学会(HRS)指南在AF管理方面带来了范式转变,从基于病程的分类转向更全面、以患者为中心的方法。这包括一种新的AF分类系统,强调早期检测和干预,包括根据每个患者的风险状况调整风险因素和生活方式。此外,这些建议提倡采用多学科护理模式,确保由初级保健提供者和专家进行协调管理。即使在AF发生之前,初级保健提供者在启动风险因素管理和生活方式干预方面也发挥着关键作用。本综述旨在全面审视AF的诊断和管理指南,并为普通内科医生提供必要的见解,以便他们有效地应对不断变化的AF护理格局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d8f3/11678337/bb0797ec2563/jcm-13-07846-g001.jpg

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