Slany J, Stöllberger C
II. Medizinischen Abteilung, Krankenanstalt Rudolfstiftung, Wien.
Wien Med Wochenschr. 1994;144(14-15):374-8.
Atrial fibrillation may develop in patients without (line atrial fibrillation) or with heart disease. Its prevalence raises with age. Medical or electrical cardioversion should be considered in view of the unfavourable hemodynamics and the increased risk of embolic events. Class-I antiarrhythmics given to sustain sinus rhythm after cardioversion are fraught with the risk of sudden death and should therefore be replaced by class-III antiarrhythmics. Control of heart rate in persisting atrial fibrillation is achieved best by digitalis glycosides at rest and by calcium channel blockers of the verapamil type or beta blockers during exercise. The risk of embolism in nonvalvular atrial fibrillation is reduced by mild oral anticoagulation and, probably to some extent, also by aspirin (300 mg daily). Ablation of the AV-node or an accessory pathway or heart surgery (maze procedure) may provide help in special cases.
房颤可发生于无（隐匿性房颤）或有心脏病的患者中。其患病率随年龄增长而升高。鉴于血流动力学不利及栓塞事件风险增加，应考虑药物或电复律。复律后用于维持窦性心律的I类抗心律失常药物存在猝死风险，因此应由III类抗心律失常药物替代。持续性房颤时，静息状态下控制心率最佳选用洋地黄糖苷，运动时选用维拉帕米类钙通道阻滞剂或β受体阻滞剂。非瓣膜性房颤的栓塞风险可通过轻度口服抗凝治疗降低，阿司匹林（每日300毫克）可能在一定程度上也有帮助。在特殊情况下，房室结消融、旁路消融或心脏手术（迷宫手术）可能会有所帮助。
