Sopher S M, Camm A J
Department of Cardiological Sciences, St. George's Hospital and Medical School, London, United Kingdom.
Am J Cardiol. 1996 Jan 25;77(3):24A-37A. doi: 10.1016/s0002-9149(97)89115-1.
Atrial fibrillation represents a common and challenging arrhythmia. A rational approach to management of the individual case depends on careful assessment of the temporal of the arrhythmia, any associated cardiovascular disease, and any particular features suggesting the advisability or risks of any particular treatment regimen. The nature of an arrhythmia and of individual patient factors change over time, requiring a flexible approach to long-term treatment that may be defined only after months or years. While new treatment options such as catheter ablation techniques and implantable atrial defibrillators are being tested, old therapies (e.g., low-dose amiodarone) are undergoing reappraisal. Increasing recognition of the dangers of antiarrhythmic therapy used to maintain sinus rhythm is focusing attention on nonpharmacologic methods. All patients with persistent atrial fibrillation merit serious consideration for direct current cardioversion before accepting that atrial fibrillation is permanent, and many patients may benefit from more than one attempt to restore and maintain sinus rhythm.
心房颤动是一种常见且具有挑战性的心律失常。对个体病例进行合理的管理方法取决于对心律失常的发作时间、任何相关心血管疾病以及任何表明特定治疗方案的可取性或风险的特殊特征进行仔细评估。心律失常的性质和个体患者因素会随时间变化，这就需要一种灵活的长期治疗方法，而这种方法可能只有在数月或数年之后才能确定。虽然诸如导管消融技术和植入式心房除颤器等新的治疗选择正在接受测试，但旧的疗法（如低剂量胺碘酮）正在重新评估。人们越来越认识到用于维持窦性心律的抗心律失常治疗的危险性，这使得注意力集中在非药物方法上。所有持续性心房颤动患者在接受心房颤动为永久性之前都值得认真考虑进行直流电复律，而且许多患者可能会从不止一次恢复和维持窦性心律的尝试中获益。
