Berjón Reyero J, Olaz Preciado F, de los Arcos Lage E
Servicio de Cardiología, Hospital de Navarra, Pamplona.
Rev Esp Cardiol. 1996;49 Suppl 2:1-7.
Atrial fibrillation is a frequent arrhythmia which has a high prevalence after 65 years of age, thus the typical patient's age is about 75. There are two atrial fibrillation predictors: traditional factors of cardiovascular risk (age, male sex, high blood pressure, diabetes), and structural heart disorders (heart failure, valvular heart disease). All preventive measures to reduce atrial fibrillation incidence, must be directed towards these factors. Additionally, left atrial size, ejection fraction and ventricular hypertrophy are echocardiographic predictors. Atrial fibrillation doubles the mortality rate and is related to an annual stroke rate of 4.5%. The stroke risk factors are: age, hypertension, diabetes, previous stroke, congestive heart failure, coronary heart disease, mitral stenosis, prosthetic heart valves and thyrotoxicosis. Left atrial size and ventricular disfunction are echocardiographic stroke risk factors. Each patient's risk can be stratified on the basis of these factors. All of this information is essential to handle the arrhythmia appropriately; this arrhythmia may be more important than has been thought. Atrial flutter is not very frequent and so it is less studied; however it is an arrhythmia with a similar clinical context to atrial fibrillation, although, probably, with a smaller embolic risk.
心房颤动是一种常见的心律失常，65岁以后患病率很高，因此典型患者的年龄约为75岁。有两个心房颤动预测因素：心血管风险的传统因素（年龄、男性、高血压、糖尿病）和结构性心脏病（心力衰竭、心脏瓣膜病）。所有降低心房颤动发病率的预防措施都必须针对这些因素。此外，左心房大小、射血分数和心室肥厚是超声心动图预测指标。心房颤动使死亡率加倍，且与每年4.5%的中风发生率相关。中风的危险因素有：年龄、高血压、糖尿病、既往中风、充血性心力衰竭、冠心病、二尖瓣狭窄、人工心脏瓣膜和甲状腺毒症。左心房大小和心室功能障碍是超声心动图中风危险因素。根据这些因素可以对每个患者的风险进行分层。所有这些信息对于妥善处理这种心律失常至关重要；这种心律失常可能比人们想象的更为重要。心房扑动不太常见，因此研究较少；然而，它是一种与心房颤动临床情况相似的心律失常，尽管其栓塞风险可能较小。
