Blitzer M, Costeas C, Kassotis J, Reiffel J A
Division of Cardiology, Department of Medicine, Columbia University, New York, New York, USA.
Pacing Clin Electrophysiol. 1998 Mar;21(3):590-602. doi: 10.1111/j.1540-8159.1998.tb00103.x.
Atrial fibrillation (AF) is the most common, sustained, symptomatic tachyarrhythmia that clinicians are called upon to manage. Management strategies include ventricular rate control coupled with anticoagulation, versus restoration and maintenance of sinus rhythm. Rate control may be achieved pharmacologically, with agents that impair AV nodal conduction directly and/or by increasing parasympathetic/sympathetic balance, or by modifying or ablating the AV nodal region anatomically. Rhythm control may be achieved by electrical or pharmacological conversion followed by maintenance of sinus rhythm by pharmacological (or occasionally ablative) therapies. This article will present current approaches to rate and rhythm control issues in AF. Part 1, the current manuscript, details approaches to rate control and includes a drug selection algorithmic conclusion. It also introduces the subject of the pursuit of sinus rhythm. Parts 2 and 3, to be published in subsequent editions of PACE, will deal with therapeutic measures to restore and maintain sinus rhythm.
心房颤动（AF）是临床医生需要处理的最常见的持续性有症状快速心律失常。治疗策略包括心室率控制联合抗凝治疗，以及恢复和维持窦性心律。心率控制可通过药理学方法实现，使用直接损害房室结传导和/或通过增加副交感神经/交感神经平衡的药物，或通过解剖学上改变或消融房室结区域来实现。节律控制可通过电复律或药物转复，随后通过药物（或偶尔通过消融）治疗维持窦性心律来实现。本文将介绍目前房颤心率和节律控制问题的处理方法。第1部分，即当前的稿件，详细介绍了心率控制方法，并包括一个药物选择算法结论。它还介绍了追求窦性心律的主题。第2部分和第3部分将发表在《PACE》的后续版本中，将讨论恢复和维持窦性心律的治疗措施。
