Li H, Easley A, Barrington W, Windle J
Department of Internal Medicine, University of Nebraska Medical Center, Omaha, USA.
Emerg Med Clin North Am. 1998 May;16(2):389-403. doi: 10.1016/s0733-8627(05)70008-0.
AF is the most common sustained cardiac arrhythmia. Recognition and appropriate management of AF is important to optimize care of concurrent medical problems and prevent long-term consequences. DC cardioversion under sedation should be performed in patients with pulmonary edema, angina, or hypotension. Ventricular rate control is the first choice in stable patients with rapid ventricular rate. Anticoagulation should be considered in all patients with AF duration < 48 hours, except for those under 65 years old and having no other risk factors of stroke. Recent data imply that early attempts at cardioversion may increase success rates and decrease AF recurrence rates. Thus, transesophageal echocardiogram-guided early cardioversion may become more widely used.
房颤是最常见的持续性心律失常。识别并妥善处理房颤对于优化合并症的治疗以及预防长期后果至关重要。对于伴有肺水肿、心绞痛或低血压的患者，应在镇静状态下进行直流电复律。心室率控制是心室率快速的稳定患者的首选。对于房颤持续时间<48小时的所有患者均应考虑抗凝治疗，但65岁以下且无其他卒中危险因素的患者除外。近期数据表明，早期尝试复律可能会提高成功率并降低房颤复发率。因此，经食管超声心动图引导下的早期复律可能会得到更广泛的应用。
