Lévy S
University of Marseille, School of Medicine, and the Division of Cardiology, Hôpital Nord, France.
J Cardiovasc Electrophysiol. 1998 Aug;9(8 Suppl):S78-82.
Atrial fibrillation (AF) is a common clinical problem, particularly in the elderly and in patients with organic heart disease. AF generally is classified into paroxysmal and chronic forms. Chronic AF can be the end result of paroxysmal AF in about 30% of patients. Paroxysmal AF can be defined as attacks of arrhythmia lasting < 7 days separated by prolonged periods of sinus rhythm. Chronic AF is AF established for > 7 days. Therefore, the differentiation of paroxysmal from chronic or established AF is based on the history of recurrent episodes and the duration of the current episode of AF. The first episode of persistent AF or the first discovery of AF often is referred to as recent onset AF. Most epidemiologic studies highly underestimate the incidence of paroxysmal and/or asymptomatic AF. The prevalence of AF varies with the age group and patient population studied. AF is found in 3% to 5% of the population > 60 years of age. AF is associated with organic heart disease in 70% to 80% of patients. Of the patients admitted to our Cardiology Division during 1 year, 15% of hospitalized patients had a documented history of AF. The risk of an individual patient developing AF often is difficult to assess, but increasing age and the presence of valvular heart disease and congestive heart failure increase the risk of AF. Other important predictive and causative factors of AF include hypertension, diabetes in women, left ventricular hypertrophy in both sexes, and coronary artery disease, mainly in older patients and patients with left ventricular dysfunction. Other causes of AF include coronary artery disease, hypertrophic cardiomyopathy and dilated cardiomyopathy, chronic obstructive pulmonary disease, pericarditis, and congenital heart disease such as left atrial myxoma and atrial septal. AF can occur in the absence of detectable organic heart disease, so-called "lone AF," in about 30% of cases. The term "idiopathic AF" implies the absence of any detectable etiology including hyperthyroidism, overt sinus node dysfunction, and overt or concealed preexcitation. Stroke is the most important factor of mortality and morbidity associated with AF. These epidemiologic data are essential for designing appropriate therapeutic treatment of this common arrhythmia.
心房颤动（AF）是一个常见的临床问题，尤其在老年人和患有器质性心脏病的患者中。AF通常分为阵发性和慢性两种类型。在约30%的患者中，慢性AF可能是阵发性AF的最终结果。阵发性AF可定义为心律失常发作持续时间<7天，其间有较长的窦性心律间期。慢性AF是指AF持续时间>7天。因此，阵发性AF与慢性或持续性AF的鉴别基于复发发作史和当前AF发作的持续时间。持续性AF的首次发作或AF的首次发现通常称为近期发作的AF。大多数流行病学研究严重低估了阵发性和/或无症状AF的发病率。AF的患病率因研究的年龄组和患者群体而异。在60岁以上的人群中，AF的发生率为3%至5%。70%至80%的患者AF与器质性心脏病有关。在我们心脏病科1年内收治的患者中，15%的住院患者有AF的记录病史。个体患者发生AF的风险通常难以评估，但年龄增长、存在瓣膜性心脏病和充血性心力衰竭会增加AF的风险。AF的其他重要预测和致病因素包括高血压、女性糖尿病、男女两性的左心室肥厚以及冠状动脉疾病，主要见于老年患者和左心室功能不全的患者。AF的其他病因包括冠状动脉疾病、肥厚型心肌病和扩张型心肌病、慢性阻塞性肺疾病、心包炎以及先天性心脏病，如左心房黏液瘤和房间隔缺损。在约30%的病例中，AF可在无明显器质性心脏病的情况下发生，即所谓的“孤立性AF”。术语“特发性AF”意味着不存在任何可检测到的病因，包括甲状腺功能亢进、明显的窦房结功能障碍以及显性或隐匿性预激。中风是与AF相关的最重要的死亡和发病因素。这些流行病学数据对于设计针对这种常见心律失常的适当治疗至关重要。
