非瓣膜性房颤的规范化药物治疗

房颤(AF)是最常见的可持续的心律失常,目前药物治疗仍是其基础治疗,而其中抗凝药物是各种治疗的基础和核心。国内关于AF的规范化药物治疗与国际指南要求尚有一定差距。本文综述AF的规范化药物治疗。     

心房纤颤的抗心律失常药物临床应用评价

心房纤颤(atrial fibrilation，简称AF)是一种常见的心律失常。据统计，≥75岁的老人，AF的发生率5％，随增龄而增加。根据病情合理使用抗心律失常药物治疗，可使AF恢复为窦性心律(复律)、延长患者的存活时间，提高患者的生存质量。本文综述评价抗心律失常药物治疗AF的临床疗效。     

抗心律失常新药维纳卡兰在房颤治疗中的应用

恢复和维持窦性心律是房颤(AF)治疗的重要策略.默克公司开发的维纳卡兰对急性AF转复的疗效优于其他药物,有可能成为替代胺碘酮的有效药物.本文综述维纳卡兰药动学特点、作用机制、疗效及安全性.     

心房颤动的药物治疗

心房颤动(atrial fibrillation,AF),简称"房颤",是一种十分常见的心律失常,其发病率随年龄的增长而增加.房颤根据其持续的时间可以分为阵发性房颤(paroxysmal AF)、持续性房颤(persistent AF)、永久性房颤(permanent AF)3大类[1],即3P分类法.不同的类型对选择治疗方法有重要意义.房颤的治疗包括药物治疗和非药物治疗两方面.在非药物治疗方面包括电复律、射频消融、外科迷宫术、起搏器植入等,特别是射频消融治疗为房颤的根治带来希望[2].但由于非药物治疗对医院技术条件的要求,所以目前对于基层医院而言药物治疗是临床最重要的选择.     

房颤抗心律失常药物治疗策略的选择

房颤(AF)病例分布广,发病率增长快,相关临床后果严重,如脑卒中、生活质量及活动能力下降、住院率增加、左室功能下降乃至死亡等。对AF患者的抗心律失常药物治疗,必须面对两种治疗策略的选择。本文综合近期陆续发表的一些临床研究结果,初步探讨临床治疗策略选择。     

室性心律失常药物治疗

室性早搏的药物治疗现状 早搏治疗原则：多数不必应用抗心律失常药物（AAD）,治疗对象为频发房性早搏诱发室上性心动过速、心房颤动（AF）者,室性早搏町能诱发室性心动过速、心室颤动者,长QT间期基础上早搏,多形性性室早搏,构成症状的早搏。     

室性心律失常药物治疗

一、室性早搏的药物治疗现状 早搏治疗原则:多数不必应用抗心律失常药物(AAD),治疗对象为频发房早诱发室上速、房颤(AF)者,室早可能诱发室速、室颤者,长QT间期基础上早搏,多形性室早,构成症状的早搏.     

房颤治疗，首选导管消融

房颤的治疗一般分为药物、非药物治疗两种方法。药物治疗分两方面，主要包括抗心律失常药物治疗以及抗凝药物治疗。这些治疗对控制房颤发作时的症状，预防中风有积极的作用，但很难使心脏恢复正常搏动。     

肾素-血管紧张素系统与心房重构关系的研究进展

心房颤动（Atrial fibrillation,AF,以下简称房颤）,是临床上十分常见的一种心律失常,其发病率可随着年龄的增加有明显增高。目前房颤的药物治疗包括复律并维持窦律、控制心室率及抗凝治疗,但临床上所用的复律并维持窦律的抗心律失常药物转复成功后,能长期维持窦律者不到一半,且这些药物的毒副作用限制了其广泛应用;     

共词聚类法分析儿童心律失常的药物治疗状况

目的探讨儿童心律失常的药物治疗状况。方法采用共词聚类分析法对2002年至2012年Pubmed数据库中收录的儿童心律失常药物治疗相关文献的主题词作为分析对象,进行词频统计和共现分析。结果儿童心律失常药物治疗研究的热点主要包括交界性异位心动过速的药物治疗、完全性房室传导阻滞的治疗、长QT综合征的药物治疗及房性心律失常的治疗。结论正确识别和判断心律失常的危重性,并选择合理、及时的治疗措施,是挽救危重心律失常患儿生命的关键。     

Pharmacologic targets for atrial fibrillation

Despite advances in treatment, atrial fibrillation (AF) remains the most common arrhythmia in humans. Antiarrhythmic drug therapy continues to be a cornerstone of AF treatment, even in light of emerging non-pharmacologic therapies. Conventional antiarrhythmic drugs target cardiac ion channels and are often associated with modest AF suppression and the risk of ventricular proarrhythmia. Ongoing drug development has focused on targeting atrial-specific ion channels as well as novel non-ionic targets. Targeting non-ionic mechanisms may also provide new drugs directed towards the underlying mechanisms responsible for AF and possibly greater antiarrhythmic potency. Agents that act against these new targets may offer improved safety and efficacy in AF treatment.     

New pharmacological approaches to atrial fibrillation

Atrial fibrillation (AF) is the most common cardiac arrhythmia facing physicians, afflicting 13% of men and 11% of women over 85 years of age. Epidemiological studies estimate that there are ≥ 11 million AF sufferers in the seven major economies and that its prevalence will increase two- to threefold over the next 50 years. Current strategies for treating AF involve either sinus rhythm (SR) maintenance or heart rate control, combined with anticoagulation therapy. Although SR control is the preferred and most effective treatment of AF, none of the SR control drugs currently available are able to maintain rhythm without significant side effects. In this article we discuss some of the recent advancements in developing new antiarrhythmic drugs for AF.     

Pharmacotherapy for atrial fibrillation: is rhythm control achievable?

As the most common sustained cardiac arrhythmia, the health burden presented by atrial fibrillation (AF) continues to grow. One of the current dilemmas in managing AF lies in the decision of whether to pursue a rate or rhythm control strategy. Current antiarrhythmic drugs have many limitations in terms of efficacy and adverse effects, and the availability of better antiarrhythmic drugs that are effective and safe would probably improve outcomes in AF. Enthusiasm for pulmonary vein ablation procedures has been tempered by the relatively high frequency of recurrences of AF, which are often asymptomatic. Ablation also frequently converts symptomatic episodes to asymptomatic recurrences. Irrespective of whether a rate control or a rhythm control strategy is adopted in patients with persistent AF, appropriate antithrombotic therapy should be used.     

Pharmacotherapy for atrial fibrillation: is rhythm control achievable?

As the most common sustained cardiac arrhythmia, the health burden presented by atrial fibrillation (AF) continues to grow. One of the current dilemmas in managing AF lies in the decision of whether to pursue a rate or rhythm control strategy. Current antiarrhythmic drugs have many limitations in terms of efficacy and adverse effects, and the availability of better antiarrhythmic drugs that are effective and safe would probably improve outcomes in AF. Enthusiasm for pulmonary vein ablation procedures has been tempered by the relatively high frequency of recurrences of AF, which are often asymptomatic. Ablation also frequently converts symptomatic episodes to asymptomatic recurrences. Irrespective of whether a rate control or a rhythm control strategy is adopted in patients with persistent AF, appropriate antithrombotic therapy should be used.     

他汀类药物对非缺血性心力衰竭并心房颤动患者的疗效

目的探讨应用他汀类药物对非缺血性心力衰竭并心房颤动患者的作用。方法108例非缺血性心力衰竭并心房颤动患者,随机分为他汀类药物治疗组(50例)和对照组(58例),对照组给予常规治疗,治疗组在此基础上加用他汀类药物,所有受试者均查24h动态心电图、心脏超声彩色多普勒和6min步行距离,测定室性心律失常、左室射血分数和心功能分级,观察病死率。结果他汀类药物治疗组与对照组比较,治疗后两组左室射血分数、6min步行距离均有所提高,室性心律失常、心功能分级、病死率均下降,有统计学差异。结论他汀类药物治疗能改善非缺血性心力衰竭并心房颤动患者预后,疗效明显。     

扬州地区心房颤动住院病例回顾性调查

目的 了解扬州地区心房颤动(AF)患者流行病学特征及治疗现状.方法 对2005～2008年扬州市苏北人民医院诊断AF患者1172例住院患者进行同顾性分析和统计.结果 患者中位年龄69岁,男女比例1.07:1.00.AF病因及相关冈素统计(单项%)分别为老年64.8%、高血压49.0%、冠心病51.9%、风湿性瓣膜病15.6%、甲状腺机能亢进1.8%、特发性AF 0.8%、心肌病11.1%和糖尿病8.4%;心房增大65.3%,射血分数降低28.0%;阵发性AF 28.1%,持续性AF42.2%,永久性AF 29.8%.阵发性AF 3%采用节律控制治疗,57.4%采用心室率控制治疗,药物以β受体阻滞剂、地高辛最多,其次为胺碘酮;慢性AF 75.3%接受心室率控制治疗,常用药物为地高辛、β受体阻滞剂及钙拮抗剂等;脑卒中患病率10.4%;非瓣膜病AF者脑卒中危险因素与AF类型、心房大小无显著相关,而与高龄、高血压、性别密切相关;接受抗血栓治疗79.1%(抗血小板68.3%、抗凝10.3%).结论 扬州地区AF患者在年龄分布、病因及相关因素、AF类型、脑卒中危险因素等流行病学特点与国内外报道相似;多数AF患者采用心室率控制和以抗血小板治疗为主的抗血栓治疗.     

他汀类药物对非缺血性心力衰竭并心房颤动患者的疗效

OBJECTIVE To study the effect of statin therapy in patients with non-ischemic heart failure(HF) and atrial fibrillation(AF).METHODS One hundred and eight patients with non-ischemic HF and AF were randomly divided into 2 groups.Patients in control group(n=     

某院托管前后心房纤颤治疗情况比较研究

目的了解蒲江县人民医院被托管1年来心房纤颤（房颤）患者的治疗情况,探讨医院托管模式对房颤治疗的影响。方法采用回顾性研究方法,分析托管后2011年4月至2012年8月在该院内科住院、资料相对完整的房颤患者的临床资料．并以被拖管前2010年1月至20112年3月住院患者作为对照。结果被托管后1年来,初发房颤、阵发性房颤的复律无明显差异,行射频消融的比例提高,使用血管紧张素转换酶抑制剂（ACEI）或血管紧张素Ⅱ受体拮抗剂（ARB）的比例提高。持续性房颤抗栓治疗的比较提高,使用华法林和低分子肝素的比例提高。永久性房颤服用华法林的比较有所提高,心室率控制的比例提高。结论托管后1年来,该院房颤的治疗情况更加规范,但房颤的抗栓治疗仍需要加强．