非器质性心脏病心房颤动的治疗策略进展

心房颤动(房颤)是一种常见的心律失常。根据房颤的症状和时程可分为首发房颤、阵发性房颤、持续性房颤、长程持续性房颤和永久性房颤。根据血流动力性是否稳定和病程长短,可选择复律维持窦性心律策略、心室率控制策略和长期抗凝策略。新型口服抗凝剂可作为传统口服抗凝药物(OAC)的替代选择。除了药物治疗措施之外,房颤进行导管消融的地位逐渐提高,特别是对于非器质性心脏病的阵发性房颤患者,已经从过去的药物治疗失败后的可选治疗策略发展成为一线治疗策略。

Progress of treatment strategy in atrial fibrillation with non-structural heart disease

Atrial fibrillation (AF) is one of the most common cardiac arrhythmias. Based on the symptom and duration, AF can be clinically classified into five types: first detected, paroxysmal, persistent, long-standing persistent and permanent AF. According to the haemodynamic condition and duration, rhythm-control strategy (conversion and maintenance of sinus rhythm), rate-control strategy and continuous anticoagulation strategy are optional. Non-vitamin K antagonist oral anticoagulants (NOACs) have been proposed as alternatives to vitamin K antagonists (VKAs). The status of catheter ablation improves gradually, especially for the paroxysmal AF with non-structural heart disease, and now catheter ablation has been considered as a first line treatment and may be prior to anti-arrhythmic drug therapy in symptomatic paroxysmal AF with non-structural heart disease.