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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Rhythm management in atrial fibrillation--with a primary emphasis on pharmacologic therapy: Part 3.
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Rhythm management in atrial fibrillation--with a primary emphasis on pharmacologic therapy: Part 3.

机译：心房颤动的节律管理-主要侧重于药物治疗：第3部分。

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摘要

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 pharmacologic conversion followed by maintenance of sinus rhythm by pharmacologic (or occasionally ablative) therapies. This article will present current approaches to rate and rhythm control issues in atrial fibrillation. Parts 1 and 2, published previously, dealt with rate control and with the restoration of sinus rhythm. Part 3, the current article, details the selection process of choosing a therapy to maintain sinus rhythm, including the likelihood of success, the risks of therapy, and individualization of therapy as dependent upon the nature of the structural heart disease present. It also discusses nonpharmacologic approaches that have been recently developed or are undergoing development. One suggested drug selection algorithm is provided.
机译：心房颤动（AF）是临床医生需要处理的最常见的，持续的，有症状的心律失常。管理策略包括心室率控制和抗凝治疗，以及窦性心律的恢复和维持。速率控制可以通过药理学来实现，可以使用直接损害AV节点传导的药物和/或通过增加副交感神经/交感神经平衡或通过解剖方式修改或消融AV节点区域来实现。节律的控制可通过电或药理转换，然后通过药理（或偶尔消融）疗法维持窦性心律来实现。本文将介绍心房纤颤中速率和节律控制问题的当前方法。先前出版的第1部分和第2部分涉及速率控制和窦性心律的恢复。当前文章的第3部分详细介绍了选择维持窦性心律的疗法的选择过程，包括成功的可能性，疗法的风险以及取决于存在的结构性心脏病的性质的疗法的个体化。它还讨论了最近开发或正在开发的非药物方法。提供了一种建议的药物选择算法。

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