中国全科医学 ›› 2024, Vol. 27 ›› Issue (27): 3331-3335.DOI: 10.12114/j.issn.1007-9572.2023.0826

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心房颤动伴长间歇的治疗策略:共识与争议

王潇睿1, 郑若瑶2, 孙凤志1, 张树龙1,*()   

  1. 1.116000 辽宁省大连市,大连大学附属中山医院循环科
    2.061002 河北省沧州市人民医院
  • 收稿日期:2023-11-15 修回日期:2024-04-02 出版日期:2024-09-20 发布日期:2024-06-14
  • 通讯作者: 张树龙

  • 作者贡献:

    王潇睿、郑若瑶负责研究的构思与设计,研究的实施,撰写论文;孙凤志进行论文的修订;张树龙负责文章的质量控制与审查,对文章整体负责,监督管理。

  • 基金资助:
    辽宁省自然科学基金资助项目(LJKZ1191)

Treatment Strategies for Atrial Fibrillation with Long Interval: Consensus and Controversy

WANG Xiaorui1, ZHENG Ruoyao2, SUN Fengzhi1, ZHANG Shulong1,*()   

  1. 1.Department of Circulation, Zhongshan Hospital Affiliated to Dalian University, Dalian 116000, China
    2.Cangzhou People's Hospital, Cangzhou 061002, China
  • Received:2023-11-15 Revised:2024-04-02 Published:2024-09-20 Online:2024-06-14
  • Contact: ZHANG Shulong

摘要: 心房颤动(房颤)是心血管疾病中最为常见的心律失常,其常与病态窦房结综合征并存且相互作用。既往临床上对于有症状的房颤伴长间歇治疗多倾向于植入心脏起搏器联合抗心律失常药物,但近年来越来越多的研究表明,与植入起搏器相比,射频消融能降低房性心动过速相关心律失常的住院率、有效控制房颤,改善患者预后及心力衰竭住院率。但同时部分患者存在固有窦房结功能障碍(SND),且SND可在部分患有房颤的患者中逐渐进展及加重。因此,房颤伴长间歇患者的一线治疗策略仍存在争议。本文以房颤伴长间歇治疗策略的选择进行综述。

关键词: 心房颤动, 病窦综合征, 窦性停搏,心脏, 心脏起搏器,人工, 消融技术

Abstract:

Atrial fibrillation (AF) is the most common arrhythmia in cardiovascular disease, and it often coexists and interacts with sick sinus syndrome. In the past, pacemaker implantation combined with antiarrhythmic drugs was preferred for symptomatic atrial fibrillation with long interval treatment. However, in recent years, more and more studies have shown that compared with pacemaker implantation, radiofrequency ablation can reduce the hospitalization rate related to tachycardia, effectively control atrial fibrillation, and improve patient prognosis and hospitalization rate of heart failure. However, some patients present intrinsic sinus node dysfunction (SND), and SND may progress and worsen in some patients with atrial fibrillation. Therefore, the first-line treatment strategy for patients with atrial fibrillation with long interval remains controversial. This article reviews the selection of long-term intermittent treatment strategies for atrial fibrillation.

Key words: Atrial fibrillation, Sick sinus syndrome, Sinus arrest, cardiac, Pacemaker, artificial, Ablation techniques