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心房颤动(房颤)是临床上最常见的心律失常。房颤的治疗在当下仍是一大挑战。研究显示,长时间的心动过速会导致心肌结构重构,电重构和神经体液重构,即所谓的心动过速性心肌病。流行病学的调查证实,房颤是心力衰竭、脑卒中、死亡的独立危险因素。毫无疑问,尽早的转复并维持窦性心律给患者来带的血流动力学及其他方面的益处是室率控制策略不可比拟的,但是目前抗心律失常的治疗措施仍然不尽人意。十几年来,对房颤治疗的两种基本策略——室率控制和节律控制,结合抗栓治疗的临床研究一直没有停歇,然而这些研究似乎都得出一个结论:两种治疗策略对于整体房颤人群的预后没有显著性的差异。但是对这些临床研究的深层解读告诉我们:对房颤患者进行早期节律干预仍是我们的治疗目标。
Atrial fibrillation (atrial fibrillation) is the most clinically common cardiac arrhythmia. The treatment of atrial fibrillation in the moment is still a big challenge. Studies have shown that prolonged tachycardia leads to structural remodeling, electrical remodeling and neurohumoral remodeling, the so-called tachycardia cardiomyopathy. Epidemiological investigation confirmed that atrial fibrillation is an independent risk factor for heart failure, stroke and death. Undoubtedly, the haemodynamic and other benefits of early sinus rhythm reinfusion and maintenance of sinus rhythm are incomparable with room rate control strategies, but the current anti-arrhythmic treatment is still not satisfactory. For more than a decade, two basic strategies for the treatment of atrial fibrillation, ventricular rate control and rhythm control, have not ceased in clinical studies in combination with antithrombotic therapy. However, these studies all seem to conclude that the two treatment strategies for the whole room There was no significant difference in the prognosis of the tremor population. But a deep reading of these clinical studies tells us that early rhythm intervention in patients with atrial fibrillation is still our goal.