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Tratamiento de la fibrilación auricular
Eric N Prystowsky1, Benzy J Padanilam1, Richard I Fogel1
1St Vincent Medical Group, St Vincent Hospital, Indianapolis, Indiana.
JAMA
|July 22, 2015
Resumen
El tratamiento de la fibrilación auricular se centra en abordar las causas y controlar el ritmo cardíaco. El mantenimiento del ritmo sinusal a través de medicamentos o ablación es individualizado para las necesidades del paciente.
Área de la Ciencia:
- Cardiología
- Electrofisiología
Sus antecedentes:
- La fibrilación auricular (FA) afecta a millones de personas, aumentando el riesgo de accidente cerebrovascular y la mortalidad.
- El manejo eficaz de la FA es crucial para los resultados de los pacientes.
Objetivo del estudio:
- Resumir las estrategias actuales de tratamiento de la fibrilación auricular (FA), excluyendo la prevención del ictus.
- Proporcionar una visión general de las opciones de gestión del AF.
Principales métodos:
- Búsqueda exhaustiva de la literatura de Ovidio MEDLINE (5044 referencias) desde 2010 hasta 2015.
- Revisión de la guía de AF de la Asociación Americana del Corazón, el Colegio Americano de Cardiología y la Sociedad del Ritmo Cardíaco de 2014.
Principales resultados:
- La modificación de los factores de riesgo (pérdida de peso, tratamiento de la hipertensión, diabetes, apnea del sueño) puede reducir los episodios de FA.
- El control de la tasa es seguro en adultos mayores; el tratamiento individualizado es clave.
- La ablación por catéter es un tratamiento de segunda línea eficaz para muchos pacientes.
Conclusiones:
- El tratamiento de la FA implica el manejo de las causas y la anticoagulación.
- El control de la tasa es esencial para todos los pacientes.
- El mantenimiento del ritmo sinusal mediante fármacos o ablación debe considerarse en función de las necesidades individuales del paciente.
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