心房細動の治療
Eric N Prystowsky1, Benzy J Padanilam1, Richard I Fogel1
1St Vincent Medical Group, St Vincent Hospital, Indianapolis, Indiana.
JAMA
|July 22, 2015
まとめ
心房細動の治療は 原因を特定し 心拍数を制御することに焦点を当てています 薬剤や切除により シヌスリズムを維持することは,患者のニーズに応じて個別化されます.
科学分野:
- 心臓病科
- 電気生理学
背景:
- 心房細動 (AF) は 何百万もの患者に影響し,脳卒中のリスクと死亡率を高めます.
- AFの有効な管理は 患者のアウトカムにとって極めて重要です
研究 の 目的:
- 脳卒中の予防を除いて,現在の心房細動 (AF) 治療戦略を要約します.
- AF管理オプションの概要を提示する.
主な方法:
- 2010年から2015年にかけてのOvid MEDLINE (5044件の参照) の包括的な文献検索.
- 2014年のアメリカ心臓協会,アメリカ心臓学会,心臓リズム協会のAFガイドラインのレビュー.
主要な成果:
- リスクファクターの修正 (体重減少,高血圧の治療,糖尿病,睡眠時無呼吸) はAFエピソードを減らすことができます.
- 高齢者において,レートコントロールは安全であり,個別化された治療が鍵となる.
- カテーテル除去は多くの患者にとって有効なセカンドライン治療です.
結論:
- AF治療には原因の管理と 抗凝固薬が必要です
- すべての患者にとって,レートコントロールは不可欠です.
- シヌスリズム維持は,個々の患者のニーズに基づいて,薬剤またはアブレーションを考慮する必要があります.
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