動脈動脈動脈動脈を制御する
Isabelle C Van Gelder1, Michiel Rienstra1, Harry J G M Crijns2
1Department of Cardiology, Thoraxcenter, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
Lancet (London, England)
|August 26, 2016
まとめ
心房細動の管理には 心拍を制御することが含まれます これはすべての患者にとって重要なステップです 心拍の制御のための治療の選択は,患者の要因と利用可能な治療法に基づいて個別化されます.
科学分野:
- 心臓病科
- 内科 医学
背景:
- 心房細動 (AF) の管理には,効果的な心拍数制御が必要です.
- リズム制御の目標に関係なく,すべてのAF患者にとってレート制御は主要な考慮事項です.
研究 の 目的:
- 心房細動における心拍数制御の根拠,患者の選択,および利用可能な治療法を検討する.
- AF率の制御のための薬物選択と介入戦略に関するガイドラインを提供すること.
主な方法:
- 心房細動の管理戦略に関する現在の文献のレビュー.
- 心拍の制御のための薬学的および介入的選択肢の分析.
主要な成果:
- 心拍のコントロールはAFの管理に不可欠であり,個々の患者のプロフィールに合わせて薬の選択が行われます.
- ベータ阻害剤と非ジヒドロピリジンカルシウムチャネル阻害剤は有効だが,ディゴキシンの作用は限られている.
- 心房結節切除は最後の手段であり,AFのキャセータ切除は好ましい代替手段である.
結論:
- 心房細動の患者に個別のペースコントロールが不可欠です.
- ベータ・ブロッカーやカルシウム・チャネル・ブロッカーのような 薬学的選択肢は第一線です
- 介入処置は慎重に検討し,AV節の切除よりもAF切除を優先すべきである.
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