心房高频发作对中风和心血管死亡的影响:最新情况
Tobias Toennis1,2, Emanuele Bertaglia3, Axel Brandes4,5
1Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg 20246, Germany.
概括
高频率心房发作 (AHRE) 在老年患者中很常见,可能会增加中风风险. 未来的试验将确定血液稀释剂是否安全和有效用于管理AHRE.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医疗器械 医疗器械
背景情况:
- 在没有被诊断为心房动的老年人中,10-30%的老年人被植入的设备检测到心房高频发作 (AHRE).
- 艾瑞的临床意义和治疗后果在很大程度上仍未确定.
- 由于持续监测和可穿戴技术的广泛使用,AHRE检测正在增加.
研究的目的:
- 为了研究AHRE的治疗影响.
- 评估口服抗凝剂在AHRE患者中降低中风风险的疗效和安全性.
- 为了澄清患有AHRE的患者的临床管理.
主要方法:
- 关于AHRE患病率和相关中风风险的观察数据.
- 在AHRE的背景下分析口服抗凝剂的潜在益处和风险.
- 预测来自两个主要随机临床试验的结果:NOAH-AFNET6和ARTESiA.
主要成果:
- 与没有AHRE的患者相比,AHRE患者的中风风险增加.
- 在AHRE患者中,中风的发生率似乎低于已确定的心房动患者.
- 口服抗凝药具有严重出血的重大风险 (每年约2%).
结论:
- 目前尚不清楚AHRE的最佳管理策略,特别是关于抗凝药的最佳管理策略.
- 即将到来的NOAH-AFNET6和ARTESiA试验准备提供关于AHRE抗凝剂有效性和安全性的关键证据.
- 进一步的研究对于指导临床实践和改善越来越多的人群中检测到心房律乱的患者结果至关重要.
相关概念视频
01:28Disturbances in Heart Rhythm
1.0K
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
1.0K
01:22Cardiac Output II: Effect of Stroke Volume on Cardiac Output
1.1K
Cardiac output (CO), the amount of blood the heart pumps per minute, is a parameter in cardiovascular physiology determined by stroke volume and heart rate. Stroke volume, the amount of blood pushed from one of the ventricles per heartbeat, is influenced by preload, afterload, and contractility.
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...
1.1K
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
50
Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
50
01:18Dysrhythmias IV: Characteristics of Bradyarrhythmias
12
Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
12
01:27Regulation of Stroke Volume
3.3K
The regulation of stroke volume, which is the amount of blood the heart pumps out during each heartbeat, is critical for maintaining a healthy circulatory system. Stroke volume is influenced by three main factors: preload, contractility, and afterload.
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
3.3K
01:19Cardiac Output I:Effect of Heart Rate on Cardiac Output
905
Cardiac Output
Cardiac output (CO) refers to the total amount of blood ejected by one of the ventricles in liters per minute (L/min). In a resting adult, CO ranges from 5 to 6 L/min, adjusting according to the body's metabolic requirements.
Effect of Heart Rate on Cardiac Output
Cardiac output adapts to metabolic demands during stress, physical activity, or illness. The autonomic nervous system regulates heart rate via the sinoatrial node. The parasympathetic nervous system decreases heart...
Cardiac output (CO) refers to the total amount of blood ejected by one of the ventricles in liters per minute (L/min). In a resting adult, CO ranges from 5 to 6 L/min, adjusting according to the body's metabolic requirements.
Effect of Heart Rate on Cardiac Output
Cardiac output adapts to metabolic demands during stress, physical activity, or illness. The autonomic nervous system regulates heart rate via the sinoatrial node. The parasympathetic nervous system decreases heart...
905