通过心脏器件发现的心房律不整的管理
1UOS Week Cardiology, UOC Cardiology, San Giovanni Addolorata Hospital, Rome.
概括
通过可植入装置检测到的亚临床心房动 (AF) 与明显的AF相比,具有较低的血栓栓塞风险. 目前的指导方针缺乏明确性,需要个性化风险评估,而不是简单的存在/缺席方法.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 医疗器械 医疗器械
背景情况:
- 可植入的心脏器件显示,心房动 (AF) 比以前认为的更常见.
- 亚临床AF,也称为心房高率事件 (AHREs),是无症状的发作,需要更明确的管理指南.
研究的目的:
- 评估亚临床AF (AHREs) 的临床意义和最佳治疗管理.
- 为了解决在患有AHREs的患者中围绕抗凝药治疗决定的不确定性.
主要方法:
- 最近关于亚临床AF的随机研究 (NOAH-AFNET 6,ARTESIA) 的综述.
- 在AHRE患者中分析与抗凝固剂治疗相关的血栓栓塞风险和出血风险.
主要成果:
- 与临床表现的AF相比,亚临床AF具有较低的血栓栓塞风险 (大约1%),而非临床表现的AF.
- 在许多患有AHREs的患者中,出血的风险可能会超过抗凝剂的益处.
结论:
- 关于亚临床AF抗凝剂治疗的决定应该超出简单的"是"或"不是"二分法.
- 个性化的方法,量化事件负担 (数量,持续时间) 并考虑CHADSVASC得分,对于风险分层至关重要.
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