亚临床心房动/心房高频发作:有什么意义和决策?
Giuseppe Boriani1, Enrico Tartaglia1, Paola Trapanese1
1Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, Italy University of Modena and Reggio Emilia, Policlinico di Modena, Modena 41124, Italy.
概括
被设备检测到的亚临床心房动 (AF) 和心房高频发作 (AHREs) 会增加中风风险. 口服抗凝剂减少了这种风险,但引起了出血的担忧,需要个性化治疗决策.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 临床试验 临床试验
背景情况:
- 亚临床心房动 (AF) 和心房高频发作 (AHREs) 偶然被心脏设备和可穿戴设备检测出来.
- 这些情节增加了中风风险,虽然不如临床AF,提出管理挑战.
研究的目的:
- 审查对AHREs不断变化的理解以及围绕最佳管理的不确定性,特别是口服抗凝剂 (OAC) 的使用.
- 讨论关键试验 (ARTESiA,NOAH-AFNET 6) 和关于AHREs的OACs的元分析的发现.
主要方法:
- 关于AHRE管理的当前文献和临床试验数据的综述.
- 对ARTESiA和NOAH-AFNET 6试验关于抗凝血疗效和出血风险的结果的分析.
- 包括一个评估OACs的元分析在设备检测到AHRE的患者中.
主要成果:
- ARTESiA显示,阿皮克萨班可以减少中风,但会增加出血;NOAH-AFNET 6没有发现埃多克萨班和更高出血率对心血管有显著益处.
- 分析证实OAC降低缺血性中风风险,但增加出血风险.
- 个人决策至关重要,平衡中风和出血风险.
结论:
- 对AHREs的管理需要个性化的方法,考虑中风风险,出血风险和患者的偏好.
- 共享决策对于权衡抗凝药益处与风险至关重要,特别是在进展到临床AF方面.
- 未来的研究应该完善抗凝策略,并确定高风险患者亚组.
相关概念视频
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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.
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Arrhythmias are disturbances in the heart's rhythm that lead to abnormal heartbeats. These irregularities can originate from different parts of the heart and are classified based on their origin and nature.
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Sinus Node Arrhythmias
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01:28Mechanism of Cardiac Arrhythmias
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