A proposal for new clinical concepts in the management of atrial fibrillation

被引：45

作者：

Camm, A. John ^{[1
]}

Al-Khatib, Sana M. ^{[2
]}

Calkins, Hugh ^{[3
]}

Halperin, Jonathan L. ^{[4
]}

Kirchhof, Paulus ^{[5
,6
]}

Lip, Gregory Y. H. ^{[5
]}

Nattel, Stanley ^{[7
]}

Ruskin, Jeremy ^{[8
]}

Banerjee, Amitava ^{[5
]}

Blendea, Dan ^{[7
]}

Guasch, Eduard ^{[8
]}

Needleman, Matthew ^{[3
]}

Savelieva, Irina ^{[1
]}

Viles-Gonzalez, Juan ^{[4
]}

Williams, Eric S. ^{[9
]}

机构：

[1] Univ London, London SW17 0RE, England

[2] Duke Univ, Med Ctr, Durham, NC USA

[3] Johns Hopkins Univ, Baltimore, MD USA

[4] Mt Sinai Sch Med, New York, NY USA

[5] Univ Birmingham, Ctr Cardiovasc Sci, City Hosp, Birmingham, W Midlands, England

[6] Univ Hosp Munster, Dept Cardiol Angiol, Munster, Germany

[7] Massachusetts Gen Hosp, Boston, MA 02114 USA

[8] Montreal Heart Inst, Montreal, PQ H1T 1C8, Canada

[9] Univ Washington, Med Ctr, Seattle, WA 98195 USA

来源：

AMERICAN HEART JOURNAL | 2012年 / 164卷 / 03期

关键词：

FOLLOW-UP; ATHEROSCLEROSIS RISK; HEART-FAILURE; MORTALITY; MECHANISMS; OUTCOMES; RHYTHM; LONE; PATHOPHYSIOLOGY; INFLAMMATION;

D O I：

10.1016/j.ahj.2012.05.017

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Atrial fibrillation (AF) represents a growing public health burden. It is a complex condition, involving a number of etiologic factors and arrhythmia mechanisms associated with atrial remodeling. Greater understanding of these mechanisms may improve therapy. Current AF classification schemes are limited by simplicity. A number of risk factors predict AF onset, and additional factors are being evaluated in registry studies. Doppler imaging and Holter monitoring in high-risk patients to predict the onset of AF and progression from paroxysmal to permanent AF are promising. There is a need for a novel multifactorial classification model encompassing AF duration, symptoms, markers of atrial remodeling, and a risk score for AF onset, persistence, progression, and complications to guide treatment and prognostication. Preventing AF onset with upstream therapy is of great interest, but current data are conflicting. More study is needed to optimize rhythm control with antiarrhythmic drugs and targeted ablation to specific patient populations at an earlier stage. There is little consensus on optimal rate control and no information relating to optimum rate control in specific populations. This article highlights new concepts in AF and directions for future research. (Am Heart J 2012;164:292-302.e1.)

引用

页码：292 / U193

页数：12

共 63 条

[51] Development of a risk score for atrial fibrillation (Framingham Heart Study): a community-based cohort study [J].