心房颤动患者长期管理——房颤中心的临床实践
蒋捷
摘要(Abstract):
<正>心房颤动(房颤)是最常见的心律失常之一,根据流行病学调查的结果推算,中国目前房颤患病人口有近千万[1]。同时,房颤与高血压病、糖尿病相似,也是一种慢性疾病,治疗和管理与其他慢性疾病有相似之处,却更为复杂。房颤的治疗主要包括针对节律和心率的控制及预防血栓栓塞的治疗。由于房颤人群临床情况的巨大差异,在具体的临床处置中会面临复杂的临床决策。例如,目前射频消融术已经成为指南推荐的症状性房颤患者节律控制的主要方法之一[2-3],荟萃分
关键词(KeyWords): 心房颤动;患者管理;房颤中心
基金项目(Foundation):
作者(Author): 蒋捷
参考文献(References):
- [1]周自强,胡大一,陈捷,等.中国心房颤动现状的流行病学研究.中华内科杂志,2004,43(7):491-494.
- [2]January CT,Wann LS,Alpert JS,et al.2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society.J Am Coll Cardiol,2014,64(21):e1-76.
- [3]Camm AJ,Lip GY,De Caterina R,et al.2012 focused update of the ESC Guidelines for the management of atrial fibrillation:an update of the 2010 ESC Guidelines for the management of atrial fibrillation--developed with the special contribution of the European Heart Rhythm Association.2012,14(10):1385-1413.
- [4]Parkash R,Tang AS,Sapp JL,et al.Approach to the catheter ablation technique of paroxysmal and persistent atrial fibrillation:a meta-analysis of the randomized controlled trials.J Cardiovasc Electrophysiol,2011,22(7):729-738.
- [5]Hendriks JML,de Wit R,Vrijhoef HJM,et al.An integrated chronic care program for patients with atrial fibrillation:study protocol and methodology for an ongoing prospective randomised controlled trial.Int J Nurs Stud,2010,47(10):1310-1316.
- [6]Carter L,Gardner M,Magee K,et al.An integrated management approach to atrial fibrillation.J Am Heart Assoc,2016,5(1).pii:e002950.
- [7]Hendriks JM,de Wit R,Crijns HJ,et al.Nurse-led care vs.usual care for patients with atrial fibrillation:results of a randomized trial of integrated chronic care vs.routine clinical care in ambulatory patients with atrial fibrillation.Eur Heart J,2012,33(21):2692-2699.
- [8]Hendriks J,Tomini F,van Asselt T,et al.Cost-effectiveness of a specialized atrial fibrillation clinic vs.usual care in patients with atrial fibrillation.Europace,2013,15(8):1128-1135.
- [9]Qvist I,Hendriks JM,Mller DS,et al.Effectiveness of structured,hospital-based,nurse-led atrial fibrillation clinics:a comparison between a real-world population and a clinical trial population.Open Heart,2016,3(1):e000335.