OCC 2014:合并房颤心衰患者的治疗:CRT或消融?

2014-06-09 小田 整理 医学论坛网

在5月30日的东方心脏病学会议(OCC2014),浙江绿城心血管病医院沈法荣教授作了《合并房颤心衰患者的治疗:CRT或消融?》的报告。 本质上,心衰和房颤是一组临床综合征,是一类疾病的两个方面,二者密不可分,互为因果,相互促进;且具有相同的人口学特征,即发病率随年龄增长而增加;此外,二者还有共同的危险因素,包括高血压、糖尿病、心肌梗死和瓣膜性心肌病等。 2012年CRT(心脏再同步化治

在5月30日的东方心脏病学会议(OCC2014),浙江绿城心血管病医院沈法荣教授作了《合并房颤心衰患者的治疗:CRT或消融?》的报告。

本质上,心衰和房颤是一组临床综合征,是一类疾病的两个方面,二者密不可分,互为因果,相互促进;且具有相同的人口学特征,即发病率随年龄增长而增加;此外,二者还有共同的危险因素,包括高血压、糖尿病、心肌梗死和瓣膜性心肌病等。

2012年CRT(心脏再同步化治疗)相关专家共识指出,就目前临床证据而言,CRT不能减少房颤负荷。房颤伴心衰CRT治疗需注意提升双室起搏比例及术后管理。

对合并房颤心衰患者的治疗,需结合患者自身房颤类型和病因进行合适的治疗选择,对于可复律的房颤可行射频消融。

2013年的研究显示,对于持续性房颤伴左心功能下降的患者,在除外可导致左心功能下降的其他原因后,导管消融可成功改善患者的心衰,但为维持窦律,许多患者需进行一次以上的导管消融,因此提高持续性房颤导管消融的成功率仍值得我们重视。




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    2014-06-11 zhaojie88
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