心房颤动Vorhofflimmern | Die Innere Medizin | Springer Nature Link

环球医讯 / 心脑血管来源：link.springer.com德国 - 德语2026-02-05 21:10:07 - 阅读时长29分钟 - 14247字
本文系统阐述了心房颤动的临床诊疗现状，指出该疾病是最常导致住院的心律失常，且随着人口老龄化趋势，其患病率将持续上升。文章强调基础疾病的识别与治疗是首要任务，对有症状患者应考虑抗心律失常治疗，持续性心房颤动在初始阶段和出现症状时应进行电复律。研究表明抗凝治疗对预防血栓栓塞至关重要，仅在无结构性心脏病和无血栓栓塞风险因素时可单独使用阿司匹林，而存在风险因素则必须使用香豆素类衍生物进行有效抗凝。ACE抑制剂和AT拮抗剂在维持窦性心律和降低心律失常发生率方面显示出显著优势，为动脉高血压和/或心力衰竭患者提供了额外治疗价值。新型抗凝和抗心律失常药物的研发为未来实现更有效、副作用更少的治疗方案带来了希望。
心房颤动抗心律失常治疗抗心律失常药物ACE抑制剂AT拮抗剂心脏复律抗凝治疗窦性心律血栓栓塞阿司匹林香豆素类衍生物动脉高血压心力衰竭
心房颤动

心房颤动

摘要

心房颤动是最常导致住院的心律失常。由于我们社会的人口年龄结构以及发病率和共病率的增加，可以预计这种心律失常的患病率将进一步上升。治疗效果往往不令人满意。首先，必须识别并治疗基础疾病。其次，对于有症状的患者，应考虑抗心律失常治疗。对于持续性心房颤动，初始治疗和有症状时应进行电复律。对无症状患者的重复电复律并不能带来死亡率的改善。抗心律失常治疗包括Ia、Ic和III类药物。必须进行伴随的抗凝治疗；仅在无结构性心脏病和无血栓栓塞风险因素的情况下，才可单独使用阿司匹林（ASS）。如果存在风险因素，必须使用香豆素类衍生物进行有效抗凝治疗。血管紧张素转换酶（ACE）抑制剂和血管紧张素II（AT）拮抗剂治疗对于患有动脉高血压和/或心力衰竭的患者，在电复律后维持窦性心律以及降低心律失常发生率方面具有显著优势。新型抗凝药物和新型抗心律失常药物带来了希望，未来可以更有效且副作用更少地治疗患者。

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作者信息

M. G. Hennersdorf & B. E. Strauer

心脏病学、肺病学和血管学诊所，内科和门诊B，海因里希·海涅大学，Moorenstraße 5, 40225, 杜塞尔多夫，德国

关键词

心房颤动，抗心律失常治疗，ACE抑制剂，AT拮抗剂，心脏复律

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