首页|《2023美国心脏病学会/美国心脏协会/美国胸科医师学会/美国心律学会心房颤动诊断和管理指南》更新要点解读

《2023美国心脏病学会/美国心脏协会/美国胸科医师学会/美国心律学会心房颤动诊断和管理指南》更新要点解读

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2023年11月30日美国心脏病学会(ACC)、美国心脏协会(AHA)、美国胸科医师学会(ACCP)和美国心律学会(HRS)联合发布了《2023年ACC/AHA/ACCP/HRS心房颤动诊断和管理指南》,对2014年和2019年的心房颤动管理指南进行了更新.本文将对新指南更新的以下10个方面内容进行解读:心房颤动分期建议,心房颤动的危险因素修正与预防,灵活运用包括CHA2DS2-VASc评分在内的卒中风险评估模型,卒中危险因素的管理,早期节律控制,导管消融可作为特定心房颤动患者的一线治疗方式,对合并射血分数减低的心力衰竭的心房颤动患者导管消融为1类推荐,心房高频事件(AHRE)患者的建议,左心耳封堵术治疗推荐升级,急症或手术时确诊的心房颤动患者的治疗建议.
Interpretation of update key points of 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation
The 2019 guideline update for the Diagnosis and Management of atrial fibrillation was jointly published by the American College of Cardiology(ACC),American Heart Association(AHA),American College of Chest Physicians(ACCP),and Heart Rhythm Society(HRS)on November 30,2023.This article aims to interpret key updates in the new guideline,including recommendations for different stages of atrial fibrillation,modification and prevention of atrial fibrillation risk factors,flexibility in using clinical risk scores beyond CHA2DS2-VASc for predicting stroke and systemic embolism,consideration of stroke risk modifiers,early rhythm control,and the use of catheter ablation as a first-line therapy in selected patients.The guideline also provides recommendations for catheter ablation of atrial fibrillation in patients with heart failure with reduced ejection fraction,updates for device-detected atrial fibrillation,higher level Class of Recommendation for left atrial appendage occlusion devices,and guidance for managing atrial fibrillation in patients identified during medical illness or surgery.

Atrial fibrillationGuidelineDiagnosisTreatment

张苗苗、赵玉娟

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哈尔滨医科大学附属第一医院心内科,哈尔滨 150001

心房颤动 指南 诊断 治疗

2024

中华老年医学杂志
中华医学会

中华老年医学杂志

CSTPCD北大核心
影响因子:1.606
ISSN:0254-9026
年,卷(期):2024.43(9)