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老年人脑梗死与心房颤动的关系
1 引言随着我国人口的老龄化,急性脑卒中的发病率亦在增加.在老年脑梗死病人中,部分伴发心房颤动,为探讨两病之间的关系,本文回顾性分析我院670例老年脑梗死病人的临床资料,现将结果报告如下.
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关键词: Atrial Fibrillation
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射频消融治疗房颤现状
心房颤动(AF)是常见的心律失常,指过快而极不规则的心房异位搏动,频率常为每分钟350~600次.其本身可引起心脏结构与功能的变化,恶化血流动力学状态,严重影响患者生活质量并危及生命.因而其防治突出的成功研究热点与难题.药物治疗是目前临床治疗的主要手段,但长期药物治疗难免发生毒副反应,患者的依从性亦有限.射频消融(Radiofrequency ablation;RFA)是近十年兴起的一种新的AF治疗手段.本文主要就其现有的几种消融治疗方法作一简述.
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2010版欧洲心房颤动诊疗指南解读
欧洲心脏病学会( ESC)去年正式颁布了2010版心房颤动(房颤)指南.该指南以现有临床研究证据为证据,对房颤的管理做出了全面而详细的推荐建议,在抗凝、心室率控制等方面作出了新的推荐建议.新指南有以下8个方面值得关注:1 心房颤动的分类及分级1.1心房颤动的分类国际上房颤的分类很多,新版指南根据房颤持续时间将房颤分为5类:首发房颤(首次发生的房颤)、阵发性房颤(持续时间<48 h,可以自行终止)、持续性房颤(持续时间>7d)、持久性房颤(持续时间>1年)、慢性房颤(房颤持续存在且患者已处于适应状态).
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心房颤动治疗策略随机试验结论及评价
多年来,对于心房颤动(简称房颤)病人治疗中选择节律控制还是室律控制一直存在争议,新4项随机试验对两种治疗策略进行了进一步的研究,这些随机试验包括Pharmacological Intervention in Atrial Fibrillation (PIAF) ,Strategies of Treatment of Atrial Fibrillation (STAF) pilot study,Rate Control vs.Electrical Cardioversion For Persistent Atrial Fibrillation (RACE) 和 Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) ,AFFIRM试验是迄今为止大规模的试验,也是唯一结论中死亡率有差异的试验.
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心律不齐、房颤患者64排螺旋CT冠状动脉成像技术探讨
目前64排螺旋CT在冠心病的检查中,越来越发挥重要作用,但许多医院和厂家为了达到满意的效果,往往限制做检查的病人心律要齐和心率控制在70次/min以下,但是许多合并心律不齐和房颤的病人,失去了做此项检查的机会.笔者在几个月内,通过69例心律不齐、房颤的病人检查尝试,并得出了较为满意的诊断效果.
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Objective: Catheter-based pulmonary vein isolation (PVI) is an established therapy for paroxysmal atrial fibrillation. The high-density mesh mapper (HDMM) guides circumferential PV-atrium isolation without the 3D electroanatomic mapping. This study aims to compare circumferential pulmonary vein (CPV) anatomy mapping between guiding by a 3D mapping system and the HDMM. Methods: Forty-four consecutive patients with paroxysmal atrial fibrillation were scheduled for a first procedure for PVI. A CPV ostial anatomy map guided by HDMM was set up in the CARTO system while the operator was blinded to the CARTO screen. Then CARTO-guided ipsilateral PV maps were obtained and PVI was performed. This established another set of CPV ostial anatomy maps. The differences between the two mapping images were compared and analyzed.
Results: All 176 PVs in 44 patients could be mapped by both HDMM and CARTO. About 44.9%of the PV ostial anatomies were generally similar between the two different map images. The average point-to-point straight distance between the HDMM-guided map and the CARTO-guided map was 6.2 ± 1.4 mm. The area of the circumferential right PV (CRPV) in the HDMM map was larger than that in the CARTO map (P ? 0.013). After a mean follow-up of 18.3 ± 4.3 months (6e24 months), 72.7%of patients (32/44) were free of atrial arrhythmia without anti-arrhythmic drugs (AADs).
Conclusion: Compared to the CARTO-guided CPV anatomy image, a highly similar figure could be achieved by mapping guided by the HDMM. (Clinical trial.gov number, ChiCTR-TNRC-11001390.)
Copyright ? 2015, Chinese Medical Association Production. Production and hosting by Elsevier B.V. on behalf of KeAi Communications Co., Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).