The impact of new and emerging clinical data on treatment strategies for atrial fibrillation.

作者: ERIC N PRYSTOWSKY , JOHN CAMM , GREGORY Y.H. LIP , MAURITS ALLESSIE , JEAN-FRANÇOIS BERGMANN

DOI: 10.1111/J.1540-8167.2010.01770.X

关键词: Catheter ablationRisk factorHealth careIntensive care medicineMedicineDabigatranIncidence (epidemiology)EpidemiologyDronedaroneStroke

摘要: AF Treatment Strategies. Introduction: The Atrial Fibrillation (AF) Exchange Group, an international multidisciplinary group concerned with the management of AF, was convened to review recent advances in field and potential impact on treatment strategies. Methods: Issues discussed included epidemiology rising incidence health care systems, developments pharmacological surgical interventions arrhythmias thromboprophylaxis, affect strategies, barriers implementing them. Results: associated burden systems are increasing aging populations, prevalence comorbidities more effective cardiovascular diseases. Advances available medical treatments, particular dronedarone dabigatran, other products development, offer possibility changes paradigms a greater emphasis reducing hospitalizations improvement long-term outcomes instead symptom/safety-driven approach which priority is symptom suppression without provoking drug toxicity. Developments catheter ablation techniques may mean that, experienced centers, be offered as first-line selected patient populations. Barriers optimal include underdiagnosis, lack recognition serious condition risk factor for stroke, limited access care, inadequate implementation guidelines, poor adherence treatment. Conclusions: focus changing consequence new treatments based outcome improvements they offer. However, benefits will not fully realized if guidelines guidance observed routine clinical practice. (J Cardiovasc Electrophysiol, Vol. 21, pp. 946-958, August 2010)

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