《2023 ACC/AHA/ACCP/HRS心房颤动诊断和管理指南》解读  

Interpretation of the 2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation

作　　者：杨子琪 朱泽宇 罗启余 钱永军[1] YANG Ziqi;ZHU Zeyu;LUO Qiyu;QIAN Yongjun(Department of Cardiovascular Surgery,West China Hospital,Med-X Center for Materials,Sichuan University,Chengdu,610041,P.R.China)

机构地区：[1]四川大学华西医院心脏大血管外科四川大学“医学+材料”中心,成都610041

出　　处：《中国胸心血管外科临床杂志》2024年第5期654-666,共13页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：四川大学华西医院学科卓越发展1-3-5工程临床研究孵化项目(2019HXFH029);四川省卫生健康委员会医学科技项目(21PJ035);四川省干部保健科研课题(川干研2023-116);四川省中医药管理局中医药科研专项课题(2023MS439);四川大学“医学+材料”中心医工融合创新项目(MCM202306);四川省医学会伤口疾病(泰阁)专项科研课题(2023TG12)。

摘　　要：美国心脏病学会(ACC)、美国心脏学会(AHA)、美国胸科医师协会(ACCP)和美国心律学会(HRS)根据最新的临床证据,更新并发布了《2023 ACC/AHA/ACCP/HRS心房颤动诊断和管理指南》。本文对其中的心房颤动(房颤)分类和管理方法进行了解读。立足于最新循证医学证据,指南在房颤的定义与分期、临床评估与治疗、风险因素修正、血栓栓塞预防、特定人群管理等方面均有重要更新。其中最重要的为指南提出新的房颤分期模型和相应阶段的管理策略,强调预防和早期干预的重要性。本文以房颤综合管理3大支柱为线索,着重分析卒中风险评估、生活方式与风险因素修正和特定患者群体管理以及心率控制和节律控制,指出其对临床实践的重大意义,进而指导临床医生进行更精准的治疗。This article provides an interpretive review of the"2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation",which was updated and published by the American College of Cardiology(ACC),the American Heart Association(AHA),the American College of Chest Physicians(ACCP),and the Heart Rhythm Society(HRS)based on the latest clinical evidence.It delves into the classification and management strategies for atrial fibrillation(AF),grounded in the most current evidence-based medical research.The guideline offers significant updates in various aspects such as the definition and staging of AF,clinical evaluation and treatment,modification of risk factors,prevention of thromboembolism,and management of specific populations.Notably,the introduction of a new staging model for AF and corresponding management strategies stands out,underscoring the importance of prevention and early intervention.This article focuses on the three pillars of integrated AF management-stroke risk assessment,modification of risk factors,and management of specific patient groups,in addition to rate and rhythm control,analyzes their substantial significance in clinical practice and guides clinicians in providing more precise treatment.

关 键 词：心房颤动 指南解读 诊断和管理 

分 类 号：R541.75[医药卫生—心血管疾病]