心房颤动诊断与治疗进展  

Advances in the diagnosis and treatment of atrial fibrillation

作　　者：马长生[1] 赵一泽 王雯玉 MA Changsheng;ZHAO Yize;WANG Wenyu(Cardiology Center,Beijing Anzhen Hospital,Capital Medical University,Beijing,100029,China)

机构地区：[1]首都医科大学附属北京安贞医院心脏内科中心,北京100029

出　　处：《临床心血管病杂志》2025年第3期170-175,共6页Journal of Clinical Cardiology

摘　　要：随着技术进步,心房颤动(房颤)的诊断和治疗发生了显著变化。在房颤的诊断、筛查方面,植入式心脏监测设备和长程心电图使得房颤的早期识别成为可能;基于光电容积脉搏波(PPG)技术的智能手表等可穿戴设备为房颤筛查及房颤负荷的测量提供了便捷且无创的解决方案。在治疗方面,新型口服抗凝药显著提高了抗凝治疗的安全性与有效性,而左心耳封堵术则为无法使用抗凝药物的患者提供了替代的卒中预防策略。房颤的节律控制治疗,尤其是导管消融手术,其治疗目标已逐步从单纯的症状控制转向改善患者的长期预后,并且独立术者培训周期成倍缩短,严重并发症显著减少。随着经验积累,新的消融术式显著提高了持续性房颤的治疗成功率,而脉冲场消融(PFA)作为新一代消融能量,有望在节律控制治疗中发挥重要作用。本文将重点探讨房颤在诊断、筛查和治疗方面的最新进展。With advancements in technology,the diagnosis and treatment of atrial fibrillation(AF)have undergone significant changes.In terms of diagnosis and screening,implantable cardiac monitoring devices and long-term electrocardiograms have made early detection of AF possible.Wearable devices such as smartwatches based on PPG technology provide convenient and non-invasive solutions for AF screening and the measurement of AF burden.In treatment,novel oral anticoagulants have markedly improved the safety and efficacy of anticoagulation therapy,while left atrial appendage closure offers an alternative stroke prevention strategy for patients unable to use anticoagulants.Rhythm control therapies for AF,particularly catheter ablation,have shifted their focus from mere symptom control to improving long-term patient outcomes.Additionally,the training period for independent practitioners has been significantly shortened,and the safety of the technique has greatly improved.With accumulated experience,new ablation techniques have significantly enhanced the success rate of treating persistent AF,and pulsed-field ablation(PFA),as a next-generation ablation modality,holds promise for playing a pivotal role in rhythm control therapies in the future.This article will focus on the latest advances in diagnosis,screening,and treatment of atrial fibrillation.

关 键 词：心房颤动 诊断 筛查 治疗 

分 类 号：R541.7[医药卫生—心血管疾病]