Guidelines for the management of atrial fibrillation
Рекомендации по ведению пациентов с фибрилляцией предсердий
2010-08-30
SCID: 54.1/n7k3jpm3
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atrial fibrillationcardiac arrhythmiaischemic strokestroke preventionupstream therapies
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Abstract (AI)
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, occurring in 1–2% of the general population. Over 6 million Europeans suffer from this arrhythmia, and its prevalence is estimated to at least double in the next 50 years as the population ages. It is now 4 years since the last AF guideline was published, and a new version is now needed. AF confers a 5-fold risk of stroke, and one in five of all strokes is attributed to this arrhythmia. Ischaemic strokes in association with AF are often fatal, and those patients who survive are left more disabled by their stroke and more likely to suffer a recurrence than patients with other causes of stroke. In consequence, the risk of death from AF-related stroke is doubled and the cost of care is increased 1.5-fold. There has been much research into stroke prevention, which has influenced this guideline. In the majority of patients there appears to be an inexorable progression of AF to persistent or permanent forms, associated with further development of the disease that may underlie the arrhythmia. Some advance has been made in the understanding of the dynamic development of AF from its preclinical state as an ‘arrhythmia-in-waiting’ to its final expression as an irreversible and end-stage cardiac arrhythmia associated with serious adverse cardiovascular events. Much recent therapeutic effort with ‘upstream therapies’ has been expended to slow or halt the progression of AF due to underlying cardiovascular disease and to AF itself. Limited success has been achieved and is recognized in this guideline.
Key Findings
1
AF-related stroke doubles mortality risk and increases care costs 1.5-fold compared with strokes from other causes.
2
Atrial fibrillation affects 1–2% of the general population, with over 6 million European patients and prevalence projected to at least double within 50 years.
3
Atrial fibrillation increases stroke risk fivefold and accounts for approximately one in five strokes; associated ischemic strokes are more often fatal and disabling.
4
Most patients experience progression from atrial fibrillation to persistent or permanent forms, reflecting advancing underlying cardiovascular disease.
5
Research has substantially informed stroke-prevention recommendations, whereas upstream therapies aimed at slowing AF progression have achieved only limited success.
Research Object
Atrial fibrillation (AF) as a clinical cardiac arrhythmia
Research Subject
the progression, stroke risk, underlying disease mechanisms, and therapeutic management of atrial fibrillation
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2010-08-30
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