[AF-FORUM] 34E 抗凝 Dr. Franco

[AF Symposium]

你有器质性心脏病么？
你有高血压么？
依我看，如果你没有器质性心脏病，可以考虑做导管 
消融术治疗房颤，治愈率有85％（30％的病人要做第 
二次手术）。如果你合并需要外科手术的其他心脏疾 
病，那么可以同时在术中行房颤消融术（可选用射 
频，超声，激光等）。
你不能停止抗凝治疗。
Sergio Franco
Cheif of Cardiac Surgery
Cardiovascular Surgery Department
Clinica Medellin
Medellin Colombia

  陶惠伟译 王玲洁校

  问：
我是一名68岁的医生，阵发性房颤4年，持续性房颤2 
年。已服用美托洛尔100mg\d和新抗凝（醋硝香豆素）2 
年。
我的问题是：
有没有文献或者是您个人的经验比较过房颤患者服用 
和不服用新抗凝的的区别，我是指长期服用新抗凝。
因为我有关节炎，是不是合适同时服用新抗凝和阿司 
匹林呢？
或者是服用小剂量的新抗凝（1mg)加350mg的环氧化酶抑 
制剂（阿司匹林）呢？

Dr J.C.Calatayud
Spain

  34 E  Anticoagulation.  Dr. Franco
1. Do you have any structural cardial disease ?2. Are you a  
hypertensive patient ? In my opinion if you don’t have any  
structural cardial disease, you    should  be consider a percoutaneus  
treatment for AF.  Is curative around 85%    of the  patients (30%  
needs a second procedure).  Otherwise in case you have a  surgical  
cardial disease, my recommendation is the surgical treatment of   
cardiac disease and AF (with a energy source as a radiofrecuency,  
laser,  ultrasound, etc)

ASK
 > I am a doctor 68 year with A,F (discontinous from 4 year and   
continous from 2 year) I take metoprolol (100 mg) and ACENOCUMAROL  
(SINTROM) from 2 year ago.  The cuestion is:  Do you know some  
publication o what is your experience comparing   patients with A.F  
with and without sintrom (long time treatment)?  As I have artritis/ 
atrosis it will be suitable the sustituition of  SINTROM FOR ASPIRIN?  
Or decreased sintrom (only 1 mg) together with 350 mg of acetil  
salicilic acyd?.
  Cordialy yours   > Dr.J.C.Calatayud  > Spain

--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee