[AF-FORUM] 57S 抗凝. Dr. Morillo

[AF Symposium]

象Gerstenfeld医生一样，我并没参加讨论，但注视着不 
同参会人员各自有趣的意见。有一点很重要，就是要 
站在问题本身的视角，而给出证据充分的回答，同时 
不忽略他的普遍意义。

对于这个病例，显然其症状并不重，所以我并不推荐 
消融为其首选一线治疗，抗凝治疗本身的问题提出非 
常中肯，但是毫无疑问，众多研究已显示抗凝治疗的 
好处，尤其是针对该病例的特点华法令治疗优于阿司 
匹林治疗。简言之，目前没有存在消融治疗的I类适 
应症存在（无大规模临床实验证据）。我推荐的是， 
向他现在做的那样，控制心室率，继续华发林治疗。

Carlos A. Morillo, MD, FRCPC, FACC, FHRS, FESC
Professor Department of Medicine
Director Arrhythmia Service, Cardiology Division
McMaster University - Population Health Research Institute
HGH-McMaster Clinic 5th Floor Room 501
237 Barton St. East
Hamilton, ON, Canada L8L 2X2
Tel: (905) 577-8004
Fax: (905) 521-8820
email: morillo在hhsc.ca
morillc在mcmaster.ca

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Re: [AF-FORUM] 57S Anticoagulation. Dr. Morillo

Just like Dr. Gerstenfeld, I have kept myself apart from these
discussions and I have followed with quite some interest the opinions
of various participants. It is important to put into perspective many
of the questions proposed and to give answers generally based on
evidence, without neglecting common sense.
In the case under discussion of the colleague, it is quite clear that
he is not very symptomatic, so an AF ablation is an option I would
not recommend as first-line treatment. The question of
anticoagulation is pertinent, but undoubtedly there is plenty of
evidence of the benefits from anticoagulant agents, and especially of
the superiority of warfarin compared to aspirin in the prevention of
embolic events in a person with the characteristics of our colleague.
In brief, at the moment, there is no Class I indication (in other
words, there is no evidence derived from clinical studies supporting
this recommendation) for an ablation, what I would recommend is to
control the ventricular response just as he is doing now, and to
continue with warfarin too.

Carlos A. Morillo, MD, FRCPC, FACC, FHRS, FESC
Professor Department of Medicine
Director Arrhythmia Service, Cardiology Division
McMaster University - Population Health Research Institute
HGH-McMaster Clinic 5th Floor Room 501
237 Barton St. East
Hamilton, ON, Canada L8L 2X2
Tel: (905) 577-8004
Fax: (905) 521-8820
email: morillo在hhsc.ca
morillc在mcmaster.ca

--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee