[AF-FORUM] 181S 房颤快心室率的急诊处理和后续治疗Dr. Pereira

[AF Symposium]

Dr. Vega，你好，我摘录了ACC/AHA/ESC 2006房颤指南(Fuster et  
al. JAAC, 2006, 48: e149-246)中的一段。I类适应征：1.对于 
永久性或持续性房颤的患者建议使用药物控制心室率 
(倍他受体阻滞剂或非二氢吡啶类钙离子拮抗剂可用 
于大部分患者)。 (证据级别：B)。2. 当房颤急性发作 
且不存在预激时，建议静脉运用倍他受体阻滞剂（艾 
司洛尔，美托洛尔，普奈洛尔）或非二氢吡啶类钙离 
子拮抗剂（维拉怕米，地尔硫唑）控制心室率，伴有 
低血压和心衰时要慎用。(证据级别：B)。3. 对于合并 
心衰且没有旁道的房颤患者，建议静脉运用地高辛或 
胺碘酮控制心室率。（证据级别：B）。4. 对于那些 
运动时有房颤相关症状的患者，应当评估运动时合适 
的心室率，进一步调整药物治疗以便将心室率控制在 
生理范围内。（证据级别：C）。5. 口服地高辛可有 
效的控制静息时的房颤心室率，推荐用于心衰、左室 
功能不全或静息生活方式的患者。（证据级别： 
C）。限于篇幅，我没有摘录II和III类适应征。
Dr. Luciano Pereira
--
Dr. Sergio Dubner
科委会主席
Dr. Edgardo Schapachnik
组委会主席
陶惠伟 译
181S A-Fib Tach RATE control in ER and the next day. Dr. Pereira
?Excuse me, Dr. Vega,I transcribe what the ACC/AHA/ESC 2006  
guidelines state (Fuster et al? JAAC 2006 48 :e149-246).Class I 1  
Measurements of heart rate in rest and rate control using?  
pharmacological agents (BB or nondyhydropyridinic calcium  
antagonists? in most cases) are advised for patients with persistent  
or permanent? AF. (Level of evidence: B).2. In absence of pre- 
excitation, IV administration of BB (esmolol,? metoprolol or  
propranolol) or nondyhydropyridinic calcium antagonists? (verapamil,  
diltiazem) is advised to decrease ventricular rate in AF? with acute  
onset, being cautious in patients with hypotension or? heart failure.  
(Level of evidence: B).3. IV administration of digoxin or amiodarone  
advised to control? heart rate in patients with AF and heart failure  
that do not have? accessory pathway. (Level of evidence: B).4. In  
patients that experience symptoms related to AF during activity, a  
proper rate of HR should be evaluated during exercise,?adjusting the  
pharmacological treatment as necessary to maintain the?rate within  
the physiological range. (Level of evidence: C).5. Digoxin is  
effective followed by oral administration in the?control of HR in  
rest in patients with AF, and is indicated for?patients with heart  
failure, LV dysfunction, or in sedentary?individuals. (Level of  
evidence: C).I do not transcribe the recommendations for Classes II  
and III in? order not to extend this message too much.
Kind regards,
Dr. Luciano Pereira
--
Dr. Sergio Dubner
President of Scientific Committee
Dr. Edgardo Schapachnik
President of Steering Committee








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--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee