房颤消融时代节律控制和心率控制哪个更好课件

InAtrialFibablationera isrhythmcontrolbetterthanratecontrol Epidemiologyandcomplication About1 ofallpopulationAbout10 ofseniorpeople 70yearsold About5 embolism strokeeachyearExacerbateHeartfailure Epidemiology JACC VOL 66 NO 9 2015 Epidemiology JACC VOL 66 NO 9 2015 Epidemiologyandcomplication About1 ofallpopulationAbout10 ofseniorpeople 70yearsold About5 embolism strokeeachyearExacerbateHeartfailure CHADS2 VASC CHADS2 VASC 2020 2 27 Epidemiologyandcomplication About1 ofallpopulationAbout10 ofseniorpeople 70yearsold About5 embolism strokeeachyearExacerbateheartfailure Deterioratecardiacfunction Deterioratecardiacfunction RatecontrolVSrhythmcontrol traditionalrhythmcontrolablation Therapyaim Decreasemortality strokeProtectcardiacfunction Therapyaim Decreasemortality stroke Treatstrategy RatecontrolVsRhythmcontrol whichisbetter Traditionalrhythmcontrol AFFIRMStudy paroxysmalorpersistentAF AFFIRMStudy AFFIRMStudy Hazardratiofordearth Whynodifference Sinusrhythmcontrolratelow Sinusrhythmcontrolratelow Thesinusrhythmrateis82 4 73 3 62 6 at1 3 5years Whynodifference Differenceinanticoagulationtherapy Whynodifference Differenceinanticoagulationtherapy 85 ratecontrolpatientswithwarfarin70 rhythmcontrolpatientswithwarfarin Whynodifference AFFIRMStudy LessonfromAFFIRM Usingtraditionwaytorhythmcontrol nobenefitsinpreventingmortalityandstroke Evensuccessofrhythmcontrol anticoagulationnecessaryintraditionway Successrateofrhythmcontrolinablation Whataboutablation Sinusratecontrolis 40 37 29 at1 3 5yearsforsingleablation arrhythmiafree 87 81 63 at1 3 5yearsformultipleablation arrhythmiafree singleprocedure54 1 inparoxysmalAF 41 8 innonparoxysmalAF Withmultipleprocedures thelong termsuccessrateimprovedto79 8 Sinusratecontrolis Sinusratecontrolis JAmHeartAssoc 2013Mar18 2 2 e004549 doi 10 1161 JAHA 112 004549 Sinusratecontrolis JAmHeartAssoc 2013Mar18 2 2 e004549 doi 10 1161 JAHA 112 004549 Arrhythmiafree asymptomaticAf http dx doi org 10 3346 jkms 2015 30 8 1078 JKoreanMedSci2015 30 1078 1084 Forsingleablation successrateisevenlowerthanAFFIRM Ablationdecreasestroke Indirectevidence Ablationdecreasestroke NOdirectevidenceCatheterAblationvsAntiarrhythmicDrugTherapyforAtrialFibrillation CABANA trialEarlyTreatmentofAtrialFibrillationforStrokePreventionTrial EAST Guidelinesays Therapyaim Decreasemortality strokeProtectcardiacfunction Traditionalrhythmcontrol AF CHFtrial AF CHFtrial AF CHFtrial AF CHFtrial Ablation background background Benefitincardiacfunction Adverseevents Lessonsfromtrials NobenefitincardiacfunctionintraditionalrhythmcontroltreatmentIncreaseEFbyablationAblationdoesn tameliorateCHF AFmortalityMoredataneededforEFrHF EFpHFwithAF Whatstudiesareunderinvestigation Conc