心房颤动节律控制策略与复发预测指标研究进展

Research progress on rhythm control strategy and recurrence predictive indexes of atrial fibrillation

摘要:

心房颤动是最常见的心律失常之一，多种危险因素及基础心血管病可增加发生心房颤动的风险。目前，心房颤动被认为是一种由细胞拉伸、神经体液激活、氧化应激等多种因素共同导致的纤维性心房心肌病。抗心律失常药物、射频消融等治疗尚缺乏有效性及安全性，加之多种危险因素的共同影响，致使心房颤动复发、进展，患者生活质量下降，死亡风险增加。心房颤动节律控制与复发预测指标的研究可预防和治疗病因、延缓心房颤动的进展。越来越多简便易得且可操作性强的生物标志物（重组人脑利钠肽、C反应蛋白、白细胞介素6、中性粒细胞淋巴细胞比值、ST2等）、基因检测、影像学检查等相关指标可共同评估并预测心房颤动的发生、复发、进展及预后，该文对以上内容作一综述。

Abstract:

Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. Many cardiovascular diseases and risk factors can increase the risk of AF. At present, it is generally considered as a kind of "fibrous atrial cardiomyopathy". Fibrosis results from a broad range of factors related to AF inducing pathologies such as cell stretch, neurohumoral activation, and oxidative stress. During to the lack of sufficient efficacy and safety of radiofrequency ablation and antiarrhythmic drugs, it is difficult to control the recurrence and progress of AF, moreover, reduce the quality of life of patients and increase the risk of death, and prevent the recurrence of AF. Preventing AF recurrence and blocking its progression are crucial. The understanding and in-depth study of the risk factors and recurrence prediction indexes of AF can not only prevent, treat and delay the progression of these arrhythmias, but also reduce the arrhythmia burden in patients with first detected AF, more imporant, which can improve their quality of life and survival rate. More and more biomarkers [recombinant human brain natriuretic peptide (BNP), C reactive protein (CRP), interleukin 6, neutrophil lymphocyte ratio and ST2] are more and more commonly used, simple and easy to obtain. The related indexes such as biomarkers, gene detection and imaging can be used to evaluate and predict the occurrence, recurrence, progression and prognosis of AF. This paper will summarize the above contents as follows.