Title: Atrial Fibrillation
题目：房颤
Author 作者: Semhar Tewelde

Atrial fibrillation is most commonly associated with cardiovascular disease    
房颤是与心血管疾病最密切相关的

Non cardiac causes: pulmonary disease/PE, hyperthyroidism, sympathomimetics, drugs/ETOH
非心脏原因：肺部疾病／肺动脉栓塞，甲状腺亢进，交感神经亢进，药物／酒精

AFFIRM & RACE trials compared outcomes of a fib patients treated w/ rate vs. rhythm control
AFFIRM／RACE临床研究对经过控制心率和控制心律治疗后的房颤病人的预后进行了比较

No significant difference in survival between groups
两组病人的生存率没有显著差异

Risk of thromboembolic CVA
血栓形成或栓塞性脑血管意外（CVA）危险性

Rhythm control = Rate control + anticoagulation
控制心律＝控制心率＋抗凝治疗

New data challenges the need for strict heart rate control
新的数据对严格心率控制提出了质疑

Resting heart rate should be <110 bpm
静息状态下心率低于110次／分钟即可

Use CHADS2 score to identify who requires anticoagulation based on %risk of emboli 
应用CHADS2评分标准来确定血栓形成的危险度，已决定谁应该接受（长期）抗凝治疗

Chronic heart failure, HTN, Age>75, DM, Stroke/TIA 
慢性心衰（CHF），高血压（HTN），年龄超过75，糖尿病，脑梗塞／短暂性脑缺血（TIA）

References 参考文献
Atrial Fibrillation. Bontempo L, Goralnick E. Emerg Med Clin N Am 29 (2011)747-758.