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摘要


心房顫動應該選擇心律治療以回復竇性心律,或是選擇心速控制就可以改善預後,一直是懸而未解的疑問。過去的兩大型臨床試驗AFFRIM和RACE的研究成果傾向支持心速控制。幾年之後,EAST-AFNET4改進了之前試驗的缺點,發現早期心律治療的介入能減少心血管併發症的風險。此外近期比較電燒手術與抗心律不整藥物的研究,CABANA發現兩組在重大併發症的風險不相上下,而STOP-AF和EARLY-AF兩者試驗都發現冷凍電燒組更能預防心房心律不整的復發。CASA-AF試驗則發現導管電燒術和胸腔鏡電燒術一樣有效。心律治療在心房顫動的治療策略有捲土重來的趨勢。

參考文獻


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