亚临床房颤与卒中的研究进展

Advances in subclinical atrial fibrillation and stroke

摘要:

亚临床房颤（subclinical atrial fibrillation）是无典型临床症状的心房颤动（atrial fibrillation），由心脏植入器械（cardiac implantable electronic devices，CIED）记录的高心房率事件（atrial high rate events，AHREs）是一种表现形式。近来的临床研究表明，由CIED记录到的亚临床房颤发生率较高，且此类患者卒中风险增加；在卒中患者中由植入性心电记录器（insertable cardiac monitors，ICMs）随访记录到亚临床房颤发生，亚临床房颤与卒中有关。抗凝治疗降低心房颤动卒中风险，亚临床心房颤动抗凝治疗的有效性与安全性目前暂不清楚。远程心电监测对于亚临床房颤的早期发现有重要意义。本文将对亚临床房颤的流行病学、与卒中关系、是否抗凝治疗、远程心电监测的运用方面展开讨论。

Abstract:

Subclinical atrial fibrillation is asymptomatic short episodes of atrial fibrillation（AF），which have been termed as atrial high rate events（AHREs） in patients with cardiac implantable electronic devices（CIED）. Recent clinical studies demonstrated that there was a high incidence of AHREs，which was associated with a increased risk of stroke in patients with CIED and insertable cardiac monitors. Oral anticoagulant therapy decreased the risk of stroke in AF patients，while the efficacy and safety of anticoagulation in patients with subclinical AF was unknown. Besides，remote home monitoring provides an opportunity for early identification of subclinical AF. The present review will discuss the epidemiology of subclinical AF，the relationship between subclinical AF and stroke，anticoagulant therapy and remote home monitoring of subclinical AF.