心房颤动介导的心肌病

Atrial fibrillation-mediated cardiomyopathy

关键词:  心房颤动  心力衰竭  心肌病  房颤介导心肌病

Key words:  atrial fibrillation  heart failure  cardiomyopathy  atrial fibrillation mediated cardiomyopathy

摘要:

心房颤动介导的心肌病（atrial fibrillation mediated cardiomyopathy，AMC）用于描述房颤导致的可逆性心力衰竭，随着导管消融和起搏技术的进展，房颤合并心衰患者中约有50%~60%的患者可能是"房颤介导的心肌病"，其发病机制目前尚未完全阐明，心房功能缺损、快速心室率等因素并不能完全解释心肌病的发生，遗传、炎症、代谢等因素可能介导该病的进展。室率控制和药物节律控制并不能改善该病预后，导管消融与希氏束起搏有望成为未来该病的首选治疗方案，但仍需进一步探索。本文就房颤介导的心肌病的临床研究现状进行综述。

Abstract:

Atrial fibrillation-mediated cardiomyopathy is a new concept recently proposed to describe the reversible heart failure caused by atrial fibrillation. With the development of catheter ablation and pacing technology, about 50%-60% of patients with atrial fibrillation and heart failure may be "atrial fibrillation-mediated cardiomyopathy". Its pathogenesis has not been fully elucidated, and the factors such as atrial function defect and rapid ventricular rate cannot be fully understood. Genetic, inflammatory and metabolic factors may mediate the development of cardiomyopathy. Ventricular rate control and drug rhythm control cannot improve the prognosis of the disease. Catheter ablation and its bundle pacing are expected to be the first choice for future treatment of the disease, but further exploration is needed. This paper reviews the concept of atrial fibrillation-mediated cardiomyopathy from pathogenesis to clinical management, in order to improve clinicians' understanding of the disease.