Atriyal Fibrilasyon ve Flutter: Sınıflama, Tanı ve Tedavi
Özet
AF en sık görülen kardiyak aritmi olması, artmış mortalite ve morbiditeye sebep olmasından dolayı önemli bir halk sağlığı problemidir. İnme, kalp yetmezliği, tromboemboli gibi komplikasyonlarından dolayı ölümcül sonuçlar doğurabileceği için erken tanı ve tedavisi önemli bir aritmidir. EKG, EKO gibi görüntüleme yöntemleri ile hızlıca tanı konulup unstabil hastalarda hızlıca EKV ile tedavi düşünülmelidir. Antiaritmik ilaçlar ile hız ve ritim kontrolü sağlanmalı, CHA₂DS₂-VASc Skoru ve HAS-BLED Skoru ile antikoagülasyon tedavi başlanmalı ve trombüs oluşması önlenmelidir. Son kılavuzlarda yer alan inme / antikoagülasyon, daha iyi semptom yönetimi ve hız kontrolü ana başlıkları ile amaçlanan sinüs ritminin sağlanması, hızın kontrolü ve tromboembolinin önlenmesidir.
Referanslar
Fuster V, Ryden LE, Asinger RW, et al. ACC/AHA/ESC Guidelines for the Management of Patients With Atrial Fibrillation: 2001; 104(17): 2118-50.
Hindricks G, Potpara T, Dagres N, et al. 2020 ESC Guidelines For The Diagnosis And Management Of Atrial Fibrillation. European Heart Journal, 2021; 42(5): 373-498.
Hagiwara Y, Fujita H, Oh S. L, et al. Computer-Aided Diagnosis Of Atrial Fibrillation Based On ECG Signals: A Review. The Journal of Sciences, 2018; 467: 99-114.
Pritchett E.L. Management of atrial fibrillation. The New England Journal of Medicine, 1992; 326(19): 1264-1271.
Puech P, H Latour and R Grolleau. Flutter and his limits. Archives des Maladies du Coeur et des Vaisseaux, 1970; 63(1): 116-144.
Petryszyn P, Niewinski P, Staniak A, et al. Effectiveness Of Screening For Atrial Fibrillation And Its Determinants. A Meta-Analysis. PLoS One, 2019; 14(3): e0213198.
Björck S, Palaszewski B, Friberg L, et al. Atrial fibrillation, stroke risk, and warfarin therapy revisited. Stroke. 2013; 44(11): 3103-3108.
Lip GYH, Brechin CM, Lane DA. The Global Burden of Atrial Fibrillation and Stroke: A Systematic Review of the Epidemiology of Atrial Fibrillation in Regions Outside North America and Europe. Chest. 2012; 142(6): 1489-98.
Shen AY-J, Contreras R, Sobnosky S, et al. Racial/ethnic differences in the prevalence of atrial fibrillation among older adults crosssectional study. Journal of the National Medical Association. 2010; 102(10): 906-14.
Wetterslev M, Haase, N, Hassager C, et al. New- Onset Atrial Fibrillation Ġn Adult Critically Ġll Patients: A Scoping Review. Intensive care medicine, 2019; 45(7): 928-938.
Lippi G, Sanchis-Gomar F, Cervellin G. Global Epidemiology Of Atrial Fibrillation: An Ġncreasing Epidemic And Public Health Challenge. International Journal of Stroke, 2021; 16(2): 217-221.
Uyarel H, Onat A, Yüksel H, et al. Türk halkında kronik atriyal fibrilasyon insidansı, prevalansı vemortalitesine ilişkin tahminler. Türk Kardiyoloji Derneği Arşivi. 2008; 36(4): 214-22.
Sarı C, Köseoglu C, Ayhan H. Atriyal Fibrilasyon Tedavisinde Güncel Yaklasimlar/Current Approaches In Atrial Fibrillation Treatment. Dicle Tip Dergisi, 2014; 41(3): 614.
Şengül Ş, Uysal H. Atriyal Fibrilasyon Tanısı Olan Hastalarda Obstrüktif Uyku Apnesi ve Uyku Kalitesinin Belirlenmesi. Turk J Cardiovasc Nurs, 2019; 10(22): 50-58.
Yavuz B, Ata N, Oto E, et al. Demographics, treatment and outcomes of atrial fibrillation in a developing country: the population-based TuRkish Atrial Fibrillation (TRAF) cohort. Europace. 2017; 19(5): 734-40.
Wang TJ, Larson MG, Levy D, et al. Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality. Circulation. 2003; 107(23): 2920-5.
Go AS, Hylek EM, Phillips KA, et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. Jama. 2001; 285(18): 2370-5.
Garson Jr A, et al. Atrial flutter in the young: a collaborative study of 380 cases. Journal of the American College of Cardiology, 1985; 6(4): 871-878.
Kannel W.B, et al. Epidemiologic features of chronic atrial fibrillation: the Framingham study. New England Journal of Medicine, 1982; 306(17): 1018-1022.
Won C.-K, et al. New atrial fibrillation after acute myocardial infarction independently predicts death: the GUSTO-III experience. American heart journal, 2000; 140(6): 878-885.
Diker E, et al. Prevalence and predictors of atrial fibrillation in rheumatic valvular heart disease. The American journal of cardiology, 1996: 77(1): 96-98.
Griffin B, P Topo, E. J. Nair D, et al. Manual of cardiovascular medicine. Lippincott Williams & Wilkins. 2008.
Granada J, et al. Incidence and predictors of atrial flutter in the general population. Journal of the American College of Cardiology, 2000: 36(7): 2242-2246.
Lip GYH, Watson T. Atrial fibrillation (acute onset). Clin Evid 2006; 15: 1-3.
Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 2016; 18(11): 1609-78.
January CT, Wann LS, Calkins H, et al. 2019 AHA/ACC/HRS focused update of the 2014 AHA/ ACC/HRS Guideline for the management of patients with atrial fibrillation. Circulation 2019;140: 125-151.
McCabe PJ, Rhudy LM, DeVon HA. Patients’ experiences from symptom onset to initial treatment for atrial fibrillation. J Clin Nurs 2015; 24: 786-796.
Rienstra M, Vermond RA, Crijns HJ, et al. RACE Investigators. Asymptomatic persistent atrial fibrillation and outcome: results of the RACE study. Heart Rhythm 2014; 11: 939-945.
Fengler BT, Bradt WJ, Plautz CU. Atrial fibrillation in the Wolff-Parkinson-White syndrome: ECG recognition and treatment in the ED. Am J Emerg Med. 2007; 25(5): 576-583.
Bano A, et al. Association of Diabetes With Atrial Fibrillation Phenotype and Cardiac and Neurological Comorbidities: Insights From the Swiss‐AF Study. Journal of the American Heart Association, 2021: 10(22); p. e021800.
Echouffo-Tcheugui J.B, et al. Care patterns and outcomes in atrial fibrillation patients with and without diabetes: ORBIT-AF registry. Journal of the American College of Cardiology, 2017; 70(11): 1325-1335.
Karcioglu O. Kardiyovasküler Aciller ve İleri Yaşam Desteği. İstanbul: Ema Kitap Evi; 2021.
Groenveld HF, Crijns HJ, Van den Berg MP, et al. RACE II Investigators. The effect of rate control on quality of life in patients with permanent atrial fibrillation: data from the RACE II (Rate Control Efficacy in Permanent Atrial Fibrillation II) study. J Am Coll Cardiol 2011; 58: 1795-1803.
Van Gelder IC, Wyse DG, Chandler ML, et al. RACE and AFFIRM Investigators. Does intensity of rate-control influence outcome in atrial fibrillation? An analysis of pooled data from the RACE and AFFIRM studies. Europace 2006; 8: 935-942.
Umana E, Solares CA, Alpert MA. Tachycardia-induced cardiomyopathy. The American journal of medicine. 2003; 114(1): 51-5.
Van Gelder IC, Groenveld HF, Crijns HJ, et al. Lenient versus strict rate control in patients with atrial fibrillation. The New England journal of medicine. 2010; 362(15): 1363-73.
Piccini JP, Fauchier L. Rhythm control in atrial fibrillation. Lancet (London, England). 2016; 388(10046): 829-40.
Van Gelder IC, Rienstra M, Crijns HJ, et al. Rate control in atrial fibrillation. Lancet 2016; 388: 818-828.
Turakhia MP, Santangeli P, Winkelmayer WC, et al. Increased mortality associated with digoxin in contemporary patients with atrial fibrillation: findings from the TREAT-AF study. J Am Coll Cardiol 2014; 64: 660-668.
Whitbeck MG, Charnigo RJ, Khairy P, et al. Increased mortality among patients taking digoxin analysis from the AFFIRM study. Eur Heart J 2013; 34: 1481-1488.
Clemo HF, Wood MA, Gilligan DM, et al. Intravenous amiodarone for acute heart rate control in the critically ill patient with atrial tachyarrhythmias. Am J Cardiol 1998; 81: 594-598.
Crawford M.H. “Current Diagnosis And Treatment” Serisi. (Ç. Erol. Çev. Ed.) Ankara: Güneş Tıp Kitabevleri, 2017; 141-149.
Bennett D.H. Kardiyak Aritmiler Tanı Ve Tedavi İçin Pratik Notlar. (M. Kanadacı. Çev.) Ankara: Nobel Kitabevi, 2008; 33-49.
Dan GA, Martinez-Rubio A, Agewall S, et al. ESC Scientific Document Group. Antiarrhythmic drugs-clinical use and clinical decision making: a consensus document from the European Heart Rhythm Association (EHRA) and European Society of Cardiology (ESC) Working Group on Cardiovascular Pharmacology. Europace 2018; 20: 731-732.
Conti A, Del Taglia B, Mariannini Y, et al. Management of patients with acute atrial fibrillation in the ED. Am J Emergy Med. 2010; 28(8): 903-910
Atriyal Fibrilasyon Tedavisi ESC Kılavuzunun 2012 Odaklı Güncellemesi. Türk Kardiyoloji Derneği Arş. 2013; 41(3): 53-81.
Fang MC, Singer DE, Chang Y, et al. Gender differences in the risk of ischemic stroke and peripheral embolism in atrial fibrillation: the AnTicoagulation and Risk factors In Atrial fibrillation (ATRIA) study. Circulation. 2005; 112(12): 1687-91.
Heckman GA, Braceland B. Integrating frailty assessment into cardiovascular decision making. Canadian Journal of Cardiology. 2016; 32(2): 139-41.
Cerdá M, Cerezo-Manchado JJ, Johansson E, et al. Facing real-life with direct oral anticoagulants in patients with nonvalvular atrial fibrillation: outcomes from the first observational and prospective study in a Spanish population. Journal of comparative effectiveness research. 2019; 8(3): 165-78.
Vermond RA, Crijns HJ, Tijssen JG, et al. RACE II investigators. Symptom severity is associated with cardiovascular outcome in patients with permanent atrial fibrillation in the RACE II study. Europace 2014;16: 1417-1425.
Pisters R, Lane DA, Nieuwlaat R, et al. A novel userfriendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest 2010; 138: 1093-1100.
Referanslar
Fuster V, Ryden LE, Asinger RW, et al. ACC/AHA/ESC Guidelines for the Management of Patients With Atrial Fibrillation: 2001; 104(17): 2118-50.
Hindricks G, Potpara T, Dagres N, et al. 2020 ESC Guidelines For The Diagnosis And Management Of Atrial Fibrillation. European Heart Journal, 2021; 42(5): 373-498.
Hagiwara Y, Fujita H, Oh S. L, et al. Computer-Aided Diagnosis Of Atrial Fibrillation Based On ECG Signals: A Review. The Journal of Sciences, 2018; 467: 99-114.
Pritchett E.L. Management of atrial fibrillation. The New England Journal of Medicine, 1992; 326(19): 1264-1271.
Puech P, H Latour and R Grolleau. Flutter and his limits. Archives des Maladies du Coeur et des Vaisseaux, 1970; 63(1): 116-144.
Petryszyn P, Niewinski P, Staniak A, et al. Effectiveness Of Screening For Atrial Fibrillation And Its Determinants. A Meta-Analysis. PLoS One, 2019; 14(3): e0213198.
Björck S, Palaszewski B, Friberg L, et al. Atrial fibrillation, stroke risk, and warfarin therapy revisited. Stroke. 2013; 44(11): 3103-3108.
Lip GYH, Brechin CM, Lane DA. The Global Burden of Atrial Fibrillation and Stroke: A Systematic Review of the Epidemiology of Atrial Fibrillation in Regions Outside North America and Europe. Chest. 2012; 142(6): 1489-98.
Shen AY-J, Contreras R, Sobnosky S, et al. Racial/ethnic differences in the prevalence of atrial fibrillation among older adults crosssectional study. Journal of the National Medical Association. 2010; 102(10): 906-14.
Wetterslev M, Haase, N, Hassager C, et al. New- Onset Atrial Fibrillation Ġn Adult Critically Ġll Patients: A Scoping Review. Intensive care medicine, 2019; 45(7): 928-938.
Lippi G, Sanchis-Gomar F, Cervellin G. Global Epidemiology Of Atrial Fibrillation: An Ġncreasing Epidemic And Public Health Challenge. International Journal of Stroke, 2021; 16(2): 217-221.
Uyarel H, Onat A, Yüksel H, et al. Türk halkında kronik atriyal fibrilasyon insidansı, prevalansı vemortalitesine ilişkin tahminler. Türk Kardiyoloji Derneği Arşivi. 2008; 36(4): 214-22.
Sarı C, Köseoglu C, Ayhan H. Atriyal Fibrilasyon Tedavisinde Güncel Yaklasimlar/Current Approaches In Atrial Fibrillation Treatment. Dicle Tip Dergisi, 2014; 41(3): 614.
Şengül Ş, Uysal H. Atriyal Fibrilasyon Tanısı Olan Hastalarda Obstrüktif Uyku Apnesi ve Uyku Kalitesinin Belirlenmesi. Turk J Cardiovasc Nurs, 2019; 10(22): 50-58.
Yavuz B, Ata N, Oto E, et al. Demographics, treatment and outcomes of atrial fibrillation in a developing country: the population-based TuRkish Atrial Fibrillation (TRAF) cohort. Europace. 2017; 19(5): 734-40.
Wang TJ, Larson MG, Levy D, et al. Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality. Circulation. 2003; 107(23): 2920-5.
Go AS, Hylek EM, Phillips KA, et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. Jama. 2001; 285(18): 2370-5.
Garson Jr A, et al. Atrial flutter in the young: a collaborative study of 380 cases. Journal of the American College of Cardiology, 1985; 6(4): 871-878.
Kannel W.B, et al. Epidemiologic features of chronic atrial fibrillation: the Framingham study. New England Journal of Medicine, 1982; 306(17): 1018-1022.
Won C.-K, et al. New atrial fibrillation after acute myocardial infarction independently predicts death: the GUSTO-III experience. American heart journal, 2000; 140(6): 878-885.
Diker E, et al. Prevalence and predictors of atrial fibrillation in rheumatic valvular heart disease. The American journal of cardiology, 1996: 77(1): 96-98.
Griffin B, P Topo, E. J. Nair D, et al. Manual of cardiovascular medicine. Lippincott Williams & Wilkins. 2008.
Granada J, et al. Incidence and predictors of atrial flutter in the general population. Journal of the American College of Cardiology, 2000: 36(7): 2242-2246.
Lip GYH, Watson T. Atrial fibrillation (acute onset). Clin Evid 2006; 15: 1-3.
Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 2016; 18(11): 1609-78.
January CT, Wann LS, Calkins H, et al. 2019 AHA/ACC/HRS focused update of the 2014 AHA/ ACC/HRS Guideline for the management of patients with atrial fibrillation. Circulation 2019;140: 125-151.
McCabe PJ, Rhudy LM, DeVon HA. Patients’ experiences from symptom onset to initial treatment for atrial fibrillation. J Clin Nurs 2015; 24: 786-796.
Rienstra M, Vermond RA, Crijns HJ, et al. RACE Investigators. Asymptomatic persistent atrial fibrillation and outcome: results of the RACE study. Heart Rhythm 2014; 11: 939-945.
Fengler BT, Bradt WJ, Plautz CU. Atrial fibrillation in the Wolff-Parkinson-White syndrome: ECG recognition and treatment in the ED. Am J Emerg Med. 2007; 25(5): 576-583.
Bano A, et al. Association of Diabetes With Atrial Fibrillation Phenotype and Cardiac and Neurological Comorbidities: Insights From the Swiss‐AF Study. Journal of the American Heart Association, 2021: 10(22); p. e021800.
Echouffo-Tcheugui J.B, et al. Care patterns and outcomes in atrial fibrillation patients with and without diabetes: ORBIT-AF registry. Journal of the American College of Cardiology, 2017; 70(11): 1325-1335.
Karcioglu O. Kardiyovasküler Aciller ve İleri Yaşam Desteği. İstanbul: Ema Kitap Evi; 2021.
Groenveld HF, Crijns HJ, Van den Berg MP, et al. RACE II Investigators. The effect of rate control on quality of life in patients with permanent atrial fibrillation: data from the RACE II (Rate Control Efficacy in Permanent Atrial Fibrillation II) study. J Am Coll Cardiol 2011; 58: 1795-1803.
Van Gelder IC, Wyse DG, Chandler ML, et al. RACE and AFFIRM Investigators. Does intensity of rate-control influence outcome in atrial fibrillation? An analysis of pooled data from the RACE and AFFIRM studies. Europace 2006; 8: 935-942.
Umana E, Solares CA, Alpert MA. Tachycardia-induced cardiomyopathy. The American journal of medicine. 2003; 114(1): 51-5.
Van Gelder IC, Groenveld HF, Crijns HJ, et al. Lenient versus strict rate control in patients with atrial fibrillation. The New England journal of medicine. 2010; 362(15): 1363-73.
Piccini JP, Fauchier L. Rhythm control in atrial fibrillation. Lancet (London, England). 2016; 388(10046): 829-40.
Van Gelder IC, Rienstra M, Crijns HJ, et al. Rate control in atrial fibrillation. Lancet 2016; 388: 818-828.
Turakhia MP, Santangeli P, Winkelmayer WC, et al. Increased mortality associated with digoxin in contemporary patients with atrial fibrillation: findings from the TREAT-AF study. J Am Coll Cardiol 2014; 64: 660-668.
Whitbeck MG, Charnigo RJ, Khairy P, et al. Increased mortality among patients taking digoxin analysis from the AFFIRM study. Eur Heart J 2013; 34: 1481-1488.
Clemo HF, Wood MA, Gilligan DM, et al. Intravenous amiodarone for acute heart rate control in the critically ill patient with atrial tachyarrhythmias. Am J Cardiol 1998; 81: 594-598.
Crawford M.H. “Current Diagnosis And Treatment” Serisi. (Ç. Erol. Çev. Ed.) Ankara: Güneş Tıp Kitabevleri, 2017; 141-149.
Bennett D.H. Kardiyak Aritmiler Tanı Ve Tedavi İçin Pratik Notlar. (M. Kanadacı. Çev.) Ankara: Nobel Kitabevi, 2008; 33-49.
Dan GA, Martinez-Rubio A, Agewall S, et al. ESC Scientific Document Group. Antiarrhythmic drugs-clinical use and clinical decision making: a consensus document from the European Heart Rhythm Association (EHRA) and European Society of Cardiology (ESC) Working Group on Cardiovascular Pharmacology. Europace 2018; 20: 731-732.
Conti A, Del Taglia B, Mariannini Y, et al. Management of patients with acute atrial fibrillation in the ED. Am J Emergy Med. 2010; 28(8): 903-910
Atriyal Fibrilasyon Tedavisi ESC Kılavuzunun 2012 Odaklı Güncellemesi. Türk Kardiyoloji Derneği Arş. 2013; 41(3): 53-81.
Fang MC, Singer DE, Chang Y, et al. Gender differences in the risk of ischemic stroke and peripheral embolism in atrial fibrillation: the AnTicoagulation and Risk factors In Atrial fibrillation (ATRIA) study. Circulation. 2005; 112(12): 1687-91.
Heckman GA, Braceland B. Integrating frailty assessment into cardiovascular decision making. Canadian Journal of Cardiology. 2016; 32(2): 139-41.
Cerdá M, Cerezo-Manchado JJ, Johansson E, et al. Facing real-life with direct oral anticoagulants in patients with nonvalvular atrial fibrillation: outcomes from the first observational and prospective study in a Spanish population. Journal of comparative effectiveness research. 2019; 8(3): 165-78.
Vermond RA, Crijns HJ, Tijssen JG, et al. RACE II investigators. Symptom severity is associated with cardiovascular outcome in patients with permanent atrial fibrillation in the RACE II study. Europace 2014;16: 1417-1425.
Pisters R, Lane DA, Nieuwlaat R, et al. A novel userfriendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest 2010; 138: 1093-1100.
