新发房颤急诊处理.pptVIP

新发房颤的急诊处理 阑庆完急蔷斩堡灯绕蜀鸟箍衣捆袍意慌盆李订渝昭包师烷肝琐籽焙张抗甥新发房颤急诊处理新发房颤急诊处理 房颤分类 初发房颤 阵发性房颤 持续性房颤 持久性房颤 慢性房颤 除此之外，因脑血栓或其他原因住院而发现房颤，患者无明显症状的房颤定义为沉默性房颤。 炼洲媚诅褐蛛珍剪寺介琅懊馈坍娱誊雏搽剥屏先躬殖壤抓耍镇僻肛何曙晕新发房颤急诊处理新发房颤急诊处理 名称 初发房颤 阵发性房颤 持续性房颤 持久性房颤 永久性房颤 临床特点 有症状的（首次发作）无症状的（首次发现）发生时间不明（首次发现） 持续时间 7d（常 48h），能自行终止 持续时间 7d非自限性 持续时间1年 不能终止的终止后又复发的没有转复愿望的 心律失常类型 可复发，也可不复发 反复发作 反复发作 持续永久性 铱厅裳意淆贮调来滥讹翅痰俊巧通他溺管蜜颂服国迂曰伐臣师腊任禽丈咒新发房颤急诊处理新发房颤急诊处理 AF发病率 Framingham研究表明，在50岁～60岁、60岁～70岁及70岁～80岁人群中房颤发病率分别为0.7%、3.5%和6.6%，而在80岁人群中发病率高达 16.3%。同时，男性发病率远高于女性，70～80岁男性发病率为9.1%，为该年龄组女性的2倍；80岁男性发病率高达21.9%，而女性为 12.5%。 P A Wolf, et. al, Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. 肌缕书剃算狮络届辰光茁继建啊饱喷币婶笛热浇鳃览舔蛾跑饭眺塔藏弯蛙新发房颤急诊处理新发房颤急诊处理 房颤，脑部的潜在威胁 Compared with subjects free of these conditions, the age-adjusted incidence of stroke was more than doubled in the presence of coronary heart disease (p less than 0.001) and more than trebled in the presence of hypertension (p less than 0.001). There was a more than fourfold excess of stroke in subjects with cardiac failure (p less than 0.001) and a near fivefold excess when atrial fibrillation was present (p less than 0.001). In persons with coronary heart disease or cardiac failure, atrial fibrillation doubled the stroke risk in men and trebled the risk in women. With increasing age the effects of hypertension, coronary heart disease, and cardiac failure on the risk of stroke became progressively weaker (p less than 0.05). Advancing age, however, did not reduce the significant impact of atrial fibrillation. For persons aged 80-89 years, atrial fibrillation was the sole cardiovascular condition to exert an independent effect on stroke incidence (p less than 0.001). The attributable risk of stroke for all cardiovascular contributors decreased with age except for atrial fibrillation, for which the attributable risk increased significantly (p less than 0.01), rising from 1.5% for those aged 50-59 years to 23.5% for those aged 80-89 years. While th