Rhythm Control Should Be Better for the Management of Patients With Atrial Fibrillation and Heart Failure : Rhythm Control vs. Rate Control : Which Is Better in the Management of Atrial Fibrillation? (Rhythm-Side)
スポンサーリンク
概要
- 論文の詳細を見る
The incidence of atrial fibrillation (AF) increases with advancing NHYA cardiac functional class, and it significantly affects the cardiac function of a failing heart. In such situations, clinicians should aim to maintain sinus rhythm in these patients with heart failure (HF) in order to improve their prognosis. However, according to various randomized clinical studies demonstrating the non-superiority of rhythm control over rate control, many clinicians seem to prefer to take the line of least resistance (ie, rate control). Curative catheter ablation mainly based on isolation procedure of the pulmonary veins in patients with AF and HF has demonstrated a significant improvement in left ventricular function, even in the presence of adequate ventricular rate control before the ablation. On the other hand, ablation and biventricular pacing therapy, which is an extreme rate control strategy, has not shown any beneficial effects for these patients. Therefore, a regular RR interval with an appropriate cycle length only is not sufficient to improve cardiac performance, and maintenance of sinus rhythm, which restores atrial contraction and the atrioventricular synchrony, is thought to be essential for an improvement in HF. Thoughtful clinicians should do their best to find a way to keep HF patients in sinus rhythm. (Circ J 2011; 75: 979-985)
- 2011-03-25
著者
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Kurita Takashi
Division of Cardiology, National Cardiovascular Center
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MIYAZAKI Shunichi
Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, Fujishiroda
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Hayashi Takahiro
Division Of Cardiology Department Of Internal Medicine Kinki University School Of Medicine
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Kurita Takashi
Division Of Cardiology Department Of Internal Medicine National Cardiovascular Center
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Hanyu T
Department Of Physics Faculty Of Science Tokyo Metropolitan University
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Yasuoka Ryobun
Division of Cardiology Department of Internal Medicine, Kinki University School of Medicine
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Motoki Koichiro
Division of Cardiology Department of Internal Medicine, Kinki University School of Medicine
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HIROTA Takayoshi
Division of Cardiology, Department of Medicine and Geriatrics, Kochi Medical School
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Miyazaki Shunichi
Division Of Cardiology Department Of Internal Kinki University School Of Medicine
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Yasuoka Ryobun
Division Of Cardiology Department Of Internal Medicine Kinki University School Of Medicine
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Takai H
近畿大学 医学部循環器内科部門
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Motoki Koichiro
Division Of Cardiology Department Of Internal Medicine Kinki University School Of Medicine
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Takai Hiroyuki
Division Of Cardiology Department Of Internal Medicine Kinki University School Of Medicine
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AKAIWA Yuzuru
Division of Cardiology, Faculty of Medicine, Kinki University
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KOTAKE Yasuhito
Division of Cardiology, Faculty of Medicine, Kinki University
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Miyazaki Shunichi
Division Of Cardiology Faculty Of Medicine Kinki University
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Kurita Takashi
Division Of Cardiology Faculty Of Medicine Kinki University
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Hirota Takayoshi
Division Of Cardiology Faculty Of Medicine Kinki University
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Motoki Koichiro
Division Of Cardiology Faculty Of Medicine Kinki University
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Hayashi Takeo
1st Dept. Of Internal Medicine Tohoku Univ. School Of Med.
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Kotake Yasuhito
Division Of Cardiology Faculty Of Medicine Kinki University
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Akaiwa Yuzuru
Division Of Cardiology Faculty Of Medicine Kinki University
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Hayashi Takahiro
The Department Of Cardiology Kinki University School Of Medicine
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Miyazaki Shunichi
Department of Cardiology,Kinki University School of Medicine
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Kurita Takashi
Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
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