[ESC2010]房颤的流行病学及治疗进展——J.Y. Le Heuzey教授专访
1. 您在本次会议上有一个专题讲座题为“房颤的流行病学”,能否简要概况一下当前房颤的患病率和病因学概况?房颤的总体医疗负担处在怎样的状态?
<International Circulation>: So there is potential of this drug to replace warfarin?
Dr Le Heuzey : Yes, that is the goal. The third important point is regarding antiarrhythmic therapy. As you know, for 25 years we have not had any new antiarrhythmic drugs and that was a pity because there was an unmet need. However, recently a new drug called dronedarone has become available so one of the goals of the group writing the guidelines was to well define the place of dronedarone in the armamentarium we can use for these patients.
《国际循环》:达比加群在未来是否有望替代华法林?
Heuzey教授:当然,这是我们的目标。第三个重点是关于抗心律失常治疗。在过去的25年里,没有新的抗心律失常药物出现,这是个遗憾,因为对此类药物需求很大。最近,新药决奈达隆上市。因此,指南工作组的目标之一就是很好地确定决奈达隆的治疗地位和用药剂量。
<International Circulation>:What are your comments on radiofrequency catheter ablation?
Dr Le Heuzey : It is clear that radiofrequency catheter ablation has an increasing place in the treatment of AF because although it is a difficult procedure it does work. What is important to know is that these ablation procedures will never concern a large majority of patients. As I said before, the number of patients with AF is and will continue to be huge so ablation has a place but it will concern only some of those patients.
《国际循环》:您怎么看导管射频消融?
Heuzey教授:导管射频消融疗效不错,显然在房颤治疗中占据着越来越重要的地位。导管射频消融的操作复杂,但是确实有效。不过,重要的是我们要知道导管射频消融绝不会成为适合绝大多数患者的治疗手段,只会用于少数患者。正如我一开始所提到的那样,房颤患者人数众多,因此射频消融有一席之地,但是仅限于部分患者。
<International Circulation>: What is your view of left atrial appendage occlusion in prevention of stroke for patients with AF?
Dr Le Heuzey :This is also an interesting development but I think the good indications for this procedure concern patients who are not able to take antithrombotic drugs. For example, for patients with a history of bleeding for whom it is not possible to take an antithrombotic drug, it could be a good alternative. However, it is the same as radiofrequency ablation in that it will concern only a small amount of patients.
《国际循环》:您怎么看左心耳封堵术用于房颤患者卒中的预防?
Heuzey教授:这也是一个很吸引人的房颤治疗手段,但是我想适用于不能服用抗栓药物的患者。例如有出血史而不能服用抗栓药物的患者。但是,左心耳封堵和射频消融一样只适用于一小部分患者。