Статья
Патогенетические и клинические аспекты фибрилляции предсердий при инфаркте миокарда
В новых клинических рекомендациях отсутствует какая-либо информация о важности активного выявления фибрилляции предсердий (ФП) при инфаркте миокарда (ИМ), а также об особенностях ведения таких пациентов. Целью настоящего обзора явилось представить современные данные о возможных факторах риска, особенностях патогенеза, а также прогностической значимости ФП при ИМ. Анализ литературы показал, что многими исследователями выделяется ФП, которая имелась в анамнезе до ИМ (хроническая ФП) и ФП, которая возникла впервые как осложнение текущего ИМ (“новая” ФП). Последняя, встречаясь довольно часто (от 3% до 28% среди всех пациентов с ИМ), существенно отягощает прогноз для жизни, а также является важным предиктором развития кардиоэмболических осложнений. При этом у каждого третьего пациента с ИМ ФП носит бессимптомный характер, что делает крайне актуальной разработку специальных алгоритмов, направленных на активный поиск данного нарушения ритма.
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