Revista Espanola de Cardiologia Suplementos最新文献_第9页

Tratamiento no farmacológico de la fibrilación auricular. Ablación, cardioversión eléctrica, marcapasos y cierre de la orejuela 心房颤动的非药物治疗。消融，电转位，起搏器和枕骨闭合

Revista Espanola de Cardiologia Suplementos Pub Date : 2016-01-01 DOI: 10.1016/S1131-3587(16)30013-9

Felipe Atienza , Ángel Moya

引用次数: 2

Acceso a los anticoagulantes de acción directa en España 在西班牙获得直接作用抗凝剂

Revista Espanola de Cardiologia Suplementos Pub Date : 2016-01-01 DOI: 10.1016/S1131-3587(16)30016-4

José Luis Segú

{"title":"Acceso a los anticoagulantes de acción directa en España","authors":"José Luis Segú","doi":"10.1016/S1131-3587(16)30016-4","DOIUrl":"10.1016/S1131-3587(16)30016-4","url":null,"abstract":"<div><p>In Spain, new oral anticoagulants are used in fewer than 20% of patients with nonvalvular atrial fibrillation. This is lower than the rate observed in comparable countries and lower than that expected given current official recommendations and given the number of patients known to lie outside the therapeutic range while taking vitamin-K antagonists. This article provides an overview of the possible causes of the apparently low use of new oral anticoagulants in Spain. A number of distinct barriers have been documented that affect individuals involved in treatment decision-making (i.e. patients and health-care professionals and payers). The most relevant explanatory factors appear to be resistance to change by patients and health-care professionals, prescription being restricted to particular specialists, and the variation in policies affecting access to drugs between different Spanish autonomous regions. The causative factor that appears to best explain differing access to new oral anticoagulants in the Spanish National Health System is the impact of these drugs on the health budget. In particular, difficulties have been created by the absence of a coherent common management framework that takes responsibility for both the decision to fund an innovative treatment and the budgetary implications of its use. The effectiveness of a particular type of therapy does not imply that it will be “possible” to fund it at any given time, given that it is always legitimate to limit its use if decision-making is transparent and based on clear criteria. However, keeping alive, mostly nonexistent, technical uncertainties does not help solve the problem and casts doubt on the credibility of the evaluation process.</p></div>","PeriodicalId":34926,"journal":{"name":"Revista Espanola de Cardiologia Suplementos","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1131-3587(16)30016-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56633923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

Introducción 导言

Revista Espanola de Cardiologia Suplementos Pub Date : 2016-01-01 DOI: 10.1016/S1131-3587(16)30006-1

Luis Rodríguez Padial

引用次数: 0

Epidemiología de la fibrilación auricular 心房颤动的流行病学

Revista Espanola de Cardiologia Suplementos Pub Date : 2016-01-01 DOI: 10.1016/S1131-3587(16)30007-3

Juan José Gómez-Doblas , Miguel Antonio López-Garrido , Iris Esteve-Ruiz , Gonzalo Barón-Esquivias

引用次数: 11

Tratamiento farmacológico de la fibrilación auricular. Antiarrítmicos y anticoagulantes orales 心房颤动的药物治疗。口服抗心律失常和抗凝药物

Revista Espanola de Cardiologia Suplementos Pub Date : 2016-01-01 DOI: 10.1016/S1131-3587(16)30012-7

Juan Cosin-Sales , Juan José Olalla

引用次数: 1

Desarrollo clínico del edoxabán. Estudios en fase II edoxaban的临床发展。第二阶段研究

Revista Espanola de Cardiologia Suplementos Pub Date : 2016-01-01 DOI: 10.1016/S1131-3587(16)30018-8

Manuel Almendro-Delia, Rafael Hidalgo-Urbano

引用次数: 0

Mecanismos electrofisiológicos y diagnóstico de la fibrilación auricular 心房颤动的电生理机制及诊断

Revista Espanola de Cardiologia Suplementos Pub Date : 2016-01-01 DOI: 10.1016/S1131-3587(16)30009-7

Jose Luis Merino

{"title":"Mecanismos electrofisiológicos y diagnóstico de la fibrilación auricular","authors":"Jose Luis Merino","doi":"10.1016/S1131-3587(16)30009-7","DOIUrl":"10.1016/S1131-3587(16)30009-7","url":null,"abstract":"<div><p>Despite being the most common sustained cardiac arrhythmia and despite having been first described over 100 years ago, atrial fibrillation is, like ventricular fibrillation, virtually the only arrhythmia whose mechanism is still unknown. This lack of knowledge has profound clinical implications and is not just of academic interest. Firstly, lack of knowledge means that the diagnosis of atrial fibrillation is still based on ECG findings, which can often give rise to doubts about the diagnosis, with both surface ECGs and intracardiac electrophysiological studies. Moreover, lack of knowledge about the underlying mechanism also hampers the development of both better-targeted pharmacological and invasive therapies and preventive measures that can avert, or at least delay, the onset of atrial fibrillation. This article provides a review of the most widely accepted theories about the mechanism underlying this arrhythmia, such as the multiple coexisting functional re-entry circuits theory and the mother rotor theory. In addition, the article examines factors that could influence the condition, such as atrial remodeling, atrial fibrosis and scarring, and the critical atrial mass, and considers the role of the pulmonary veins and the evidence supporting a link with re-entry. Diagnostic criteria for this arrhythmia, its classification and recommended diagnostic investigations are also discussed.</p></div>","PeriodicalId":34926,"journal":{"name":"Revista Espanola de Cardiologia Suplementos","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1131-3587(16)30009-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56633578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

La fibrilación auricular en las guías de práctica clínica 临床实践指南中的心房颤动

Revista Espanola de Cardiologia Suplementos Pub Date : 2016-01-01 DOI: 10.1016/S1131-3587(16)30015-2

José Luis Zamorano

引用次数: 3

Etiología y prevención de la fibrilación auricular 心房颤动的病因及预防

Revista Espanola de Cardiologia Suplementos Pub Date : 2016-01-01 DOI: 10.1016/S1131-3587(16)30008-5

Domingo Marzal Martín , Luis Rodríguez Padial

引用次数: 1

Fibrilación auricular en pacientes con dispositivos cardiacos electrónicos implantables 可植入电子心脏装置患者的房颤

Revista Espanola de Cardiologia Suplementos Pub Date : 2016-01-01 DOI: 10.1016/S1131-3587(16)30014-0

Finn Akerström, Marta Pachón, Alberto Puchol, Andrés Sánchez Pérez, Miguel A. Arias

{"title":"Fibrilación auricular en pacientes con dispositivos cardiacos electrónicos implantables","authors":"Finn Akerström, Marta Pachón, Alberto Puchol, Andrés Sánchez Pérez, Miguel A. Arias","doi":"10.1016/S1131-3587(16)30014-0","DOIUrl":"10.1016/S1131-3587(16)30014-0","url":null,"abstract":"<div><p>Atrial fibrillation is the most common arrhythmia seen in clinical practice. Its prevalence has increased substantially in developed countries because of population aging. Atrial fibrillation is the primary cause of cardioembolic stroke and oral anticoagulant therapy can considerably reduce its risk. Moreover, the number of patients with a cardiac implantable electronic device is increasing. Since these devices have the ability to detect heart rhythm alterations and to store electrograms, they are highly effective tools for detecting atrial high rate episodes, which in most patients usually correspond to episodes of atrial fibrillation or, to a lesser extent, to atrial flutter or tachycardia. Numerous studies have shown that episodes of subclinical atrial fibrillation are associated with an increased risk of thromboembolic events, although it has not been possible to demonstrate a temporal relationship between the two. To date, the efficacy of oral anticoagulants in patients with subclinical atrial fibrillation has been assessed in only one clinical trial, with negative results. Therefore, and until more information is available, the clinical decision on whether to start oral anticoagulant therapy in patients with subclinical atrial fibrillation is not straightforward and, at present, such treatment is not supported by solid clinical evidence.</p></div>","PeriodicalId":34926,"journal":{"name":"Revista Espanola de Cardiologia Suplementos","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1131-3587(16)30014-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56633834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0