Fibrilhação auricular: controlo do ritmo vs controlo da frequência
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Fibrilhação auricular, controlo do ritmo, controlo da frequênciaResumo
A fibrilhação auricular é a arritmia cardíaca mais frequente da prática clínica com uma prevalência crescente devido ao progressivo
envelhecimento da população. Constitui uma importante causa
de morbilidade e mortalidade, especialmente no que concerne
a acidente vascular cerebral (AVC) e insuficiência cardíaca (IC).
Existem duas principais estratégias terapêuticas para a FA:
restabelecer e/ou manter o ritmo sinusal com recurso à cardioversão eléctrica e/ou farmacológica ou controlar apenas a resposta
ventricular. Ambas associadas a terapêutica antitrombótica.
Estudos têm demonstrado resultados semelhantes em termos
de redução de morbilidade e mortalidade quando uma ou outra estratégia é aplicada.
A selecção da melhor estratégia terapêutica deve ser individual,
dependendo da natureza, intensidade e frequência dos sintomas,
comorbilidades associadas, preferência dos doentes e da resposta ao tratamento.
O presente artigo visa discutir as vantagens e desvantagens de
cada estratégia, identificar os doentes que mais beneficiam de
uma ou outra abordagem e analisar as actuais recomendações
sobre o assunto.
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Referências
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