循環器ジャーナル65巻3号

2017年07月発行

特集 不整脈診療—ずっと疑問・まだ疑問 Ⅰ．不整脈診療のベーシック

心不全と心房細動とβ遮断薬

著者： 小川正浩¹

所属機関： ¹福岡大学医学部心臓・血管内科学

ページ範囲：P.409 - P.415

Point
・心不全と心房細動はしばしば共存し，一方が一方を増悪させ，心不全の増悪，心房細動持続の長期化，血栓塞栓症や突然死を引き起こしやすく，生命予後を悪化させる．
・β遮断薬は，心不全の治療薬として，またAFリズムおよびレートコントロール薬として有用であるが，慢性化したAFのレートコントロールは必ずしも心拍数を厳格に低下させる必要はなく，症例により使い分けや用量調節することが肝要である．
・心不全合併心房細動に対するカテーテルアブレーションは，薬物治療に比べて洞調律維持，予定外入院の減少や予後改善効果が見込まれる．

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