房颤是最常见的心律失常性疾病，也是一种增龄性疾病。随着我国人口老龄化的趋势，房颤的患病率也逐年上升，为临床诊疗带来了沉重负担和巨大挑战。2024年1月11日，由苏州工业园区东方华夏心血管健康研究院主办的"亚太房颤学术交流会"在浙江省杭州市成功举行。本次会议邀请黄从新教授、郑良荣教授、廖德宁教授、李岳春教授、Dr. Tran Nhan Tuan、Prof. Satoshi Yasuda、Dr. Luk Naai Hong Vincent、王云帆教授、谢鸿发教授、Dr. Anurut Huntraku、杨剑教授、杜先锋教授、Dr. Po-Lin Lin、王丽娟教授等十五位专家参与，从房颤抗凝出血的预测与管理、伴有稳定冠状动脉疾病的房颤患者的最佳抗血栓治疗策略、合并症房颤患者的治疗选择与药物相互作用重点分析、房颤一站式治疗回顾与展望等话题展开讨论。
Atrial fibrillation is the most common arrhythmia disease and also an age-related disease. With the increasing trend of the aging population in my country, the prevalence of atrial fibrillation has also increased annually, posing a heavy burden and significant challenges to clinical diagnosis and treatment. On January 11, 2025, The “International Cooperation Exchange Program for AF Centers - APAC Academic Exchange on Atrial Fibrillation” brought together many experts from around the world to analyze the prevention and management of atrial fibrillation from all aspects, from optimizing atrial fibrillation detection and management to personalized solutions for patients with atrial fibrillation complications, and share the prevention and treatment experience of various countries. Let us review the wonderful content of the Atrial Fibrillation Forum and listen to the dialogue between Chinese and foreign experts.
剖析风险因素，优化防治策略
会议由郑良荣教授与廖德宁教授共同主持。会议主席黄从新教授指出在郑良荣教授的带领下，浙江省房颤中心工作一直走在全国前列，这一体系真正地管理到了城市每个角落的房颤患者，激发了各级医疗机构医生的热情，积极参与到房颤多样化管理事业中，取得了令人瞩目的成果。郑良荣教授提出希望通过本次会议促进国内外心血管医师及研究人员的学术沟通和临床研究活动。
The meeting was co-chaired by Professor Zheng Liangrong and Professor Liao Dening. Professor Huang congxin, chairman of the conference, pointed out that under the leadership of Professor Zheng Liangrong, the AF center of Zhejiang Province has been at the forefront of the country, and this system has truly managed atrial fibrillation patients in every corner of the city. Professor Zheng Liangrong expressed the hope that this conference will promote academic communication and clinical research activities of cardiovascular physicians and researchers at home and abroad.
李岳春教授：
抗凝治疗中出血的预测与管理
会议的第一个环节是抗凝治疗中出血的预测与管理。李岳春教授从以下三个方面展开讲述：
1、房颤抗凝治疗的出血风险；
2、抗凝治疗中出血的预测；
3、抗凝治疗中出血的管理；
在随后的讨论环节Dr. Tran Nhan Tuan提出
抗凝治疗是房颤患者预防卒中的关键，但需权衡其出血风险。
NOAC较传统抗凝药物更安全，但需加强患者的风险评估和管理。
规范化的出血管理策略可以显著减少抗凝治疗中的并发症。
Summary
•Anticoagulation therapy is crucial for stroke prevention in AF but requires a balance of bleeding risks.
•NOACs are safer than traditional anticoagulants but require thorough risk evaluation and management.
•Standardized bleeding management strategies can significantly reduce complications during anticoagulation therapy.
Satoshi Yasuda教授：
伴有稳定冠状动脉疾病的房颤患者的最佳抗血栓治疗策略
会议的第二个环节是关于伴有稳定冠状动脉疾病的房颤患者的最佳抗血栓治疗策略的演讲。Prof. Satoshi Yasuda从以下四方面展开讨论：
1、伴有稳定冠状动脉疾病的房颤患者流行病学；
2、AFIRE 研究解读；
3、EPlC-CAD随机临床试验解读；
4、Eldercare-AF研究解读。
在随后的讨论环节中，Dr. Luk Ngai Hong Vincent和王云帆教授从以下几方面展开讨论：
1.心房颤动（AF）和冠状动脉疾病（CAD）：对同时患有AF和CAD的患者管理困难，因其主要心血管事件（MACE）和出血风险均较高；
2.现行指南：对AF和稳定CAD患者，在PCI后12个月，推荐单用口服抗凝药（OAC）治疗；
3.AFIRE研究：表明利伐沙班单药治疗在心血管事件方面不逊于联合治疗（利伐沙班+抗血小板药），且在减少主要出血方面更具优势；
4.高风险患者：利伐沙班单药治疗对有心肌梗死、中风或外周动脉疾病病史的患者显示出更大的益处；
5.“减药即增效”理念：最新证据支持通过减少抗血栓治疗降低出血风险，同时不会显著增加缺血事件。
Atrial Fibrillation (AF) and Coronary Artery Disease (CAD): Managing AF in CAD patients is challenging due to increased risks of major adverse cardiac events (MACE) and bleeding. Current Guidelines: Oral anticoagulant (OAC) monotherapy is recommended 12 months after percutaneous coronary intervention (PCI) for AF patients with stable CAD. AFIRE Study: Demonstrated that rivaroxaban monotherapy is non-inferior to combination therapy (rivaroxaban + antiplatelet) for cardiovascular outcomes and superior in reducing major bleeding. High-Risk Subgroups: Rivaroxaban monotherapy showed greater benefits for patients with histories of myocardial infarction, stroke, or peripheral artery disease. “Less is More” Approach: Recent evidence supports reducing antithrombotic therapy to minimize bleeding risks without significantly increasing ischemic events.
谢鸿发教授：
合并症房颤患者的治疗选择与药物相互作用的重点分析
会议的第三个环节是关于合并症房颤患者的治疗选择与药物相互作用重点分析的演讲。谢鸿发教授从以下四方面展开讨论：
1、亚洲房颤流行病学；
2、NOAC剂量规范的价值解析；
3、艾多沙班剂量调整的深层逻辑和启示；
4、超高龄超高危出血人群的抗凝剂量选择。
在随后的讨论环节中，Dr. Anurut Huntraku和杨剑教授从以下几方面展开讨论：
房颤（AF）在亚洲老年患者中非常常见，且随年龄增加而升高；
亚洲房颤患者的中风和死亡风险较高；
ETNA-AF研究及ELDERCARE-AF研究表明，低剂量艾多沙班在非常年长且体弱的患者中有效预防中风或全身性栓塞，且主要出血风险未显著增加。
AF is highly prevalent among elderly Asian patients, with incidence increasing with age.
Asian AF patients face elevated risks of stroke and mortality.
Studies like ETNA-AF and ELDERCARE-AF showed that low-dose Edoxaban is effective in preventing stroke or systemic embolism in very elderly and frail patients without a significant increase in major bleeding risks.
杜先锋教授：
房颤LAAC+CA一站式：已知的，未知的
会议的第四个环节是房颤LAAC+CA一站式。杜先锋教授从以下六方面进行阐述：
房颤一站式治疗的探索
研究及数据支持
手术策略优化
临床指南与技术更新
经济和预后效益
未来研究方向
在随后的讨论环节中，Dr. Po-Lin Lin和王丽娟教授从以下几方面展开讨论：
探讨一站式术后AF/ATA负荷的精确评估；
新型消融能源（如PFA）与一站式的结合；
在医保政策下的普及应用。
Precise evaluation of AF/ATA burden after one-stop procedures.
Integration of novel ablation energy sources like PFA into the one-stop approach.
Broader implementation under insurance policy constraints.
本次亚太房颤学术交流会云集多位国内外房颤领域资深专家，深度剖析了房颤诊疗中所面临的共性挑战，并为房颤的精准检测、个体化治疗以及综合管理提供了全新视角和解决方案，有望促进我国房颤综合管理水平进一步提升！
This APAC Academic Exchange on Atrial Fibrillation brought together many experts in the field of atrial fibrillation from home and abroad. They deeply analyzed the common challenges faced in the diagnosis and treatment of atrial fibrillation and provided new perspectives and solutions for the accurate detection, individualized treatment and comprehensive management of atrial fibrillation, which is expected to promote further improvement in the comprehensive management level of atrial fibrillation in my country!
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