射频消融术在房颤治疗中的应用

心房颤动（atrial fibrillation,AF）是临床上常见的心律失常,且患病率随年龄增长呈逐渐上升趋势.自第一例采用射频消融术治愈房颤以来,消融技术从线性消融到肺静脉的阶段性消融、延伸的环肺静脉消融、左房的线性消融、心脏复杂碎裂电位消融、心脏神经节丛的消融等不断创新,一项新的方法在环肺静脉消融的基础上通过左房后壁来治愈房颤.射频消融在阵发性房颤患者中的成功率较高,而在持续性房颤及永久性房颤患者中效果欠佳,这些患者通过环肺静脉的消融加心房复杂碎裂电位的消融可使成功率得到极大的提高.因此,射频消融是房颤患者得到远期治愈的一种有效且确切的治疗方法.

The application of radiofrequency ablation in the treatment of atrial fibrillation

Atrial fibrillation （AF） is a common arrhythmia in clinical practice and the morbidity in- creases with age. Since the radiofrequency ablation at the first time has cured AF, numerous techniques have been constantly developed, from linear ablation to segmental pulmonary vein （PV） isolation, exten- sive encircling PV isolation, left atrial （LA） linear ablation, ablation of complex fragmented atrial elec- trograms （CFAEs）, ablation of ganglionated plexi and a new approach that cures atrial fibrillation through posterior LA based on encircling PV isolation. Radiofrequency ablation is associated with a high clinical success rate in paroxysmal AF. However, in persistent AF or longstanding persistent AF, the re-sult of PV is less desirable. The success rate of those patients could be greatly increased by utilizing a hy-brid approach of combining encircling PV isolation with complex fractionated atrial electrograms isolation. Thus, AF ablation is an effective and established treatment for AF that offers an excellent chance of a lasting cure.