慢性房颤的导管消融进展

慢性房颤导管消融方法日趋成熟,包括环肺静脉消融/隔离、左心房线性消融、复杂碎裂心房电位(CFAE)消融、神经节消融、右心房消融等均有一定的效果,但尚无定式。各种方法的有机结合及个体化治疗对慢性房颤产生了更好的消融效果,成功率为21%~95%。对慢性房颤的机制及各种三维标测方法的研究、新的消融技术和能源的应用将提高消融成功率、减低复发率和手术时程;而慢性房颤导管消融的长期效果及对心脏结构功能的影响仍有待进一步探索。

Advances in catheter ablation of chronic atrial fibrillation

Catheter ablation of atrial fibrillation is an evolving field,especially for chronic atrial fibrillation.Several approaches have been performed in clinic practice,which include circumferential pulmonary vein ablation/isolation,left atrial linear ablation,CFAE ablation,pulmonary vein denervation or stepwise ablation.However,a standard approach has not been established.The total successful rates vary from 21% to 95%.The investigations in the mechanism of chronic atrial fibrillation and methods of three-dimensional mapping,and the usage of new source and technique of ablation will increase the successful rate,decrease the recurrence rate and procedure time.The long-term result of ablation of chronic atrial fibrillation and its impact on the structure and function of heart need further investigations.