房性心动过速——不容忽视的心律失常

Atrial tachycardia：an arrhythmia should not be ignored

自20世纪50年代起人们便认识到持续性快速性心律失常能够改变心脏的结构和功能，目前心房颤动（房颤）和快速室性心律失常正成为研究的热点。房性心动过速（房速）亦属于快速心律失常的一种，起源于心房肌任一部分（除窦房结外）或与心房相连的解剖结构，如肺静脉、主动脉无冠窦内和二尖瓣环．主动脉连接处等旧40，无需房室结和房室旁路的参与，房速的频率多在120～220次／min，与房颤不同，房速通常心房律规整，如果以固定的房室传导比下传，则心室律也是规整的。但无论心室律是否规整，其危害与房颤相当，具有较高的致死率和致残率，不容忽视。

It has been well known since at least the 1950s that chronic tachycardia can alter cardiac structure and function. Atrial tachycardia （AT） is a common tachyarrhythmia originating from atrium which can be seen in patients with or without organic heart diseases. AT can occur as nonsustained, paroxysmal,incessant and chronic tachycardia. Ectopic automaticity, triggered activity and reentry may be the mechanisms of the arrhythmia. The classification of atrial tachycardia based on arrhythmogenic site and mechanism may be the better one for the purpose of clinical study and strategies of treatment. Currently available antiarrhythmic drugs have limited efficacy for acute termination of AT. Ibutilide can immediate terminate recurrent atial tachycardia after catheter ablation of atrial fibrillation safety and effectively. Radiofrequency catheter ablation may be effectively performed under the guide of electroanatomic mapping in these patients. And, radiofrequency also can decrease stroke risk, improve ventricular function with a reduction in all cause mortality, cardiac and possibly arrhythmic mortality.