慢性心房颤动导管消融的若干争议

Argues about Catheter Ablation of Chronic Atrial Fibrillation

随着房颤消融技术的迅速发展和提高,阵发性房颤射频消融已列入I类推荐,慢性房颤射频消融也列入Ⅱa类适应证。肺静脉电隔离仍是慢性房颤消融的基石。但由于慢性房颤病因不一,机制更加复杂,除了肺静脉电隔离外,还需进行心房基质改良,其消融策略、术式、终点还存在若干争议。

With the development of atrial fibrillation （AF） ablation, paroxysmal AF （PAF） has been involved into the I indication and chronic AF （CAF） has been involved into the II a indication in the new guideline of AF. The causes of CAF differ extensively with the mechanism more complicated. Though PVI is still the cornerstone of the ablation of CAF, PVI alone is not sufficient. It is necessary to modify substrate in the ablation of CAF. However, there are several argues about the ablation strategies, procedures, endpoints of ablation, and so on.