心房颤动外科治疗的历史与现状

Surgical Treatment of Atrial Fibrillation: History and Current Status

心房颤动病因机制复杂、病程长难根治,引发心力衰竭、猝死、脑卒中是病死病残率居高不下的主因。治疗目标是消除心房颤动维持窦性心律、控制心房颤动心室率、抗凝抗栓减少脑卒中、减少死亡和提高生活质量。药物治疗的有效性和安全性差,以全胸腔镜下左心房"盒状"消融术为代表的微创外科进展迅猛,与经导管心内消融优势互补,可望开创心房颤动治疗全新局面。

Atrial fibrillation has a complex etiology and mechanism. The high incidence of cardiac failure, sudden cardiac death and stroke play a significant role in the high mortality and morbidity of atrial fibrillation. The main objectives of atrial fibrillation management are to eliminate atrial fibrillation and restore sinus rhythm, control atrial fibrillation heart rate, reduce stroke by anti-coagulation and thrombus prevation, reduce mortality and improve life quality. The effectiveness and safety of drug therapy was poorly guaranteed, while the newly e- merged minimally invasive surgical techniques represented by completely thoracoseopie ＂Box lesion＂ ablation therapy are developing rapidly. The advantages of both surgical and catheter ablation therapy complimented each other, and are likely to open a new phase of atrial fibrillation therapy.