持续性心房纤颤的辅助消融策略

Adjunct ablation strategies for persistent atrial fibrillation

心房纤颤（简称房颤）是一种临床上最常见的持续性心律失常，发病率高，危害大。近年来，房颤的非药物治疗取得了较快发展，其中肺静脉隔离（PVI）就是一种有效的治疗方法。这种方法对于阵发性房颤患者治愈率较高，而在持续性房颤和长时程房颤患者中疗效一般。本综述主要探讨针对持续性房颤患者的最新辅助消融策略及其机制，包括线性消融、复杂碎裂心房电位（CFAE）消融、神经节（丛）消融、主频率消融、转子消融和与房颤触发相关的其他解剖位点消融。

Atrial fibrillation （AF） is one of the clinically most common sustained arrhythmia, with high incidence and major hazards. In recent years, great achievements have been made in its non-pharmacologic therapeutic strategies. Among them, pulmonary vein isolation （PVI） is recommended by recent guidelines as an effective procedure to control AF, and its efficacy is higher in paroxysmal AF than in persistent and long-standing persistent AF. This article reviewed and summarized the state-of-the-art of adjunct ablation strategies for patients with persistent AF, including linear ablation, ablation of complex fractionated atrial electrograms （CFAE）, ablation of ganglionated plexi, dominant frequency, rotors and other anatomical sites frequently involved in AF triggers.