重视心房颤动非肺静脉触发灶的导管消融

More attention should be payed to targeting nonpulmonary vein triggers during atrial fibrillation ablation

导管消融已逐渐成为心房颤动(房颤)治疗的有效手段,如何降低术后复发率是当前面临的挑战之一。肺静脉隔离是房颤导管消融治疗的基石,但是非肺静脉触发灶在房颤的触发和维持中发挥一定作用,是房颤术后复发的主要预测因子。消融非肺静脉触发灶有助于减少阵发性和非阵发性房颤术后心律失常复发率。

Catheter ablation have evolved as an effective therapeutic options for patients with atrial fibrillation（AF）,but how to reduce arrhythmias recurrence remains a challenge.Pulmonary veins have been shown to represent the most frequent sites of ectopic beats initiating AF and pulmonary vein isolation is the cornerstone of catheter-based therapies for AF.However,triggers for atrial fibrillation may be found spontaneously but more often,stimulation with isoproterenol is required to uncover them outside the pulmonary veins in 12%-33% of cases.The presence of an inducible nonpulmonary vein trigger is a strong predictor of arrhythmia recurrence.Nonpulmonary vein triggers should be ablated in order to decreases recurrence in paroxysmal AF and persistent AF.