心房颤动导管消融进展

Progress of catheter ablation for atrial fibrillation

如今导管射频消融已是症状性心房颤动(atrial fibrillation,简称房颤)的前沿治疗,它对阵发性房颤的治疗效果是明确的,且有大量的数据支持这一点,然而,目前持续性房颤的导管射频消融治疗效果较差,尚存在颇多争议。研究已经证明肺静脉生理学在阵发性房颤中起关键作用,然而持续性房颤的发生机制尚不明确。本综述重点阐述阵发性房颤与持续性房颤的机制基础、导管消融的作用以及治疗的最新进展。

Catheter radio frequency ablation is now at the forefront of the management of symptomatic atrial fibrillation （AF）. Its role in paroxysmal AF is well defined with considerable data supporting. Catheter ablation in persistent AF has less effective and the subject is in considerable debate. Mechanistic studies have demonstrated the critical role of pulmonary vein physiology in paroxysmal AF, whereas the mechanisms that sustain persistent AF are not well understood. This review will focus on the current understanding of the mechanistic basis of paroxysmal and persistent AF, the role of catheter ablation and recent advances in the management of these complex arrhythmias.