左心房心房扑动射频消融治疗进展

Radiofrequency Catheter Ablation of Left Atrial Flutter

心房扑动(房扑)是一种大折返性心律失常,与心房颤动关系密切,二者经常共存。导管消融术已成为房扑的一线治疗措施,但随访发现患者消融术后新发房性心律失常比例仍然较高。左心房房扑与典型右心房房扑相比机制更为复杂,常与各种原因导致的左心房纤维化有关,且左心房周围毗邻结构也较复杂,对安全有效地消融造成一定困难。随着高精密度标测系统和消融能量的发展,左心房房扑机制越来越清晰,这为左心房房扑实施有效透壁消融终止房扑提供了依据。

Atrial flutter is a common macro-reentrant arrhythmia which is closely related to atrial fibrillation,and they often coexist.Catheter ablation has become the first-line treatment for atrial flutter,but the recurrent rate of atrial arrhythmias remains high after long-term follow-up.Compared with typical right atrial flutter,the mechanism of left atrial flutter is more complicated,which is often related to left atrial fibrosis caused by various reasons.Moreover,the adjacent structures around the left atrium are complex,and how to safely and effectively achieve transmural ablation to terminate atrial flutter has become a problem for electrophysiologists.With the rapid development of 3D high-density electroanatomic mapping systems and ablation energy,the mechanism of left atrial flutter has become more and more clearly understood,and the success rate of left atrial flutter treatment can be further improved.