Atrial fibrillation: what are the targets for intervention?
Atrial fibrillation: what are the targets for intervention?
复制标题
心房颤动：干预的目标是什么？
DOI：
10.1023/a:1026332426999
复制
发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Das,MithileshK
中科院分区：
文献类型：
--
作者：
Miller,JohnM;Olgin,JeffreyE;Das,MithileshK
心房纤颤（AF）是一个棘手的问题，并且在人群中日益严重。虽然药物治疗控制了许多患者的症状，但一部分患有这种常见心律失常的患者不能单独使用药物进行最佳管理。然而，房颤的真正治愈性治疗一直是电生理学的“圣杯”之一。外科迷宫手术是第一个为房颤患者提供永久性窦性心律维持的手术，但患者必须接受心脏直视手术;迷宫手术的基于导管的转换用作导管插入技术可用于治疗AF的概念的证明。随后的经验使电生理学家的注意力缩小到AF触发的消融，最常驻留在肺静脉中，而不是需要更大的消融线来控制心律失常。以下讨论涉及心房颤动导管消融技术的发展和现状，重点是确定合适的消融靶点。
Atrial fibrillation (AF) is a difficult and growing problem in the population. While medical therapy controls symptoms in many patients, a proportion of individuals with this common arrhythmia cannot be optimally managed with drugs alone. However, truly curative therapy for AF has always been one of the “holy grails” of electrophysiology. The surgical maze procedure was the first to offer permanent maintenance of sinus rhythm in patients with AF but subjected the patient to open heart surgery; a catheter-based translation of the maze procedure served as proof of concept that a catheterization technique could be used to treat AF. Subsequent experience has narrowed the electrophysiologist's attention to ablation of triggers of AF, most often residing in the pulmonary veins, rather than requiring more extensive ablation lines to control the arrhythmia. The following discussion deals with the development and current status of techniques for catheter ablation of atrial fibrillation, focusing on determination of appropriate target sites for ablation.