Weinstock Jonathan, Wang Paul J, Homoud Munther K, Link Mark S, Estes N A Mark
Cardiac Arrhythmia Center, Division of Cardiology, Department of Medicine, Tufts University School of Medicine, Tufts-New England Medical Center, 750 Washington Street, Boston, MA 02111, USA.
J Interv Card Electrophysiol. 2003 Oct;9(2):275-88. doi: 10.1023/a:1026205028816.
With the limitations of pharmacologic and device therapies for atrial fibrillation and ventricular tachycardia, catheter ablation is assuming a larger role in the management of patients with these common arrhythmias. Multiple case series and clinical trials have helped to define the evolving role of these techniques for ablation of the atrioventricular node, atrial fibrillation, and ischemic ventricular tachycardia. Based on very low complication rates, excellent efficacy and proven outcomes with radiofrequency ablation of the atrioventricular node, this approach with permanent pacing should play a larger role in the treatment of symptomatic patients with permanent atrial fibrillation. While linear ablation of atrial fibrillation has limited clinical utility for the treatment of this common arrhythmia, the results of multiple case series of focal atrial fibrillation ablation indicate the potential for an expanding role of this curative technique. Catheter ablation techniques for ventricular tachycardia in the setting of coronary artery disease have a role as supplemental therapy to the implantable cardioverter defibrillator in patients with recurrent pharmacologically refractory ventricular arrhythmias requiring frequent device interventions.
鉴于心房颤动和室性心动过速的药物及器械治疗存在局限性，导管消融在这些常见心律失常患者的管理中发挥着越来越重要的作用。多个病例系列研究和临床试验有助于明确这些技术在房室结消融、心房颤动消融及缺血性室性心动过速消融中不断演变的作用。基于房室结射频消融极低的并发症发生率、卓越的疗效和已证实的治疗效果，这种联合永久起搏的方法在有症状的永久性心房颤动患者治疗中应发挥更大作用。虽然心房颤动的线性消融在治疗这种常见心律失常方面临床应用有限，但多个局灶性心房颤动消融病例系列研究结果表明，这种根治性技术有扩大应用的潜力。对于冠状动脉疾病患者发生的室性心动过速，导管消融技术可作为植入式心律转复除颤器的补充治疗，用于治疗复发性药物难治性室性心律失常且需要频繁进行器械干预的患者。
