Guerra Peter G, Skanes Allan C
Montreal Heart Institute, Montreal, Quebec.
Can J Cardiol. 2005 Sep;21 Suppl B:31B-34B.
Catheter ablation therapy for the treatment of atrial fibrillation (AF) has evolved considerably in the past decade. Although the therapy was initially limited to ablation of the atrioventricular node to ensure adequate rate control for patients with rapid AF, the possibility of catheter-based rhythm control has now been demonstrated in several studies. Atrial extrasystoles originating from the pulmonary veins are now known to be triggers for the initiation of AF. Consequently, attempts at ablation have focused on the ablation of these triggers or on electrical isolation of these veins using radiofrequency ablation. More recently, three-dimensional electroanatomical imaging techniques have allowed for the development of left atrial ablation techniques, whereby long, linear lesions are created around the pulmonary venous ostia. Both of these techniques have shown interesting success rates in the treatment of symptomatic paroxysmal AF. The present article reviews the evolution of these techniques and lists the recommendations for the use of catheter ablation for both rate and rhythm control of AF.
在过去十年中，用于治疗心房颤动（AF）的导管消融疗法有了很大发展。尽管该疗法最初仅限于消融房室结，以确保对快速房颤患者进行充分的心率控制，但目前多项研究已证实基于导管的节律控制是可行的。现已明确，起源于肺静脉的房性期前收缩是房颤发作的触发因素。因此，消融尝试主要集中于消融这些触发因素，或使用射频消融对这些静脉进行电隔离。最近，三维电解剖成像技术推动了左心房消融技术的发展，即围绕肺静脉口创建长的线性损伤。这两种技术在治疗有症状的阵发性房颤方面均显示出可观的成功率。本文回顾了这些技术的发展历程，并列出了使用导管消融进行房颤心率和节律控制的建议。
