Scharf C
HerzGefässZentrum, Klinik im Park, Zürich.
Praxis (Bern 1994). 2005 Nov 9;94(45):1753-9. doi: 10.1024/0369-8394.94.45.1753.
This article summarizes current understandings and therapies for both arrhythmias. Atrial flutter is most often arising from a macroreentry circuit in the right atrium or around scar tissue in case or previous cardiothoracic surgery. As a macroreentrant tachycardia it is regular and can lead to higher heart rates, especially if occurring with 1:1 conduction. In contrast atrial fibrillation, especially when occurring paroxysmal at the beginning, is arising from triggers within the pulmonary veins. Ablation strategies to electrically isolate those triggers have a treatment success rate of 80%, which is much more than can be achieved with antiarrhythmic medication (success rates 30-50%). Emergency treatment of both arrhythmias include cardioversion and pacemaker implantation with AV node ablation if necessary.
本文总结了目前对这两种心律失常的认识和治疗方法。心房扑动最常起源于右心房的大折返环或既往心胸外科手术病例中的瘢痕组织周围。作为一种大折返性心动过速，它是规则的，并且可导致较高的心率，尤其是在1:1传导时发生。相比之下，心房颤动，尤其是在开始时阵发性发作时，起源于肺静脉内的触发因素。电隔离这些触发因素的消融策略的治疗成功率为80%，这远高于抗心律失常药物所能达到的成功率（成功率为30%-50%）。这两种心律失常的紧急治疗包括心脏复律以及必要时植入起搏器并进行房室结消融。
