Kistler Peter M
Department of Cardiology, The Alfred Hospital, Melbourne, Victoria, Australia.
Aust Fam Physician. 2007 Jul;36(7):512-7.
Pharmacological management of arrhythmias is not curative, is sometimes difficult, and may be associated with significant morbidity.
This article discusses the place of catheter ablation in the treatment of arrhythmias.
Supraventricular and typical atrial flutter can be cured with catheter ablation in approximately 95% of cases with very low complication rates. Catheter ablation can successfully restore and maintain sinus rhythm in patients with atrial fibrillation (AF) and should be considered in symptomatic patients not controlled on medical therapy before the initiation of amiodarone. Results for AF ablation are best in paroxysmal patients without structural heart disease. Ventricular tachycardia in patients without structural heart disease is readily treated with catheter ablation. Catheter ablation is an effective adjunct to an implantable cardioverter defibrillator in patients with ventricular tachycardia postmyocardial infarction.
心律失常的药物治疗并非根治性的，有时存在困难，且可能伴有显著的发病率。
本文讨论导管消融在心律失常治疗中的地位。
室上性和典型心房扑动在约95%的病例中可通过导管消融治愈，并发症发生率极低。导管消融可成功恢复并维持心房颤动（AF）患者的窦性心律，对于症状性患者在开始使用胺碘酮前药物治疗无法控制时应考虑采用。AF消融在无结构性心脏病的阵发性患者中效果最佳。无结构性心脏病患者的室性心动过速很容易通过导管消融治疗。导管消融是心肌梗死后室性心动过速患者植入式心脏复律除颤器的有效辅助手段。
