Chauvin M
Department of Cardiology, CMCO Hospital, Strasbourg-Schiltigheim, France.
Cardiologia. 1991 Aug;36(8 Suppl):55-61.
Atrial fibrillation and atrial flutter are the most frequent arrhythmias encountered by the cardiologists in an everyday practice. External cardioversion, atrial temporary pacing and/or drugs are commonly and often successfully used in their treatment. The failures of these methods are rare, and for the patients who remain prone to arrhythmias or a recurrence with serious hemodynamic consequences, new therapies are presently under assessment. Electrical internal cardioversion can be performed when a permanent and bad tolerated atrial fibrillation is not managed by an external cardioversion. Elective ablation of a reentrant area will be probably the best solution to treat a recurrent atrial flutter or a junctional tachycardia by intranodal reentry. Finally, a radical solution consists to separate electrically the atria from the ventricles by interrupting totally or partially the A-V conduction. This can be performed by an endocavitary fulguration or an ablation by radiofrequency currents. To avoid recurrences, we usually use a pharmacological therapy. Permanent pacing is an exceptional solution.
心房颤动和心房扑动是心脏病专家在日常实践中最常遇到的心律失常。体外心脏复律、心房临时起搏和/或药物通常被广泛且经常成功地用于治疗它们。这些方法的失败情况很少见，对于那些仍然容易发生心律失常或复发且伴有严重血流动力学后果的患者，目前正在评估新的治疗方法。当永久性且耐受性差的心房颤动无法通过体外心脏复律控制时，可以进行体内电复律。选择性消融折返区域可能是治疗复发性心房扑动或结内折返性交界性心动过速的最佳解决方案。最后，一种根治性的解决方案是通过完全或部分中断房室传导，将心房与心室电分离。这可以通过心腔内电灼或射频电流消融来实现。为避免复发，我们通常采用药物治疗。永久性起搏是一种特殊的解决方案。
