Takahashi Kazuhiro, Shoda Morio, Manaka Tetsuyuki, Nakanishi Toshio
Department of Pediatric Cardiology, Tokyo Women's Medical University, Tokyo, Japan.
Europace. 2008 Aug;10(8):1012-4. doi: 10.1093/europace/eun132. Epub 2008 May 24.
The mechanisms responsible for atrial fibrillation (AF) in post-operative Fontan patients are unclear, and the role of catheter ablation for treating AF is not well defined. We present a case of an 18-year-old woman who experienced drug-resistant paroxysmal AF late after the Fontan operation. We eliminated the AF by the radiofrequency catheter ablation of atrial substrates with complex fractionated atrial electrograms (CFAEs). The patient remains on anti-arrhythmic therapy and has not experienced any recurrence since the catheter ablation. Right atrial substrate modification via a CFAE-targeted catheter ablation might be an adjunct therapeutic option for selected post-Fontan patients with AF.
Fontan手术术后患者发生心房颤动（AF）的机制尚不清楚，导管消融治疗AF的作用也未明确界定。我们报告一例18岁女性患者，在Fontan手术后晚期出现耐药性阵发性AF。我们通过对具有复杂碎裂心房电图（CFAE）的心房基质进行射频导管消融消除了AF。该患者仍在接受抗心律失常治疗，自导管消融后未再复发。通过针对CFAE的导管消融进行右心房基质改良可能是部分Fontan术后AF患者的辅助治疗选择。
