Lee Richard, Kruse Jane, McCarthy Patrick M
Bluhm Cardiovascular Institute, Division of Cardiothoracic Surgery, Northwestern Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, IL 60611-2968, USA.
Nat Rev Cardiol. 2009 Aug;6(8):505-13. doi: 10.1038/nrcardio.2009.106.
The field of atrial fibrillation is evolving rapidly. Although a medical rhythm control strategy has not proven to be beneficial for survival, new interventional therapies have improved the rate of sinus restoration and thus have the potential to improve outcomes. In particular, the maze procedure can be performed safely and cures the majority of patients with atrial fibrillation. Over the last two decades, the introduction of new ablation technologies has made the procedure much easier to perform and it is now more widely applied to patients with atrial fibrillation undergoing cardiac surgery. Minimally invasive modifications of the maze using these technologies have offered an important step towards developing a stand-alone procedure for the cure of atrial fibrillation with potentially decreased morbidity. We review the magnitude of the problem, the history of past surgical treatments, current surgical options and the future direction of surgical therapy.
心房颤动领域正在迅速发展。尽管医学节律控制策略尚未被证明对生存有益，但新的介入疗法提高了窦性心律恢复率，因此有可能改善治疗结果。特别是，迷宫手术可以安全地实施，并且能治愈大多数心房颤动患者。在过去的二十年里，新消融技术的引入使该手术的操作变得更加容易，现在它更广泛地应用于接受心脏手术的心房颤动患者。使用这些技术对迷宫手术进行微创改良，为开发一种独立的治疗心房颤动的手术迈出了重要一步，这可能会降低发病率。我们回顾了该问题的严重程度、过去手术治疗的历史、当前的手术选择以及手术治疗的未来方向。
