Shapira Adam R
Advanced Heart Care PA, The Heart Hospital Baylor Plano, Plano, TX 75093, USA.
Am Fam Physician. 2009 Nov 15;80(10):1089-94.
Supraventricular arrhythmias are relatively common, often persistent, and rarely life-threatening cardiac rhythm disturbances that arise from the sinus node, atrial tissue, or junctional sites between the atria and ventricles. The term "supraventricular arrhythmia" most often is used to refer to supraventricular tachycardias and atrial flutter. The term "supraventricular tachycardia" commonly refers to atrial tachycardia, atrioventricular nodal reentrant tachycardia, and atrioventricular reciprocating tachycardia, an entity that includes Wolff-Parkinson-White syndrome. Atrial fibrillation is a distinct entity classified separately. Depending on the arrhythmia, catheter ablation is a treatment option at initial diagnosis, when symptoms develop, or if medical therapy fails. Catheter ablation of supraventricular tachycardias, atrial flutter, and atrial fibrillation offers patients high effectiveness rates, durable (and often permanent) therapeutic end points, and low complication rates. Catheter ablation effectiveness rates exceed 88 percent for atrioventricular nodal reentrant tachycardia, atrioventricular reciprocating tachycardia, and atrial flutter; are greater than 86 percent for atrial tachycardia; and range from 60 to 80 percent for atrial fibrillation. Complication rates for supraventricular tachycardias and atrial flutter ablation are 0 to 8 percent. The complication rates for atrial fibrillation ablation range from 6 to 10 percent. Complications associated with catheter ablation result from radiation exposure, vascular access (e.g., hematomas, cardiac perforation with tamponade), catheter manipulation (e.g., cardiac perforation with tamponade, thromboembolic events), or ablation energy delivery (e.g., atrioventricular nodal block).
室上性心律失常相对常见，常持续存在，很少危及生命，是起源于窦房结、心房组织或心房与心室之间交界部位的心脏节律紊乱。“室上性心律失常”一词最常用于指代室上性心动过速和心房扑动。“室上性心动过速”通常指房性心动过速、房室结折返性心动过速和房室折返性心动过速，后者包括预激综合征。心房颤动是一种单独分类的不同疾病。根据心律失常的类型，导管消融可作为初始诊断时、出现症状时或药物治疗失败时的一种治疗选择。对室上性心动过速、心房扑动和心房颤动进行导管消融，为患者提供了高有效率、持久（且通常是永久性）的治疗终点和低并发症发生率。房室结折返性心动过速、房室折返性心动过速和心房扑动的导管消融有效率超过88%；房性心动过速的有效率大于86%；心房颤动的有效率为60%至80%。室上性心动过速和心房扑动消融的并发症发生率为0%至8%。心房颤动消融的并发症发生率为6%至10%。与导管消融相关的并发症源于辐射暴露、血管穿刺（如血肿、心脏穿孔伴心包填塞）、导管操作（如心脏穿孔伴心包填塞、血栓栓塞事件）或消融能量传递（如房室传导阻滞）。
