Pérez-Villacastín Julián, Pérez Castellano Nicasio, Moreno Javier, Cañadas Victoria
Unidad de Arritmias, Hospital Clínico San Carlos, Madrid, España.
Rev Esp Cardiol (Engl Ed). 2012 Jul;65 Suppl 2:22-8. doi: 10.1016/j.recesp.2012.07.007.
Catheter ablation is now well established as an alternative or complementary therapeutic approach to the use of anti-arrhythmic drugs in selected patients with atrial fibrillation. Although pulmonary vein isolation is very effective in patients with paroxysmal atrial fibrillation, it is still not possible to identify the arrhythmogenic substrate responsible for fibrillation in a large number of patients, principally those with persistent atrial fibrillation. As a result, anatomic areas in the atrium that are not involved in either the initiation or maintenance of atrial fibrillation may undergo ablation. Until we have a better understanding of the pathophysiology of the different stages of atrial fibrillation, it would be wise to treat arrhythmias early, before anatomic or electrical deterioration of the atrium occurs.
导管消融术现已成为房颤患者中抗心律失常药物的替代或补充治疗方法，在特定患者中得到了广泛应用。尽管肺静脉隔离对于阵发性房颤患者非常有效，但在很多患者，主要是持续性房颤患者中，仍无法识别导致房颤的致心律失常基质。因此，心房中与房颤的起始或维持均无关的解剖区域可能会接受消融。在我们更好地理解房颤不同阶段的病理生理学之前，在心房发生解剖或电生理恶化之前尽早治疗心律失常是明智的。
