Sticherling Christian, Knecht Sven, Kühne Michael, Osswald Stefan
Kardiologie, Universitätsspital Basel.
Ther Umsch. 2014 Feb;71(2):87-92. doi: 10.1024/0040-5930/a000486.
Atrial fibrillation is the most common cardiac arrhythmia occurring in 2 % of the population. Aside from initiating oral anticoagulation in patients with an increased risk for thromboembolic complications, rhythm control often is the therapeutic target, particularly in the young and highly symptomatic. The ablation of patients with paroxysmal atrial fibrillation has emerged as an alternative to long-term treatment with antiarrhythmic drugs. It targets to isolate the pulmonary veins as the main triggers for atrial fibrillation in structurally normal atria. In the case of long-standing persistent atrial fibrillation, there is no agreement about the ablation strategy and the success rates are significantly lower. This review addresses the underlying pathophysiology, the ablation techniques, success rates and complications as well as alternative invasive treatment options.
心房颤动是最常见的心律失常,在2%的人群中出现。除了对血栓栓塞并发症风险增加的患者启动口服抗凝治疗外,节律控制通常是治疗目标,尤其是在年轻且症状严重的患者中。阵发性心房颤动患者的消融已成为抗心律失常药物长期治疗的替代方法。它旨在隔离肺静脉,将其作为结构正常心房中心房颤动的主要触发因素。对于长期持续性心房颤动,消融策略尚无共识,成功率也显著较低。本综述探讨了潜在的病理生理学、消融技术、成功率和并发症以及替代性侵入性治疗选择。