Ajijola Olujimi A, Boyle Noel G, Shivkumar Kalyanam
UCLA Cardiac Arrhythmia Center, UCLA Health System/David Geffen School of Medicine at UCLA, University of California, Los Angeles Los Angeles, CA, USA.
Front Physiol. 2015 Mar 27;6:90. doi: 10.3389/fphys.2015.00090. eCollection 2015.
Atrial fibrillation (AF) is the most common arrhythmia prompting clinical presentation, is associated with significant morbidity and mortality. The incidence and prevalence of this arrhythmia is expected to grow significantly in the coming decades. Of the available pharmacologic and non-pharmacologic treatment options, the fastest growing and most intensely studied is catheter-based ablation therapy for AF. Given the varying success rates for AF ablation, the increasingly complex factors that need to be taken into account when deciding to proceed with ablation, as well as varying definitions of procedural success, accurate detection of arrhythmia recurrence and its burden is of significance. Detecting and monitoring AF recurrence following catheter ablation is therefore an important consideration. Multiple studies have demonstrated the close relationship between the intensity of rhythm monitoring with wearable ambulatory cardiac monitors, or implantable cardiac rhythm monitors and the detection of arrhythmia recurrence. Other studies have employed algorithms dependent on intensive monitoring and arrhythmia detection in the decision tree on whether to proceed with repeat ablation or medical therapy. In this review, we discuss these considerations, types of monitoring devices, and implications for monitoring AF recurrence following catheter ablation.
心房颤动（AF）是促使临床表现的最常见心律失常，与显著的发病率和死亡率相关。预计在未来几十年中，这种心律失常的发病率和患病率将显著增长。在现有的药物和非药物治疗选择中，增长最快且研究最深入的是用于房颤的导管消融治疗。鉴于房颤消融的成功率各不相同，决定进行消融时需要考虑的因素日益复杂，以及手术成功的定义各异，准确检测心律失常复发及其负担具有重要意义。因此，检测和监测导管消融术后房颤复发是一个重要的考虑因素。多项研究表明，使用可穿戴式动态心脏监测仪或植入式心脏节律监测仪进行节律监测的强度与心律失常复发的检测之间存在密切关系。其他研究在决定是否进行重复消融或药物治疗的决策树中采用了依赖于强化监测和心律失常检测的算法。在本综述中，我们讨论了这些注意事项、监测设备的类型以及导管消融术后监测房颤复发的意义。
