Suppr超能文献

消融心房颤动:临床医生的转化科学视角

Ablating atrial fibrillation: A translational science perspective for clinicians.

作者信息

Weiss James N, Qu Zhilin, Shivkumar Kalyanam

机构信息

UCLA Cardiovascular Research Laboratory.

UCLA Cardiovascular Research Laboratory.

出版信息

Heart Rhythm. 2016 Sep;13(9):1868-77. doi: 10.1016/j.hrthm.2016.05.026. Epub 2016 May 27.

Abstract

Although considerable progress has been made in developing ablation approaches to cure atrial fibrillation (AF), outcomes are still suboptimal, especially for persistent and long-lasting persistent AF. In this topical review, we review the arrhythmia mechanisms, both reentrant and nonreentrant, that are potentially relevant to human AF at various stages/settings. We describe arrhythmia mapping techniques used to distinguish between the different mechanisms, with a particular focus on the detection of rotors. We discuss which arrhythmia mechanisms are likely to respond to ablation, and the challenges and prospects for improving upon current ablation strategies to achieve better outcomes.

摘要

尽管在开发用于治疗心房颤动(AF)的消融方法方面已经取得了相当大的进展,但治疗效果仍然不尽人意,尤其是对于持续性和长期持续性房颤。在本篇专题综述中,我们回顾了在不同阶段/情况下可能与人类房颤相关的折返性和非折返性心律失常机制。我们描述了用于区分不同机制的心律失常标测技术,特别关注转子的检测。我们讨论了哪些心律失常机制可能对消融有反应,以及改进当前消融策略以获得更好治疗效果所面临的挑战和前景。

相似文献

1
Ablating atrial fibrillation: A translational science perspective for clinicians.
Heart Rhythm. 2016 Sep;13(9):1868-77. doi: 10.1016/j.hrthm.2016.05.026. Epub 2016 May 27.
2
Ablating Atrial Fibrillation: Customizing Lesion Sets Guided by Rotor Mapping.
Methodist Debakey Cardiovasc J. 2015 Apr-Jun;11(2):76-81. doi: 10.14797/mdcj-11-2-76.
3
Prevalence, characteristics, mapping, and catheter ablation of potential rotors in nonparoxysmal atrial fibrillation.
Circ Arrhythm Electrophysiol. 2013 Oct;6(5):851-8. doi: 10.1161/CIRCEP.113.000318. Epub 2013 Aug 27.
4
Mapping and ablating stable sources for atrial fibrillation: summary of the literature on Focal Impulse and Rotor Modulation (FIRM).
J Interv Card Electrophysiol. 2014 Sep;40(3):237-44. doi: 10.1007/s10840-014-9889-8. Epub 2014 Mar 20.
5
Rotors as drivers of atrial fibrillation and targets for ablation.
Curr Cardiol Rep. 2014 Aug;16(8):509. doi: 10.1007/s11886-014-0509-0.
7
Radiofrequency Catheter Ablation For Atrial Fibrillation: Approaches And Outcomes.
Heart Lung Circ. 2017 Sep;26(9):941-949. doi: 10.1016/j.hlc.2017.05.125. Epub 2017 Jun 13.
8
Clinical Benefit of Ablating Localized Sources for Human Atrial Fibrillation: The Indiana University FIRM Registry.
J Am Coll Cardiol. 2017 Mar 14;69(10):1247-1256. doi: 10.1016/j.jacc.2016.11.079.
9
[Interventional therapy of atrial fibrillation: possibilities and limitations].
Dtsch Med Wochenschr. 2010 Mar;135 Suppl 2:S48-54. doi: 10.1055/s-0030-1249209. Epub 2010 Mar 10.
10
Catheter Ablation for Long-Standing Persistent Atrial Fibrillation.
Methodist Debakey Cardiovasc J. 2015 Apr-Jun;11(2):87-93. doi: 10.14797/mdcj-11-2-87.

引用本文的文献

1
A novel murine model of atrial fibrillation by diphtheria toxin-induced injury.
Front Physiol. 2022 Oct 31;13:977735. doi: 10.3389/fphys.2022.977735. eCollection 2022.
4
Novel approaches to mechanism-based atrial fibrillation ablation.
Cardiovasc Res. 2021 Jun 16;117(7):1662-1681. doi: 10.1093/cvr/cvab108.
5
Revisiting Antiarrhythmic Drug Therapy for Atrial Fibrillation: Reviewing Lessons Learned and Redefining Therapeutic Paradigms.
Front Pharmacol. 2020 Nov 9;11:581837. doi: 10.3389/fphar.2020.581837. eCollection 2020.
7
Challenges Associated with Interpreting Mechanisms of AF.
Arrhythm Electrophysiol Rev. 2020 Feb 12;8(4):273-284. doi: 10.15420/aer.2019.08.
8
Multicellular Models of Cardiac Arrhythmias: Focus on Atrial Fibrillation.
Front Cardiovasc Med. 2020 Mar 31;7:43. doi: 10.3389/fcvm.2020.00043. eCollection 2020.
9
Directed Networks as a Novel Way to Describe and Analyze Cardiac Excitation: Directed Graph Mapping.
Front Physiol. 2019 Sep 10;10:1138. doi: 10.3389/fphys.2019.01138. eCollection 2019.

本文引用的文献

1
Impact of Rotor Ablation in Nonparoxysmal Atrial Fibrillation Patients: Results From the Randomized OASIS Trial.
J Am Coll Cardiol. 2016 Jul 19;68(3):274-282. doi: 10.1016/j.jacc.2016.04.015. Epub 2016 May 6.
2
Direct Proof of Endo-Epicardial Asynchrony of the Atrial Wall During Atrial Fibrillation in Humans.
Circ Arrhythm Electrophysiol. 2016 May;9(5). doi: 10.1161/CIRCEP.115.003648.
3
Identification of Rotors during Human Atrial Fibrillation Using Contact Mapping and Phase Singularity Detection: Technical Considerations.
IEEE Trans Biomed Eng. 2017 Feb;64(2):310-318. doi: 10.1109/TBME.2016.2554660. Epub 2016 Apr 15.
4
Current controversies in determining the main mechanisms of atrial fibrillation.
J Intern Med. 2016 May;279(5):428-38. doi: 10.1111/joim.12492. Epub 2016 Mar 16.
7
Long-term clinical outcomes of focal impulse and rotor modulation for treatment of atrial fibrillation: A multicenter experience.
Heart Rhythm. 2016 Mar;13(3):636-41. doi: 10.1016/j.hrthm.2015.10.031. Epub 2015 Oct 21.
8
Mechanisms for the Termination of Atrial Fibrillation by Localized Ablation: Computational and Clinical Studies.
Circ Arrhythm Electrophysiol. 2015 Dec;8(6):1325-33. doi: 10.1161/CIRCEP.115.002956. Epub 2015 Sep 10.
9
Delayed afterdepolarizations generate both triggers and a vulnerable substrate promoting reentry in cardiac tissue.
Heart Rhythm. 2015 Oct;12(10):2115-24. doi: 10.1016/j.hrthm.2015.06.019. Epub 2015 Jun 10.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验