Weiss James N, Qu Zhilin, Shivkumar Kalyanam
UCLA Cardiovascular Research Laboratory.
UCLA Cardiovascular Research Laboratory.
Heart Rhythm. 2016 Sep;13(9):1868-77. doi: 10.1016/j.hrthm.2016.05.026. Epub 2016 May 27.
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.
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。