房间隔缺损与心房颤动：已知与未知
Atrial Septal Defect and Atrial Fibrillation: The Known and Unknown.
作者信息
Blake George E, Lakkireddy Dhanunjaya
机构信息
Mid America Cardiology @ University of Kansas Hospital, Kansas City, KS.
出版信息
J Atr Fibrillation. 2008 Sep 16;1(3):45. doi: 10.4022/jafib.45. eCollection 2008 Sep-Nov.
Abstract
Atrial fibrillation (AF) is a common complication in patients with atrial septal defects (ASDs). The link between AF and ASD is fairly complex and entails modifications in electrophysiologic, contractile and structural properties, at the cellular and tissue level, of both atria, mainly due to chronic atrial stretch and dilation. Surgical repair or percutaneous closure of ASDs are equally effective in reducing mortality and symptoms but limited in preventing or curbing AF, unless combined with an arrhythmia-specific procedure. Transesophageal echocardiography (TEE) and intracardiac echocardiography (ICE) have improved the safety and success of the above procedures. Finally, clearer understanding of the pathophysiology of AF in patients with ASD (and CHF, in general) has led to target-specific advances in medical management.
摘要
心房颤动（AF）是房间隔缺损（ASD）患者的常见并发症。AF与ASD之间的联系相当复杂，主要由于慢性心房牵张和扩张，在细胞和组织水平上，导致两个心房的电生理、收缩和结构特性发生改变。ASD的手术修复或经皮封堵在降低死亡率和症状方面同样有效，但在预防或控制AF方面有限，除非与心律失常特异性手术相结合。经食管超声心动图（TEE）和心内超声心动图（ICE）提高了上述手术的安全性和成功率。最后，对ASD（以及一般的CHF）患者AF病理生理学的更清晰理解导致了药物治疗方面针对特定靶点的进展。
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