Cheng Richard, Chang Melisa, Yuan Ng Chee
Cedars-Sinai Medical Center, Los Angeles.
J Atr Fibrillation. 2012 Apr 14;4(6):455. doi: 10.4022/jafib.455. eCollection 2012 Apr-May.
Atrial fibrillation (AF) is the most common arrhythmia and is a significant burden to healthcare cost. AF causes congestive heart failure, thromboembolic events such as stroke and intolerable symptoms in some patients. With the advances and increasing experience in catheter ablation, there is now an established role for catheter ablation in patients with atrial fibrillation. The risks, complications and patient features associated with it are increasingly recognized. A recent worldwide survey has shown an increasing number of medical centers that are practicing catheter ablation of atrial fibrillation, predominantly with pulmonary vein isolation techniques. However, catheter ablation is an invasive therapy in AF and is associated with a few major complications. Patient selection, ablation technique, and catheter energy source all influence the efficacy and safety of the procedure. Finally, while several randomized control trials have compared the efficacy of catheter ablation versus antiarrhythmic drug therapy, a number of trials are on the horizon to explore its role as a first line therapy for atrial fibrillation. New energy catheter energy sources are also being explored.
心房颤动(AF)是最常见的心律失常,给医疗成本带来了沉重负担。AF可导致充血性心力衰竭、血栓栓塞事件(如中风)以及部分患者出现难以忍受的症状。随着导管消融技术的进步和经验的增加,导管消融在心房颤动患者中已有明确的作用。与之相关的风险、并发症和患者特征也越来越受到认可。最近一项全球调查显示,越来越多的医疗中心开展心房颤动的导管消融,主要采用肺静脉隔离技术。然而,导管消融是房颤的一种侵入性治疗方法,且与一些主要并发症相关。患者选择、消融技术和导管能量来源都会影响该手术的疗效和安全性。最后,虽然已有多项随机对照试验比较了导管消融与抗心律失常药物治疗的疗效,但仍有许多试验即将开展,以探索其作为心房颤动一线治疗方法的作用。新型能量导管能量来源也在探索之中。