Spragg David
Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD USA.
J Atr Fibrillation. 2013 Apr 6;5(6):810. doi: 10.4022/jafib.810. eCollection 2013 Apr-May.
The mechanisms of atrial fibrillation are complex, and have been the subject of intensive study for over fifty years. There is likely a complex interplay between triggers and substrate that mediates the initiation and maintenance of AF. Increasingly, atrial fibrosis has been recognized as a key component of that substrate, playing a critical role in conduction abnormalities in the left atrium that appear necessary to maintaining AF. In the last several years, our abilities to quantify left atrial fibrosis - both through catheter- and MRI-based techniques - has shed important light on the underlying mechanisms of AF, and on therapeutic strategies to treat AF. Whether our increased appreciation of the role of atrial fibrosis in AF translates into improved efficacy of catheter ablation or anti-arrhythmic therapy, though, remains to be seen. The aim of this review is to summarize clinical investigations of atrial fibrosis as a factor in the development and treatment of atrial fibrillation.
心房颤动的机制很复杂，五十多年来一直是深入研究的课题。触发因素和基质之间可能存在复杂的相互作用，介导房颤的起始和维持。心房纤维化越来越被认为是该基质的关键组成部分，在左心房传导异常中起关键作用，而这种传导异常似乎是维持房颤所必需的。在过去几年中，我们通过基于导管和磁共振成像的技术量化左心房纤维化的能力，为房颤的潜在机制以及治疗房颤的策略提供了重要线索。然而，我们对心房纤维化在房颤中作用的进一步认识是否能转化为导管消融或抗心律失常治疗疗效的提高，仍有待观察。本综述的目的是总结将心房纤维化作为心房颤动发生和治疗因素的临床研究。
