From Department of Cardiology, Royal Melbourne Hospital, Parkville, Australia (J.M.K.); Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Australia (J.M.K.); Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Australia (P.S.); Department of Cardiology, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Israel (R.S.); and Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD (H.C.).
Circulation. 2017 Aug 1;136(5):490-499. doi: 10.1161/CIRCULATIONAHA.116.024926.
Since the original description of atrial fibrillation ablation, numerous studies have demonstrated the superiority of catheter ablation over pharmacological therapy for maintenance of sinus rhythm in patients with both paroxysmal and persistent atrial fibrillation. However, to date, no randomized studies have been powered to demonstrate a mortality or stroke reduction benefit of rhythm control with catheter ablation over a rate control strategy. The results of such ongoing studies are not expected until 2018 or 2019. Thus, the only indication for atrial fibrillation ablation in recent guidelines has been the presence of symptoms. However, up to 40% of an atrial fibrillation population may be asymptomatic. In 2017, in the absence of randomized studies, are there nevertheless data that support atrial fibrillation ablation in asymptomatic patients?
自心房颤动消融的最初描述以来，大量研究表明，在阵发性和持续性心房颤动患者中，导管消融在维持窦性心律方面优于药物治疗。然而，迄今为止，尚无随机研究表明导管消融节律控制策略优于心率控制策略可降低死亡率或卒中风险。这些正在进行的研究结果预计要到 2018 年或 2019 年才会公布。因此，最近的指南中，心房颤动消融的唯一适应证是存在症状。然而，多达 40%的心房颤动患者可能无症状。那么，在 2017 年没有随机研究的情况下，是否有数据支持对无症状患者进行心房颤动消融呢？
