Shi Rui, Norman Mark, Chen Zhong, Wong Tom
Heart Rhythm Center, The Royal Brompton & Harefield NHS Foundation Trust, National Heart & Lung Institute, Imperial College London, London, UK.
Future Cardiol. 2018 May 1;14(3):237-249. doi: 10.2217/fca-2017-0109. Epub 2018 Feb 14.
Atrial fibrillation (AF) is the most common clinical arrhythmia encountered. Catheter ablation has become the first-line therapy for symptomatic drug-refractory paroxysmal and persistent AF. Although pulmonary vein electrical isolation is still the cornerstone of the ablation strategy, the clinical outcome particularly in treating persistent AF is suboptimal. Significant efforts have been applied with live global chamber mapping of AF aimed to identify patient-specific drivers and/or maintainers located outside of the pulmonary veins to further improve the outcome of catheter ablation. Within this review, we present an overview of contemporary global chamber AF mapping technologies and characteristics, with a particular focus on global, noncontact, dipole density mapping illustrated with a clinical case of persistent AF ablation using this novel methodology.
心房颤动(AF)是临床上最常见的心律失常。导管消融已成为有症状的药物难治性阵发性和持续性AF的一线治疗方法。尽管肺静脉电隔离仍是消融策略的基石,但临床结果尤其是在治疗持续性AF方面并不理想。人们已付出巨大努力对AF进行实时整体心腔标测,旨在识别位于肺静脉之外的患者特异性驱动因素和/或维持因素,以进一步改善导管消融的结果。在本综述中,我们概述了当代整体心腔AF标测技术及其特点,特别关注整体、非接触式偶极密度标测,并通过使用这种新方法进行持续性AF消融的临床病例进行说明。