University of Rennes, CHU Rennes, INSERM, LTSI-UMR 1099, Rennes, France.
University of Rennes, CHU Rennes, INSERM, LTSI-UMR 1099, Rennes, France.
JACC Clin Electrophysiol. 2019 Jul;5(7):753-765. doi: 10.1016/j.jacep.2019.05.019.
Ablation of atrial fibrillation (AF) is the cornerstone therapy for patients with symptomatic AF resistant to anti-arrhythmic drugs or as first-line therapy, and is based on permanent pulmonary vein (PV) isolation. The presence of a conduction gap in a wide antral circumferential ablation lesion around PVs is often sufficient to transform an initially successful ablation into a procedural failure, thus necessitating a redo intervention. The strategy during a redo procedure is based on the detection and ablation of the reconnection gap. Finding gaps is often simple, but also sometimes challenging, because gaps may be difficult to detect, resulting in unnecessary radiofrequency delivery. The present review aimed to describe the various techniques published thus far to detect residual reconnections along the encircling ablation lines around PVs, to help electrophysiologists to detect and ablate reconnection gaps.
心房颤动 (AF) 的消融是对药物难治或作为一线治疗的有症状 AF 患者的基石治疗，基于永久性肺静脉 (PV) 隔离。在围绕 PV 的广泛窦房结环周消融病变中存在传导间隙通常足以使最初成功的消融转变为程序失败，因此需要重新介入。在重新介入程序中的策略基于重新连接间隙的检测和消融。发现间隙通常很简单，但有时也具有挑战性，因为间隙可能难以检测，导致不必要的射频传递。本综述旨在描述迄今为止发表的各种技术，以检测围绕 PV 的环周消融线中残留的再连接，以帮助电生理学家检测和消融再连接间隙。
