Kacprzyk Marta, Kuniewicz Marcin, Lelakowski Jacek
Department of Electrocardiology, the John Paul II Hospital, Kraków, Poland.
Department of Electrocardiology, the John Paul II Hospital, Kraków, Poland; Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland.
Pol Merkur Lekarski. 2020 Jun 17;48(285):204-208.
Atrial flutter (AFL) is one of the most common arrhythmias present in clinical practice, both for the GPs and cardiologist practice. After atrial fibrillation (AF) is second the most common supraventricular arrhythmia. This usually occurs along the cavo-tricuspid isthmus of the right atrium though atrial flutter can originate from the left atrium as well. As AFL is rarely susceptible to pharmacotherapy, that is why, the guidelines of the European and American Cardiology Societies suggest non-pharmacological treatment - an ablation, which is a "gold standard". Due to the reentrant nature of atrial flutter, it is often possible to ablate the circuit that causes atrial flutter with radiofrequency catheter ablation. Catheter ablation is considered to be a first-line treatment method for many people with typical atrial flutter due to its high rate of success (>90%) and low incidence of complications. This is done in the cardiac electrophysiology lab by causing a ridge of scar tissue in the cavo-tricuspid isthmus that crosses the path of the circuit that causes atrial flutter. Eliminating conduction through the isthmus prevents reentry, and if successful, prevents the recurrence of the atrial flutter. Atrial fibrillation often occurs after catheter ablation for atrial flutter. We present an up to date overview of the most important information about AFL based on the available literature.
心房扑动（AFL）是临床实践中最常见的心律失常之一，无论是在全科医生还是心脏病专家的诊疗中。仅次于心房颤动（AF），是第二常见的室上性心律失常。虽然心房扑动也可起源于左心房，但通常沿右心房的腔静脉-三尖瓣峡部发生。由于心房扑动很少对药物治疗敏感，这就是为什么欧美心脏病学会的指南建议采用非药物治疗——消融术，这是一种“金标准”。由于心房扑动具有折返性，通常可以通过射频导管消融术消融导致心房扑动的环路。导管消融因其成功率高（>90%）且并发症发生率低，被认为是许多典型心房扑动患者的一线治疗方法。这是在心脏电生理实验室中通过在腔静脉-三尖瓣峡部形成一道瘢痕组织嵴来完成的，该嵴穿过导致心房扑动的环路路径。消除峡部的传导可防止折返，如果成功，则可防止心房扑动复发。心房颤动常在心房扑动的导管消融术后发生。我们根据现有文献对心房扑动的最重要信息进行了最新综述。
