Della Rocca Domenico G, Tarantino Nicola, Trivedi Chintan, Mohanty Sanghamitra, Anannab Alisara, Salwan Anu S, Gianni Carola, Bassiouny Mohamed, Al-Ahmad Amin, Romero Jorge, Briceño David F, Burkhardt J David, Gallinghouse G Joseph, Horton Rodney P, Di Biase Luigi, Natale Andrea
Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas.
Arrhythmia Services, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
J Cardiovasc Electrophysiol. 2020 Aug;31(8):2154-2167. doi: 10.1111/jce.14638. Epub 2020 Jul 6.
Rhythm control of persistent atrial fibrillation (AF) patients represents a challenge for the modern interventional cardiac electrophysiologist; as a matter of fact, there is still divergence regarding the best ablative approach to adopt in this population. Different investigational endpoints, variability of techniques and tools, significant technological evolution, and the lack of universally accepted pathophysiological models engendered a considerable heterogeneity in terms of techniques and outcomes, so much that the treatment of persistent subtypes of AF commonly still relies mainly on pulmonary vein (PV) isolation. The purpose of the present review is to report the current experimental and clinical evidence supporting the importance of mapping and ablating non-PV triggers and describe our institutional approach for the ablation of nonparoxysmal AF.
对于现代介入心脏电生理学家而言，持续性心房颤动（AF）患者的节律控制是一项挑战；事实上，对于该人群应采用的最佳消融方法仍存在分歧。不同的研究终点、技术和工具的可变性、重大的技术进步，以及缺乏普遍接受的病理生理模型，导致在技术和结果方面存在相当大的异质性，以至于持续性AF亚型的治疗目前通常仍主要依赖肺静脉（PV）隔离。本综述的目的是报告支持标测和消融非PV触发灶重要性的当前实验和临床证据，并描述我们机构针对非阵发性AF的消融方法。
