Duke University Medical Center and Duke Clinical Research Institute, Durham, NC (J.P.P.).
Medical School of Rowan University, Camden, NJ (A.M.R.).
Circ Arrhythm Electrophysiol. 2022 Dec;15(12):e009911. doi: 10.1161/CIRCEP.121.009911. Epub 2022 Nov 28.
Despite the global COVID-19 pandemic, during the past 2 years, there have been numerous advances in our understanding of arrhythmia mechanisms and diagnosis and in new therapies. We increased our understanding of risk factors and mechanisms of atrial arrhythmias, the prediction of atrial arrhythmias, response to treatment, and outcomes using machine learning and artificial intelligence. There have been new technologies and techniques for atrial fibrillation ablation, including pulsed field ablation. There have been new randomized trials in atrial fibrillation ablation, giving insight about rhythm control, and long-term outcomes. There have been advances in our understanding of treatment of inherited disorders such as catecholaminergic polymorphic ventricular tachycardia. We have gained new insights into the recurrence of ventricular arrhythmias in the setting of various conditions such as myocarditis and inherited cardiomyopathic disorders. Novel computational approaches may help predict occurrence of ventricular arrhythmias and localize arrhythmias to guide ablation. There are further advances in our understanding of noninvasive radiotherapy. We have increased our understanding of the role of His bundle pacing and left bundle branch area pacing to maintain synchronous ventricular activation. There have also been significant advances in the defibrillators, cardiac resynchronization therapy, remote monitoring, and infection prevention. There have been advances in our understanding of the pathways and mechanisms involved in atrial and ventricular arrhythmogenesis.
尽管全球 COVID-19 大流行,但在过去的 2 年中,我们对心律失常机制和诊断以及新疗法的认识有了很多进展。我们通过机器学习和人工智能加深了对房性心律失常的危险因素和机制、房性心律失常的预测、治疗反应和结果的理解。在房颤消融方面有新技术和新方法,包括脉冲场消融。房颤消融的新随机试验提供了节律控制和长期结果的见解。在治疗儿茶酚胺能多形性室性心动过速等遗传性疾病方面也取得了进展。我们对心肌炎和遗传性心肌病等各种情况下室性心律失常的复发有了新的认识。新的计算方法可能有助于预测室性心律失常的发生并定位心律失常以指导消融。非侵入性放射治疗也有了进一步的进展。我们加深了对希氏束起搏和左束支区域起搏在维持心室同步激活中的作用的理解。在除颤器、心脏再同步治疗、远程监测和感染预防方面也取得了重大进展。我们对涉及房性和室性心律失常发生的途径和机制的理解也有了进展。