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导管消融治疗心房颤动:文献综述

Catheter Ablation for the Management of Atrial Fibrillation: An Update of the Literature.

作者信息

Hussain Shahana, Sohrabi Catrin, Providencia Rui, Ahsan Syed, Papageorgiou Nikolaos

机构信息

Electrophysiology Department, Barts Heart Centre, St Bartholomew's Hospital, London EC1A 7BE, UK.

Royal Free London NHS Foundation Trust, London NW3 2QG, UK.

出版信息

Life (Basel). 2023 Aug 21;13(8):1784. doi: 10.3390/life13081784.

Abstract

Catheter ablation has been shown to be more effective at maintaining sinus rhythm and improving quality of life when compared to antiarrhythmic drugs. Radiofrequency and cryoablation are two effective methods. However, catheter-only ablation strategies have not consistently produced high success rates in treating longstanding and persistent AF patients. The emerging treatment of choice for such cases is hybrid ablation, which involves a multidisciplinary and minimally invasive approach to achieve surgical ablation of the direct posterior left atrial wall in combination with endocardial catheter ablation. Studies have shown promising results for the hybrid approach when compared with catheter ablation alone, but it is not without risks. Large and randomised studies are necessary to further evaluate these strategies for managing AF.

摘要

与抗心律失常药物相比,导管消融在维持窦性心律和改善生活质量方面已被证明更有效。射频消融和冷冻消融是两种有效的方法。然而,仅采用导管消融策略在治疗长期持续性房颤患者时,成功率并不稳定。对于此类病例,新出现的首选治疗方法是杂交消融,它采用多学科和微创方法,将直接左心房后壁的外科消融与心内膜导管消融相结合。研究表明,与单纯导管消融相比,杂交消融方法取得了令人满意的结果,但也并非没有风险。有必要开展大规模随机研究,以进一步评估这些房颤管理策略。

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