Rottner Laura, Metzner Andreas
Universitäres Herz- und Gefäßzentrum Hamburg, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.
Universitäres Herz- und Gefäßzentrum Hamburg, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20251, Hamburg, Deutschland.
Herzschrittmacherther Elektrophysiol. 2023 Dec;34(4):286-290. doi: 10.1007/s00399-023-00972-1. Epub 2023 Oct 20.
Ablation is an established treatment option for atrial fibrillation (AF) and is associated with convincing success rates and a reasonable safety profile. Ablation strategies going beyond pulmonary vein isolation in patients with chronic forms of AF are less well established and reproducible. Especially in patients with progressed AF forms multiple ablation procedures might be mandatory to achieve reasonable clinical success. An early ablation strategy might stop or prolong the progress from paroxysmal to persistent AF. In addition, ablation is more effective than drug-based treatment and comparably safe. Long-term success rates after a single and after multiple ablation procedures in paroxysmal AF are reported with 60-70% and up to 80%, while success rates in persistent or long-standing persistent AF are less favorable (single procedure 40-50%, multiple procedures 70%). However, currently non-recurrence of AF is the most established but potentially not the best endpoint. The burden of AF after ablation as assessed by novel monitoring modalities might gain further clinical importance.
消融术是心房颤动(AF)的一种既定治疗选择,具有令人信服的成功率和合理的安全性。对于慢性房颤患者,超越肺静脉隔离的消融策略尚未得到充分确立和重复验证。特别是在进展期房颤患者中,可能需要多次消融手术才能取得合理的临床成功。早期消融策略可能会阻止或延缓阵发性房颤向持续性房颤的进展。此外,消融术比药物治疗更有效且安全性相当