Akrawinthawong Krittapoom, Yamada Takumi
Section of Cardiac Electrophysiology, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA.
Section of Cardiac Electrophysiology, Cardiovascular Division, University of Minnesota, Minneapolis, MN 55455, USA.
Rev Cardiovasc Med. 2024 Mar 28;25(4):122. doi: 10.31083/j.rcm2504122. eCollection 2024 Apr.
The central anatomical locus in the context of atrial fibrillation (AF) ablation has been the pulmonary veins. Despite the attainment of a modest long-term success rate through pulmonary vein isolation (PVI), the pursuit of achieving a therapeutic efficacy nearing a definitive cure has spurred an investigation into alternative strategies and anatomical loci beyond the pulmonary veins. Despite extensive exploration, none of these alternative targets have succeeded in establishing themselves as routine ablation sites comparable to the pulmonary veins. Consequently, there exists an imperative for further inquiry and refinement of ablation strategies to propel advancements within the domain of AF ablation, thereby augmenting patient outcomes. Simultaneously, the examination of the autonomic system's role in AF pathophysiology introduces an additional ablation target aimed at rectifying sympathovagal imbalance. This discourse presents a contemporary review of renal denervation (RDN) as an emergent and auspicious technique poised to complement PVI, thereby contributing substantively to the augmentation of long-term success within the ambit of AF rhythm-control strategies.
在心房颤动（AF）消融背景下，中央解剖学靶点一直是肺静脉。尽管通过肺静脉隔离（PVI）取得了一定的长期成功率，但追求接近根治性治疗效果的努力促使人们对肺静脉以外的替代策略和解剖靶点进行研究。尽管进行了广泛探索，但这些替代靶点中没有一个成功确立为与肺静脉相当的常规消融部位。因此，迫切需要进一步探究和完善消融策略，以推动AF消融领域的进展，从而改善患者预后。同时，对自主神经系统在AF病理生理学中作用的研究引入了另一个消融靶点，旨在纠正交感迷走神经失衡。本文对肾去神经支配（RDN）作为一种新兴且有前景的技术进行了当代综述，该技术有望补充PVI，从而在AF节律控制策略范围内对提高长期成功率做出实质性贡献。
