Trohman Richard G
Section of Electrophysiology, Division of Cardiology, Department of Internal Medicine, Rush University Medical Center, 1653 W. Congress, Chicago, IL, 60612, USA.
Cardiol Ther. 2024 Sep;13(3):493-528. doi: 10.1007/s40119-024-00377-2. Epub 2024 Aug 12.
Although significant strides have been made in non-pharmacologic management of atrial fibrillation (AF), these treatments remain a work in progress. While catheter ablation is often effective for management of paroxysmal AF, it is less successful in patients with persistent or longstanding persistent AF. This review was undertaken to clarify the risks, benefits, and alternatives to catheter ablation for non-pharmacologic AF management. In order to clarify the roles of surgical and hybrid ablation, this narrative review was undertaken by searching MEDLINE to identify peer-reviewed clinical trials, randomized controlled trials, meta-analyses, review articles, and other clinically relevant studies. The search was limited to English-language reports published between 1960 and 2023. Atrial fibrillation was searched using the terms surgical ablation, catheter ablation, hybrid ablation, stroke prevention, left atrial occlusion, and atrial excision. Google and Google Scholar, as well as bibliographies of identified articles, were also reviewed for additional references. The Cox-maze surgical approach is still the most efficacious non-pharmacological treatment for AF. Hybrid ablation, combining cardiac surgical and catheter ablation techniques, has become an attractive option for persistent or longstanding persistent AF.
尽管在心房颤动（AF）的非药物治疗方面已经取得了显著进展，但这些治疗仍在不断完善中。虽然导管消融术通常对阵发性AF的治疗有效，但对持续性或长期持续性AF患者的成功率较低。本综述旨在阐明导管消融术在非药物性AF治疗中的风险、益处及替代方案。为了明确外科消融和杂交消融的作用，通过检索MEDLINE来识别同行评审的临床试验、随机对照试验、荟萃分析、综述文章及其他临床相关研究，进行了本叙述性综述。检索仅限于1960年至2023年发表的英文报告。使用外科消融、导管消融、杂交消融、卒中预防、左心房封堵和心房切除术等术语检索心房颤动。还对谷歌和谷歌学术以及已识别文章的参考文献进行了审查以获取更多参考文献。Cox迷宫手术方法仍然是AF最有效的非药物治疗方法。将心脏外科手术和导管消融技术相结合的杂交消融术，已成为持续性或长期持续性AF的一个有吸引力的选择。
