Marascu Gabriela-Elena, Deaconu Alexandru Ioan, Mitran Raluca-Elena, Stanciulescu Laura Adina, Vatasescu Radu Gabriel
Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Cardiology Department, Clinical Emergency Hospital, 014461 Bucharest, Romania.
J Clin Med. 2025 Jul 20;14(14):5147. doi: 10.3390/jcm14145147.
Pulmonary vein isolation (PVI) is the cornerstone of atrial fibrillation (AF) ablation, especially effective in patients with paroxysmal AF, where the pulmonary veins (PVs) are the primary triggers. More complex arrhythmogenic mechanisms are involved in persistent AF (PsAF), and PVI alone may not be sufficient. Personalized, substrate-based ablation strategies are increasingly used and can significantly enhance outcomes in PsAF patients. While radiofrequency ablation remains the gold standard, cryoablation provides effective PVI, and pulsed field ablation is emerging as a safer, promising alternative. Advanced mapping techniques may better target scar areas responsible for arrhythmogenesis, optimizing procedural results. While still in development, artificial intelligence and machine learning enable more personalized and precise ablation strategies and may improve long-term outcomes.
肺静脉隔离（PVI）是房颤（AF）消融的基石，对阵发性房颤患者尤为有效，因为肺静脉（PVs）是主要触发因素。持续性房颤（PsAF）涉及更复杂的致心律失常机制，仅进行肺静脉隔离可能并不足够。基于基质的个性化消融策略越来越多地被采用，可显著改善PsAF患者的治疗效果。虽然射频消融仍是金标准，但冷冻消融也能实现有效的肺静脉隔离，而脉冲场消融正成为一种更安全、有前景的替代方法。先进的标测技术可以更好地靶向导致心律失常的瘢痕区域，优化手术效果。虽然仍在发展中，但人工智能和机器学习能够实现更个性化、精确的消融策略，并可能改善长期治疗效果。
