Saksena S, Epstein A E, Lazzara R, Maloney J D, Zipes D P, Benditt D G, Camm A J, Domanski M J, Fisher J D, Gersh B J
Pacing Clin Electrophysiol. 1995 Apr;18(4 Pt 1):637-54. doi: 10.1111/j.1540-8159.1995.tb04659.x.
The goal of radiofrequency catheter ablation and the criterion for efficacy is the elimination of arrhythmogenic myocardium. The application of radiofrequency current in the heart clearly results in lower morbidity and mortality rates than thoracic and cardiac surgical procedures in general, and comparisons of therapy with radiofrequency catheter ablation and therapy with thoracic and cardiac surgical procedures in randomized clinical trials are unwarranted. Trials of radiofrequency catheter ablation versus medical or implantable cardioverter defibrillator therapy may be indicated in certain conditions, such as ventricular tachycardia associated with coronary artery disease. Randomized trials are recommended for new and radical departures in technology that aim to accomplish the same goals as radiofrequency catheter ablation. Surveillance using registries and/or databases is necessary in the assessment of long-term safety and efficacy.
射频导管消融的目标及疗效标准是消除致心律失常心肌。总体而言,在心脏中应用射频电流显然比胸外科和心脏外科手术具有更低的发病率和死亡率,因此在随机临床试验中对射频导管消融治疗与胸外科和心脏外科手术治疗进行比较是没有必要的。在某些情况下,如与冠状动脉疾病相关的室性心动过速,可能需要进行射频导管消融与药物或植入式心脏复律除颤器治疗的对比试验。对于旨在实现与射频导管消融相同目标的新技术的新突破和根本性进展,建议进行随机试验。在评估长期安全性和疗效时,使用登记处和/或数据库进行监测是必要的。