Steinbeck G, Hoffmann E
Medical Hospital I, University of Munich, Germany.
Eur Heart J. 1998 May;19 Suppl E:E10-2, E48-9.
Atrial tachycardia is a rare form of supraventricular tachycardia, accounting for about 10-15% of patients presenting to experienced arrhythmia centres for radiofrequency catheter ablation. The mechanism may be either focal due to increased or abnormal automaticity or triggered activity, or macro re-entrant. When incessant tachycardia is present, tachycardiomyopathy may develop. The efficacy of antiarrhythmic drugs for long-term management of atrial tachycardia is poorly defined, but is probably limited. Class IC or class I agents may be used in re-entrant atrial tachycardia, and verapamil, beta-blockers or class IC agents in the focal type. If these drugs fail, amiodarone may be tried. Experience with radiofrequency catheter ablation to cure atrial tachycardia is limited, but results are very promising with success rates between 80% and 95%, and an acceptably low recurrence and complication rate. Thus, it is likely that, with more experience, radiofrequency catheter ablation will become therapy of first choice for atrial tachycardia when this arrhythmia is not easily and effectively controlled by drugs.
房性心动过速是室上性心动过速的一种少见形式，约占前往经验丰富的心律失常中心接受射频导管消融治疗患者的10% - 15%。其机制可能是由于自律性增加或异常导致的局灶性机制或触发活动，也可能是大折返机制。当存在持续性心动过速时，可能会发展为心动过速性心肌病。抗心律失常药物用于房性心动过速长期治疗的疗效尚不明确，但可能有限。IC类或I类药物可用于折返性房性心动过速，维拉帕米、β受体阻滞剂或IC类药物可用于局灶性类型。如果这些药物无效，可尝试胺碘酮。射频导管消融治愈房性心动过速的经验有限，但结果非常有前景，成功率在80%至95%之间，复发率和并发症率可接受且较低。因此，随着经验的增加，当这种心律失常不易被药物有效控制时，射频导管消融很可能会成为房性心动过速的首选治疗方法。
