[1]李烽 姜海 章海燕 朱永翔 龙明智.射频导管消融术阻滞二尖瓣峡部的研究进展[J].心血管病学进展,2020,(1):14-18.[doi:10.16806/j.cnki.issn.1004-3934.2020.01.005]
　LI Feng,JIANG Hai,ZHANG Haiyan,et al.Radiofrequency Catheter Ablation for Mitral Isthmus[J].Advances in Cardiovascular Diseases,2020,(1):14-18.[doi:10.16806/j.cnki.issn.1004-3934.2020.01.005]
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射频导管消融术阻滞二尖瓣峡部的研究进展()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2020年1期
页码:
14-18
栏目:
综述
出版日期:
2020-02-04

文章信息/Info

Title:
Radiofrequency Catheter Ablation for Mitral Isthmus
作者:
李烽1; 2 姜海 2 章海燕 2 朱永翔 1; 2 龙明智 2
(1.南京医科大学,江苏 南京 211166;2.南京医科大学第二附属医院心血管内科,江苏 南京 210011)
Author(s):
LI Feng1; 2;  JIANG Hai2;  ZHANG Haiyan2 ;  ZHU Yongxiang1; 2;  LONG Mingzhi2
(1. Nanjing Medical University,Nanjing 211166,Jiangsu,China; 2. Department of Cardiology,The Second Affiliated Hospital of Nanjing Medical University,Nanjing 210011,Jiangsu,China)
关键词:
二尖瓣峡部; 射频导管消融术; 研究进展
Keywords:
Mitral isthmus;  Radiofrequency catheter ablation;  Research progress
DOI:
10.16806/j.cnki.issn.1004-3934.2020.01.005
摘要:
目前，射频导管消融术阻滞二尖瓣峡部已成为心脏电生理领域的研究热点。然而，实现二尖瓣峡部双向传导阻滞仍存在巨大的挑战。现就二尖瓣峡部消融的一般介绍、应用难点、应对策略和展望四个方面做一综述。
Abstract:
Radiofrequency catheter ablation of the mitral isthmus,has become a research hotspot in the field of cardiac electrophysiology nowadays . However,achieving bidirectional conduction block of the mitral isthmus ablation line is still challenging. This article reviews the general introduction,application difficulties,coping strategies and prospective of mitral isthmus ablation.

参考文献/References:

[1] Luria DM,Nemec J,Etheridge SP,et al. Intra-atrial conduction block along the mitral valve annulus during accessory pathway ablation:evidence for a left atrial "isthmus"[J]. J Cardiovasc Electrophysiol,2001,12(7):744-749.

[2] Ja?s P,Hocini M,Hsu LF,et al. Technique and results of linear ablation at the mitral isthmus[J]. Circulation,2004,110(19):2996-3002.

[3] Ha?ssaguerre M,Sanders P,Hocini M,et al. Catheter ablation of long-lasting persistent atrial fibrillation:critical structures for termination[J]. J Cardiovasc Electrophysiol,2005,16(11):1125-1137.

[4] 陈佳磊,梁兆光. 心房颤动射频导管消融现状[J]. 心血管病学进展,2018,39(6):893-896.

[5] Calkins H,Hindricks G,Cappato R,et al. 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation[J]. Europace,2018,20(1):e1-e160.

[6] Wong KC,Betts TR. A review of mitral isthmus ablation[J]. Indian Pacing Electrophysiol J,2012,12(4):152-170.

[7] Paisey J,Betts TR,de Bono J,et al. Validation of coronary sinus activation pattern during left atrial appendage pacing for beat-to-beat assessment of mitral isthmus conduction/block[J]. J Cardiovasc Electrophysiol,2010,21(4):418-422.

[8] Liu Y,Shehata M,Wang X. Alternative approach for ablation of the mitral isthmus[J]. Circ Arrhythm Electrophysiol,2017,10(10).pii: e005814.

[9] Scherr D,Derval N,Sohal M,et al. Length of the mitral isthmus but not anatomical location of ablation line predicts bidirectional mitral isthmus block in patients undergoing catheter ablation of persistent atrial fibrillation:a randomized controlled trial[J]. J Cardiovasc Electrophysiol,2015,26(6):629-634.

[10] Latcu DG,Squara F,Massaad Y,et al. Electroanatomic characteristics of the mitral isthmus associated with successful mitral isthmus ablation[J]. Europace,2016,18(2):274-280.

[11] Chen S,Zhou G,Lu X,et al. The importance of identifying conduction breakthrough sites across the mitral isthmus by elaborate mapping for mitral isthmus linear ablation[J]. Europace,2019,21(6):950-960.

[12] Lee JH,Nam GB,Go TH,et al. Alternative strategies to improve success rate of mitral isthmus block[J]. Medicine (Baltimore),2018,97(48):e13060.

[13] Yokokawa M,Sundaram B,Garg A,et al. Impact of mitral isthmus anatomy on the likelihood of achieving linear block in patients undergoing catheter ablation of persistent atrial fibrillation[J]. Heart Rhythm,2011,8(9):1404-1410.

[14] Kurotobi T,Shimada Y,Kino N,et al. Local coronary flow is associated with an unsuccessful complete block line at the mitral isthmus in patients with atrial fibrillation[J]. Circ Arrhythm Electrophysiol,2011,4(6):838-843.

[15] Antz M,Otomo K,Arruda M,et al. Electrical conduction between the right atrium and the left atrium via the musculature of the coronary sinus[J]. Circulation,1998,98(17):1790-1795.

[16] Rodríguez-Ma?ero M,Schurmann P,Valderrábano M. Ligament and vein of Marshall:a therapeutic opportunity in atrial fibrillation[J]. Heart Rhythm ,2016,13(2):593-601.

[17] Chugh A,Gurm HS,Krishnasamy K,et al. Spectrum of atrial arrhythmias using the ligament of Marshall in patients with atrial fibrillation[J]. Heart Rhythm,2018,15(1):17-24.

[18] Kawaguchi N,Okishige K,Yamauchi Y,et al. Clinical impact of ethanol infusion into the vein of Marshall on the mitral isthmus area evaluated by atrial electrograms recorded inside the coronary sinus[J]. Heart Rhythm,2019,16(7):1030-1038.

[19] Takatsuki S,Extramiana F,Hayashi M,et al. Conduction through the lateral mitral isthmus:block or pseudoblock[J]. J Cardiovasc Electrophysiol,2008,19(1):98-99.

[20] Shah AJ,Pascale P,Miyazaki S,et al. Prevalence and types of pitfall in the assessment of mitral isthmus linear conduction block[J]. Circ Arrhythm Electrophysiol,2012,5(5):957-967.

[21] Barkagan M,Shapira-Daniels A,Leshem E,et al. Pseudoblock of the posterior mitral line with epicardial bridging connections is a frequent cause of complex perimitral tachycardias[J]. Circ Arrhythm Electrophysiol,2019,12(1):e006933.

[22] Lapenna E,de Bonis M,Giambuzzi I,et al. Long-term outcomes of stand-alone MazeⅣfor persistent/long-standing persistent atrial fibrillation[J]. Ann Thorac Surg,2019,109(1):124-131.

[23] Cho Y,Lee W,Park EA,et al. The anatomical characteristics of three different endocardial lines in the left atrium:evaluation by computed tomography prior to mitral isthmus block attempt[J]. Europace,2012,14(8):1104-1111.

[24] Ho?da MK,Koziej M,Ho?da J,et al. Anatomic characteristics of the mitral isthmus region:the left atrial appendage isthmus as a possible ablation target[J]. Ann Anat,2017,210:103-111.

[25] Huemer M,Wutzler A,Parwani AS,et al. Comparison of the anterior and posterior mitral isthmus ablation lines in patients with perimitral annulus flutter or persistent atrial fibrillation[J]. J Interv Card Electrophysiol,2015,44(2):119-129.

[26] Barbhaiya CR,Michaud GF. Jump for perimitral conduction block[J]. J Cardiovasc Electrophysiol,2015,26(7):737-738.

[27] Maurer T,Metzner A,Ho SY,et al. Catheter ablation of the superolateral mitral isthmus line:a novel approach to reduce the need for epicardial ablation[J]. Circ Arrhythm Electrophysiol,2017,10(10).pii:e005191.

[28] Nishiyama T,Kimura T,Fujisawa T,et al. Mitral isthmus ablation using a circular mapping catheter positioned in the left atrial appendage as a reference for conduction block[J]. Oncotarget,2017,8(32):52724-52734.

[29] Matsuo S,Yamane T,Date T,et al. Completion of mitral isthmus ablation using a steerable sheath:prospective randomized comparison with a nonsteerable sheath[J]. J Cardiovasc Electrophysiol,2011,22(12):1331-1338.

[30] Gay HC,Baldridge AS,Huffman MD. Feasibility,process,and outcomes of cardiovascular clinical trial data sharing:a reproduction analysis of the SMART-AF trial[J]. JAMA Cardiol,2017,2(12):1375-1379.

[31] Berruezo A,Bisbal F,Fernández-Armenta J,et al. Transthoracic epicardial ablation of mitral isthmus for treatment of recurrent perimitral flutter[J]. Heart Rhythm,2014,11(1):26-33.

[32] Verma A,Jiang CY,Betts TR,et al. Approaches to catheter ablation for persistent atrial fibrillation[J]. N Engl J Med,2015,372(19):1812-1822.

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备注/Memo

备注/Memo:
基金项目: 南京市医学科技发展资金资助项目（ZKX18051）
通讯作者: 龙明智，E-mail：longmzh@hotmail.com
更新日期/Last Update: 2020-03-23