[1]汪俊,杨浩.心房颤动射频消融的术式演变[J].心血管病学进展,2015,(5):574-579.[doi:10.3969/j.issn.1004-3934.2015.05.013]
 WANG Jun,YANG Hao.Evolution of Radiofrequency Ablation of Atrial Fibrillation[J].Advances in Cardiovascular Diseases,2015,(5):574-579.[doi:10.3969/j.issn.1004-3934.2015.05.013]
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心房颤动射频消融的术式演变()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2015年5期
页码:
574-579
栏目:
综述
出版日期:
2016-05-20

文章信息/Info

Title:
Evolution of Radiofrequency Ablation of Atrial Fibrillation
作者:
汪俊杨浩
皖南医学院第一附属医院心血管内科,安徽 芜湖 241000
Author(s):
WANG JunYANG Hao
Department of Cardiology,The First Affiliated Hospital of Wannan Medical College,Wuhu 241000,Anhui,China
关键词:
心房颤动 射频消融 术式演变
Keywords:
atrial fibrillation radiofrequency ablation surgical evolution
分类号:
R541.7
DOI:
10.3969/j.issn.1004-3934.2015.05.013
文献标志码:
A
摘要:
心房颤动的治疗目前主要有抗栓、控制心室率、电复律以及导管射频消融等,仅有导管射频消融为治愈心房颤动提供了可能,从最初的法国波尔多中心尝试性运用点消融至今已有数十个年头,随着对心房颤动机制的深入研究,消融术式得到了极大的发展,期间提出了多种心房颤动的产生及维持机制,但临床上对心房颤动,尤其是持续性的消融仍远未达到满意的疗效,通过对不同术式的研究并取长补短,一定程度上可提高消融成功率。
Abstract:
The main treatment of atrial fibrillation is multi-faceted. It involves antithrombotic, ventricular rate control, electrical cardio-version, radiofrequency catheter ablation and much more. Only radiofrequency catheter ablation offers the possibility to cure atrial fibrillation. The Bordeaux, France, initial center point ablation has been used for many years, and coincided with the in-depth study of the mechanism of atrial fibrillation. As such ablation style, proposed mechanisms to produce and how to maintain a variety of atrial fibrillation during atrial fibrillation has been greatly developed. However clinically, especially sustained atrial fibrillation ablation is still far from providing satisfactory results. Through the study of different surgical procedures that can learn from each other, the success rate of ablation can be improved to a certain extent.

参考文献/References:

[1] Zhang S.Atrial fibrillation in mainland China:epidemiology and current management[J]. Heart,2009,95:1052-1055.
[2] Haissaguerre M,Jais P,Shah DC,et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins[J].N Eng J Med,1998,339:659-666.
[3] Haissaguerre M,Jais P,Shah DC,et al. Right and left atrial radiofrequency catheter therapy of paroxysmal atrial fibrillation[J].J Cardiovasc Electrophysiol,1996,7:1132-1144.
[4] Lim TW,Jassal IS,Ross DL,et al.Medium-term efficacy of segmental ostial pulmonary vein isolation for the treatment of permanent and persistent atrial fibrillation[J].Pacing Clin Electrophysiol,2006,29(4):374-379.
[5] Pappone C,Rosanio S,Oreto G,et al. Circumferential ablation of pulmonary vein ostia.A new anatomic approach for curing atrial fibrillation[J]. Circulation,2000,102:2619-2628.
[6] Chierchia GB,Capulzini L,de Asmundis C,et al. Cryoballoon ablation for paroxysmal atrial fibrillation in septuagenarians:a prospective study[J]. Indian Pacing Electrophysiol J,2010,10:393-399.
[7] Kiliszek M, Mizek N, Peller M,et al. Influence of left atrial size on the outcome of pulmonary vein isolation in patients with atrial fibrillation[J].Kardiol Pol,2014,72(11):1135-1140.
[8] Nadernanee K, McKenzie J, Kosar E, et al.A new approach for catheter ablation of atrial fibrillation:mapping of the electrophysiologic substrate[J].J Am Coll Cardiol,2004,43:2044-2053.
[9] Scherlag BJ,Nakagawa H,Jackman WM.et al.Electrical stimulation to identify neural elements on the heart:their role in atrial fibrillation[J].J Interv Card Electrophysiol,2005,13(suppl1):37-42.
[10] Oral H, Cbugh A, Good E, et al. Radiofrequency catheter ablation of chronic atrial fibrillation guided by complex electrograms[J]. Circulation, 2007,115:2606-2612.
[11] 徐楷,刘旭,王远龙,等. 长期持续性心房颤动导管消融策略的临床研究[J]. 中华心律失常学杂志, 2014, 20(6):89-93.
[12] Ouyang F, Ernst S,Chun J, et al.Electrophysiological findings during ablation of persistent atrial fibrillation with electroanatomic mapping and double Lasso catheter technique[J].Circulation,2005,112:3038-3048.
[13] 徐亚伟,黄从新,张劲林,等. 双Lasso导管和三维标测指导下环肺静脉线性隔离术治疗心房颤动[J]. 中国心脏起搏与电生理杂志,2006,20(3):205-209.
[14] Pappone C,Santinelli V,Manguso F,et al.Pulmonary vein denervation enhances long-term benefit after circumferential ablation for paroxysmal atrial fibrillation[J].Circulation,2004,109:327-334.
[15] Schauerte P, Scherlag BJ, Pitha J,et al.Catheter ablation of cardiac autonomic nerves for prevention of vagal atrial fibrillation[J].Circulation,2000,102:2774 -2780.
[16] 何元,邹操,赵波,等.阵发性心房颤动患者迷走神经功能的变化[J].当代医学,2013,19(16):33.
[17] Yorgun H,Avtemir K,Canpolat U,et al. Additional benifit of cryoballoon-based atrial fibrillation beyond pulmonary vein isolation:modification of ganglionated plexi[J]. Europace,2014,16(5):645-651.
[18] Pokushalov E,Turov A,Shugayev P,et al.Catheter ablation of left atrial ganglionated plexi for atrial fibrillation[J].Asian Cardiovasc Thorac Ann,2008,16(3):194-201.
[19] Po SS,Nakagawa H,Jackman WM. Localization of left atrial ganglionated plexi in patients with atrial fibrillation[J].J Cardiovase Electrophysiol,2009,20:1186-1189.
[20] O'Neill MD,Jais P,Takahashi Y,et al.The stepwise ablation approach for chronic atrial fibrillation—evidence for a cumulative effect[J].J Interv Card Electrophysiol,2006,16:153-167.
[21] Haissaguerre M, Hocini M, Sanders P,et al.Catheter ablation of long-lasting persistent atrial fibrillation: clinical outcome and mechanisms of subsequent arrhythmias[J]. J Cardiovase Electrophysiol,2005,16:1138-1147.
[22] 张劲林,苏唏,唐成,等. 以终止持续性心房颤动为手术终点的递进式消融200例总结[J]. 中国心脏起搏与电生理杂志,2012,26(3):221-224.
[23] 王新华, 刘旭, 施海峰,等.慢性心房颤动导管消融: 碎裂电位消融和线性消融的比较[J]. 中国心脏起搏与心电生理杂志,2011,25:206-209.
[24] 姚焰.心房颤动的7字线消融术式及临床应用[J].中国心脏起搏与电生理杂志,2008,22(4):292-294.
[25] 马凌,王菲,蔡晓庆,等. 环肺静脉前庭隔离消融术与7字线消融术治疗心房颤动的对比研究[J]. 中国循环杂志,2014,29(10):787-790.
[26] Lin Y,Zhang F,Chen M,et al.Comparison of left atrial electrophysiologic abnormalities during sinus rhythm in patients with different type of atrial fibrillation[J].Interv Card Electrophysiol,2014,39(1):57-67.
[27] Rolf S, Kircher S, Arya A,et al. Tailored atrial substrate modification based on low-voltage areas in catheter ablation of atrial fibrillation[J].Circ Arrhythm Electrophysiol,2014,7(5):825-833.
[28] Wang XH, Li Z, Mao JL, et al. A novel individualized substrate modification approach for the treatment of long-standing persistent atrial fibrillation: preliminary results[J].Int J Cardiol,2014,175(1):162-168.
[29] Pappone C,Vicedomini G,Manguso F,et al. Robotic magnetic navigation for atrial fibrillation ablation[J]. J Am Coll Cardiol,2006,47(7):1390-1400.
[30] 杨晓敏,陈瑶,过庆华,等.运用磁导航行心房颤动消融与手动消融的比较分析及护理[J].护士进修杂志, 2014,29(15):1374-1379.
[31] Da Costa A, BenH'dech M, Romeyer-Bouchard C, et al. Remote-controlled magnetic pulmonary vein isolation using a new three-dimensional non-fluoroscopic navigation system:a single-center prospective study[J]. Arch Cardiovasc Dis,2013,106(8-9):423-432.

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备注/Memo

备注/Memo:
作者简介:汪俊(1989—),在读硕士,主要从事临床心血管内科电生理研究。Email: wangjunmedical@sina.com 通信作者:杨浩(1966—),主任医师,硕士,主要从事心血管内科电生理研究。Email: yjsxnyh@sina.com
更新日期/Last Update: 2016-05-20