杨军,陈明龙

• 1:南京医科大学第一附属医院

摘要(Abstract)：

<正>心房颤动(房颤)是一种常见的具有潜在危害的心律失常。目前为止,房颤触发与维持的电生理机制还没有彻底阐述清楚。房颤需要基质来维持,电学或组织学的基质在维持房颤中起着重要的作用。电学基质重构常常是暂时的和可逆的,在阵发性房颤的维持中占有很重要的比重,而组织学重构趋于不可逆和进展的,在阵发性和持续性房颤的维持中均占主导地位~([1-2])。1心房纤维化和房颤心房组织学研究证实,不管病因学是什么,心房细胞的

关键词(KeyWords)： 心房颤动;消融;瘢痕;均质化

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 杨军,陈明龙

参考文献(References)：

• [1]Schoonderwoerd BA,Van Gelder IC,Van Veldhuisen DJ,et al.Electrical and structural remodeling:role in the genesis and maintenance of atrial fibrillation.Prog Cardiovasc Dis,2005,48(3):153-168.
• [2]Hoit BD,Shao Y,Gabel M.Left atrial systolic and diastolic function accompanying chronic rapid pacing-induced atrial failure.Am J Physiol,1998,275(1 Pt 2):H183-H189.
• [3]Frustaci A,Chimenti C,Bellocci F,et al.Histological substrate of atrial biopsies in patients with lone atrial fibrillation.Circulation,1997,96(4):1180-1184.
• [4]Frustaci A,Cameli S,Zeppilli P.Biopsy evidence of atrial myocarditis in an athlete developing transient sinoatrial disease.Chest,1995,108(5):1460-1462.
• [5]Mihm MJ,Yu F,Carnes CA,et al.Impaired myofibrillar energetics and oxidative injury during human atrial fibrillation.Circulation,2001,104(2):174-180.
• [6]Liu T,Li G,Li L,et al.Association between C-reactive protein and recurrence of atrial fibrillation after successful electrical cardioversion:a meta-analysis.J Am Coll Cardiol,2007,49(15):1642-1648.
• [7]Boldt A,Wetzel U,Lauschke J,et al.Fibrosis in left atrial tissue of patients with atrial fibrillation with and without underlying mitral valve disease.Heart,2004,90(4):400-405.
• [8]Kainuma S,Masai T,Yoshitatsu M,et al.Advanced left-atrial fibrosis is associated with unsuccessful maze operation for valvular atrial fibrillation.Eur J Cardiothorac Surg,2011,40(1):61-69.
• [9]Corradi D,Callegari S,Benussi S,et al.Regional left atrial interstitial remodeling in patients with chronic atrial fibrillation undergoing mitral-valve surgery.Virchows Arch,2004,445(5):498-505.
• [10]Assayag P,CarréF,Chevalier B,et al.Compensated cardiac hypertrophy:arrhythmogenicity and the new myocardial phenotype.I.Fibrosis.Cardiovasc Res,1997,34(3):439-444.
• [11]Kawara T,Derksen R,de Groot JR,et al.Activation delay after premature stimulation in chronically diseased human myocardium relates to the architecture of interstitial fibrosis.Circulation,2001,104(25):3069-3075.
• [12]Teh AW,Kistler PM,Lee G,et al.Electroanatomic remodeling of the left atrium in paroxysmal and persistent atrial fibrillation patients without structural heart disease.J Cardiovasc Electrophysiol,2012,23(3):232-238.
• [13]Lin Y,Yang B,Garcia FC,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.
• [14]Verma A,Wazni OM,Marrouche NF,et al.Pre-existent left atrial scarring in patients undergoing pulmonary vein antrum isolation:an independent predictor of procedural failure.J Am Coll Cardiol,2005,45(2):285-292.
• [15]Mc Gann CJ,Silva F,Patel A,et al.Left Atrial Structural Remodeling on LGE MRI Correlates with Histology.J Am Coll Cardiol.2012,59(13):E1235.
• [16]Akoum N,Daccarett M,Mc Gann C,et al.Atrial fibrosis helps select the appropriate patient and strategy in catheter ablation of atrial fibrillation:a DE-MRI guided approach.J Cardiovasc Electrophysiol,2011,22(1):16-22.
• [17]Mc Gann C,Akoum N,Patel A,et al.Atrial fibrillation ablation outcome is predicted by left atrial remodeling on MRI.Circ Arrhythm Electrophysiol,2014,7(1):23-30.
• [18]Mahnkopf C,Badger TJ,Burgon NS,et al.Evaluation of the left atrial substrate in patients with lone atrial fibrillation using delayed-enhanced MRI:implications for disease progression and response to catheter ablation.Heart Rhythm,2010,7(10):1475-1481.
• [19]Marrouche NF,Wilber D,Hindricks G,et al.Association of atrial tissue fibrosis identified by delayed enhancement MRI and atrial fibrillation catheter ablation The DECAAF Study.JAMA,2014,311(5):498-506.
• [20]Hwang SH,Oh YW,Lee DI,et al.Evaluation of quantification methods for left arial late gadolinium enhancement based on different references in patients with atrial fibrillation.Int JCardiovasc Imaging,2015,31(Suppl 1):91-101.
• [21]Haissaguerre M,Shah AJ,Cochet H,et al.Intermittent drivers anchoring to structural heterogeneities as a major pathophysiological mechanism of human persistent atrial fibrillation.J Physiol,2016,594(9):2387-2398.
• [22]Yang G,Yang B,Wei Y,et al.Catheter ablation of nonparoxysmal atrial fibrillation using electrophysiologically guided substrate modification during sinus rhythm after pulmonary vein isolation.Circ Arrhythm Electrophysiol,2016,9(2):e003382.
• [23]Jadidi AS,Lehrmann H,Keyl C,et al.Ablation of Persistent Atrial Fibrillation Targeting Low-Voltage Areas With Selective Activation Characteristics.Circ Arrhythm Electrophysiol,2016,9(3).pii:e002962.
• [24]Rolf S,Kircher S,Arya A,et al.Tailored atrial substrate modification based on low-voltage areas in catheter ablation of atrial fibrillation.Circ Arrhythm Electrophysiol,2014,7(5):825-833.
• [25]Kottkamp H,Berg J,Bender R,et al.Box Isolation of Fibrotic Areas(BIFA):A Patient-Tailored Substrate Modification Approach for Ablation of Atrial Fibrillation.J Cardiovasc Electrophysiol,2016,27(1):22-30.
• [26]Cutler MJ,Johnson J,Abozguia K,et al.Impact of Voltage Mapping to Guide Whether to Perform Ablation of the Posterior Wall in Patients With Persistent Atrial Fibrillation.J Cardiovasc Electrophysiol,2016,7(1):13-21.
• [27]Mohanty S,Mohanty P,Di Biase L,et al.Long-term follow-up of patients with paroxysmal atrial fibrillation and severe left atrial scarring:comparison between pulmonary vein antrum isolation only or pulmonary vein isolation combined with either scar homogenization or trigger ablation.Europace,2016,[Epub ahead of print].
• [28]Yamaguchi T,Tsuchiya T,Nakahara S,et al.Efficacy of Left Atrial Voltage-Based Catheter Ablation of Persistent Atrial Fibrillation.J Cardiovasc Electrophysiol,2016,27(9):1055-1063.
• [29]Jadidi AS,Lehrmann H,Keyl C,et al.Ablation of persistent atrial fibrillation targeting low-voltage areas with selective activation characteristics.Circ Arrhythm Electrophysiol,2016,9(3):e002962.
• [30]Yagishita A,Gimbel JR,DE Oliveira S,et al.Long-term outcome of left atrial voltage-guided substrate ablation during atrial fibrillation:A novel adjunctive ablation strategy.JCardiovasc Electrophysiol,2017,28(2):147-155.
• [31]Kapa S,Desjardins B,Callans DJ,et al.Contact electroanatomic mapping derived voltage criteria for characterizing left atrial scar in patients undergoing ablation for atrial fibrillation.J Cardiovasc Electrophysiol,2014,25(10):1044-1052.
• [32]Yagishita A,DE Oliveira S,Cakulev I,et al.Correlation of left atrial voltage distribution between sinus rhythm and atrial fibrillation:Identifying structural remodeling by 3-Delectroanatomic mapping irrespective of the rhythm.J Cardiovasc Electrophysiol,2016,27(8):905-912.