慢性心房颤动消融术式的研究
张晓栋,刘旭
摘要(Abstract):
<正>心房颤动(房颤)是临床上最常见的心律失常之一,其发病率有逐年升高的趋势。随着近几年来房颤导管消融技术的进步,导管消融已成为药物难治性阵发性房颤的一线治疗方案。但由于慢性房颤的发生和维持机制尚不明确,慢性房颤的导管消融还没有一个标准的术式,仍处于深入探索阶段。一、节段性肺静脉电学隔离术节段性肺静脉电学隔离是2000年Haissaguerre等[1]最早提出的,研究发现肺静脉开口部的左心房-肺静脉的电连接是不连续的,存在节段性电突破,所以他们提出节段性消
关键词(KeyWords):
基金项目(Foundation):
作者(Author): 张晓栋,刘旭
参考文献(References):
- [1]Haissaguerre M,Shah DC,Jais P,et al.Electrophysiological breakthroughs from the left atrium to the pulmonary veins.Circulation,2000,102:2463-2465.
- [2]Oral H,Knight BP,Tada H,et al.Pulmonary vein isolation for paroxysmal and persistent atrial fibrillation.Circulation,2002,105:1077-1081.
- [3]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.Pacing Clin Electrophysiol,2006,29:374-379.
- [4]Pappone C,Rosanio S,Oreto G,et al.Circumferential radiofrequency ablation of pulmonary vein ostia:A new anatomic approach for curing atrial fibrillation.Circulation,2000,102:2619-2628.
- [5]Pappone C,Oreto G,Rosanio S,et al.Atrial electroanatomicremodeling after circumferential radiofrequency pulmonary vein ablation:efficacy of an anatomic approach in a large cohort of patients with atrial fibrillation.Circulation,2001,104:2539-2544.
- [6]Pappone C,Rosanio S,Augello G,et al.Mortality,morbidity,and quality of life after circumferential pulmonary vein ablation for atrial fibrillation outcomes from a controlled nonrandomized long-term study.J Am CollCardiol,2003,42:185-197.
- [7]Pappone C,Manguso F,Vicedomini G,et al.Prevention of iatrogenic atrial tachycardia after ablation of atrial fibrillation:a prospective randomized study comparing circumferential pulmonary vein ablation with a modified approach.Circulation,2004,110:3036-3042.
- [8]Oral H,Pappone C,Chugh A,et al.Circumferential pulmonary-vein ablation for chronic atrial fibrillation.N Engl J Med,2006,354:934-941.
- [9]Gerstenfeld EP,Callans DJ,Dixit S,et al.Mechanisms of organized left tachycardias occurring after pulmonary vein isolation.Circulation,2004,110:1351-1357.
- [10]Ouyang F,Ernst S,Chun J,et al.Electrophysiological findings during ablation of persistent atrial fibrillation with electroanatomic mapping and double Lasso catheter technique.Circulation,2005,112:3038-3048.
- [11]Nademanee K,Mckenzie J,Kosar E,et al.A new approach for catheter ablation of atrial fibrillation:mapping the electrophysiologicsubstrate.J Am Coll Cardiol,2004,43:2044-2053.
- [12]Nademanee K,Schwab MC,Kosar EM,et al.Clinical outcomes of catheter substrate ablation for high risk patients with atrial fibrillation.J Am CollCardiol,2008,51:843-849.
- [13]Oral H,Chugh A,Good E,et al.Radiofrequency catheter ablation of chronic atrial fibrillation guided by complex electrograms.Circulation,2007,115:2606-2612.
- [14]O'Neill MD,Jas P,Takahashi Y,et al.The stepwise ablation approach for chronic atrial fibrillation-evidence for a cumulative effect.J Interv Card Electrophysiol,2006,16:153-167.
- [15]Hassaguerre M,Hocini M,Sanders P,et al.Catheter ablation of long-lasting persistent atrial fibrillation:Clinical outcome and mechanisms of subsequent arrhythmias.J Cardiovasc Electrophysiol,2005,16:1138-1147.
- [16]Schauerte P,Scherlag BJ,Pitha J,et al.Catheter ablation of cardiac autonomic nerves for prevention of vagal atrial fibrillation.Circulation,2000,102:2774-2780.
- [17]Nakagawa H,Scherlag BJ,Lockwood DJ,et al.Localization of left atrial autonomic ganglionated plexuses using endocardial and epicardial high frequency stimulation in patients with atrial fibrillation.Heart Rhythm,2005,6:S10.
- [18]Po SS,Nakagawa H,Jackman WM.Localization of left atrial ganglionated plexi in patients with atrial fibrillation.J Cardiovasc Electrophysiol,2009,20:1186-1189.
- [19]刘旭,主编.心房颤动导管消融学.上海:上海交通大学出版社,2009:280-388.
- [20]Estner HL,Hessling G,Ndrepepa G,et al.Electrogram-guided substrate ablation with or without pulmonary vein isolation in patients with persistent atrial fibrillation.Europace,2008,10:1281-1287.
- [21]Estner HL,Hesslinbg G,Ndrepepa G,et al.Acute effects and long-term outcome of pulmonary vein isolation in combination with electrogram-guided substrate ablation for persistent atrial fibrillation.Am J Cariol,2008,101:332-337.
- [22]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.中国心脏起搏与心电生理杂志,2011,25:206-209.