• 中国科技核心期刊
  • 中文科技期刊数据库刊源
  • 中国科技论文统计源期刊
  • 美国化学文摘社《化学文摘》刊源

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

三尖瓣峡部线性消融在心房颤动治疗中的效果

马艺波 张栋 易甫

马艺波, 张栋, 易甫. 三尖瓣峡部线性消融在心房颤动治疗中的效果[J]. 心脏杂志, 2023, 35(1): 106-110. doi: 10.12125/j.chj.202108047
引用本文: 马艺波, 张栋, 易甫. 三尖瓣峡部线性消融在心房颤动治疗中的效果[J]. 心脏杂志, 2023, 35(1): 106-110. doi: 10.12125/j.chj.202108047
Yi-bo MA, Dong ZHANG, Fu YI. Therapeutic effect of cavotricuspid isthmus linear ablation in treatment of atrial fibrillation[J]. Chinese Heart Journal, 2023, 35(1): 106-110. doi: 10.12125/j.chj.202108047
Citation: Yi-bo MA, Dong ZHANG, Fu YI. Therapeutic effect of cavotricuspid isthmus linear ablation in treatment of atrial fibrillation[J]. Chinese Heart Journal, 2023, 35(1): 106-110. doi: 10.12125/j.chj.202108047

三尖瓣峡部线性消融在心房颤动治疗中的效果

doi: 10.12125/j.chj.202108047
详细信息
    作者简介:

    马艺波,硕士生 Email:1045508935@qq.com

    通讯作者:

    易甫,副主任医师,主要从事心律失常研究Email:yi12fu56@126.com

  • 中图分类号: R541.75

Therapeutic effect of cavotricuspid isthmus linear ablation in treatment of atrial fibrillation

  • 摘要: 三尖瓣峡部是典型房扑折返环中的缓慢传导区域,对这一解剖结构进行线性消融以达到双向传导阻滞是典型房扑的一线治疗方法。房颤与典型房扑内在关系密切,一方面房颤与典型房扑往往共存于同一患者,另一方面房颤患者在电生理检查中常可见到典型房扑的诱发。因此在房颤射频消融术中常常补充三尖瓣峡部线性消融,以期病人获得更好的远期预后。但最近的研究对这一术式的疗效提出了质疑。本文以两种心律失常的内在联系为切入点,就三尖瓣峡部消融在房颤射频消融术中的疗效进行综述。

     

  • [1] Morillo CA, Verma A, Connolly SJ, et al. Radiofrequency ablation vs antiarrhythmic drugs as first-line treatment of paroxysmal atrial fibrillation (RAAFT-2): a randomized trial[J]. JAMA, 2014, 311(7): 692 – 700. doi: 10.1001/jama.2014.467
    [2] 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. doi: 10.1056/NEJMoa1408288
    [3] Hindricks G, Potpara T, Dagres N, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC[J]. Eur Heart J, 2021, 42(5): 373 – 498. doi: 10.1093/eurheartj/ehaa612
    [4] Patel NJ, Deshmukh A, Pau D, et al. Contemporary utilization and safety outcomes of catheter ablation of atrial flutter in the United States: Analysis of 89, 638 procedures[J]. Heart Rhythm, 2016, 13(6): 1317 – 1325. doi: 10.1016/j.hrthm.2016.02.005
    [5] Natale A, Newby KH, Pisanó E, et al. Prospective randomized comparison of antiarrhythmic therapy versus first-line radiofrequency ablation in patients with atrial flutter[J]. J Am Coll Cardiol, 2000, 35(7): 1898 – 1904. doi: 10.1016/S0735-1097(00)00635-5
    [6] Scharf C, Veerareddy S, Ozaydin M, et al. Clinical significance of inducible atrial flutter during pulmonary vein isolation in patients with atrial fibrillation[J]. J Am Coll Cardiol, 2004, 43(11): 2057 – 2062. doi: 10.1016/j.jacc.2003.11.063
    [7] Romero J, Patel K, Briceno D, et al. Cavotricuspid isthmus line in patients undergoing catheter ablation of atrial fibrillation with or without history of typical atrial flutter: a meta-analysis[J]. J Cardiovasc Electrophysiol, 2020, 31(8): 1987 – 1995. doi: 10.1111/jce.14614
    [8] Waldo AL, Feld GK. Inter-relationships of atrial fibrillation and atrial flutter mechanisms and clinical implications[J]. J Am Coll Cardiol, 2008, 51(8): 779 – 786. doi: 10.1016/j.jacc.2007.08.066
    [9] Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS[J]. Eur Heart J, 2016, 37(38): 2893 – 2962. doi: 10.1093/eurheartj/ehw210
    [10] Shah DC, Sunthorn H, Burri H, et al. Evaluation of an individualized strategy of cavotricuspid isthmus ablation as an adjunct to atrial fibrillation ablation[J]. J Cardiovasc Electrophysiol, 2007, 18(9): 926 – 930. doi: 10.1111/j.1540-8167.2007.00896.x
    [11] Wijesurendra RS, Casadei B. Mechanisms of atrial fibrillation[J]. Heart, 2019, 105(24): 1860 – 1867. doi: 10.1136/heartjnl-2018-314267
    [12] Haïssaguerre M, Jaïs P, Shah DC, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins[J]. N Engl J Med, 1998, 339(10): 659 – 666. doi: 10.1056/NEJM199809033391003
    [13] Iwasaki YK, Nishida K, Kato T, et al. Atrial fibrillation pathophysiology: implications for management[J]. Circulation, 2011, 124(20): 2264 – 2274. doi: 10.1161/CIRCULATIONAHA.111.019893
    [14] Moe GK, Abildskov JA. Atrial fibrillation as a self-sustaining arrhythmia independent of focal discharge[J]. Am Heart J, 1959, 58(1): 59 – 70. doi: 10.1016/0002-8703(59)90274-1
    [15] 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[J]. JAMA, 2014, 311(5): 498 – 506. doi: 10.1001/jama.2014.3
    [16] Shimizu A, Nozaki A, Rudy Y, et al. Onset of induced atrial flutter in the canine pericarditis model[J]. J Am Coll Cardiol, 1991, 17(5): 1223 – 1234. doi: 10.1016/0735-1097(91)90857-6
    [17] Uno K, Kumagai K, Khrestian CM, et al. New insights regarding the atrial flutter reentrant circuit: studies in the canine sterile pericarditis model[J]. Circulation, 1999, 100(12): 1354 – 1360. doi: 10.1161/01.CIR.100.12.1354
    [18] Mohanty S, Mohanty P, Di Biase L, et al. Results from a single-blind, randomized study comparing the impact of different ablation approaches on long-term procedure outcome in coexistent atrial fibrillation and flutter (approval)[J]. Circulation, 2013, 127(18): 1853 – 1860. doi: 10.1161/CIRCULATIONAHA.113.001855
    [19] Wazni O, Marrouche NF, Martin DO, et al. Randomized study comparing combined pulmonary vein–left atrial junction disconnection and cavotricuspid isthmus ablation versus pulmonary vein–left atrial junction disconnection alone in patients presenting with typical atrial flutter and atrial fibrillation[J]. Circulation, 2003, 108(20): 2479 – 2483. doi: 10.1161/01.CIR.0000101684.88679.AB
    [20] Nabar A, Rodriguez LM, Timmermans C, et al. Class IC antiarrhythmic drug induced atrial flutter: electrocardiographic and electrophysiological findings and their importance for long term outcome after right atrial isthmus ablation[J]. Heart, 2001, 85(4): 424 – 429. doi: 10.1136/heart.85.4.424
    [21] Moreira W, Timmermans C, Wellens HJ, et al. Can common-type atrial flutter be a sign of an arrhythmogenic substrate in paroxysmal atrial fibrillation?: clinical and ablative consequences in patients with coexistent paroxysmal atrial fibrillation/atrial flutter[J]. Circulation, 2007, 116(24): 2786 – 2792. doi: 10.1161/CIRCULATIONAHA.107.711622
    [22] Hsieh MH, Tai CT, Tsai CF, et al. Mechanism of spontaneous transition from typical atrial flutter to atrial fibrillation: role of ectopic atrial fibrillation foci[J]. Pacing Clin Electrophysiol, 2001, 24(1): 46 – 52. doi: 10.1046/j.1460-9592.2001.00046.x
    [23] Barnett SD, Ad N. Surgical ablation as treatment for the elimination of atrial fibrillation: a meta-analysis[J]. J Thorac Cardiovasc Surg, 2006, 131(5): 1029 – 1035. doi: 10.1016/j.jtcvs.2005.10.020
    [24] Onorati F, Esposito A, Messina G, et al. Right isthmus ablation reduces supraventricular arrhythmias after surgery for chronic atrial fibrillation[J]. Ann Thorac Surg, 2008, 85(1): 39 – 48. doi: 10.1016/j.athoracsur.2007.07.056
    [25] Pontoppidan J, Nielsen JC, Poulsen SH, et al. Prophylactic cavotricuspid isthmus block during atrial fibrillation ablation in patients without atrial flutter: a randomised controlled trial[J]. Heart, 2009, 95(12): 994 – 999. doi: 10.1136/hrt.2008.153965
    [26] Kim SH, Oh YS, Choi Y, et al. Long-term efficacy of prophylactic cavotricuspid isthmus ablation during atrial fibrillation ablation in patients without typical atrial flutter: a prospective, multicentre, randomized trial[J]. Korean Circ J, 2020, 51(1): 58 – 64. doi: 10.4070/kcj.2020.0174
    [27] Lee WC, Fang HY, Chen HC, et al. Additional cavotricuspid isthmus block ablation may not improve the outcome of atrial fibrillation ablation[J]. Pacing Clin Electrophysiol, 2019, 42(11): 1421 – 1428. doi: 10.1111/pace.13799
    [28] Chinitz JS, Gerstenfeld EP, Marchlinski FE, et al. Atrial fibrillation is common after ablation of isolated atrial flutter during long-term follow-up[J]. Heart Rhythm, 2007, 4(8): 1029 – 1033. doi: 10.1016/j.hrthm.2007.04.002
    [29] Chugh A, Latchamsetty R, Oral H, et al. Characteristics of cavotricuspid isthmus-dependent atrial flutter after left atrial ablation of atrial fibrillation[[J]. Circulation, 2006, 113(5): 609 – 615. doi: 10.1161/CIRCULATIONAHA.105.580936
    [30] Yang B, Jiang C, Lin Y, et al. STABLE-SR (electrophysiological substrate ablation in the left atrium during sinus rhythm) for the treatment of nonparoxysmal atrial fibrillation: a prospective, multicenter randomized clinical trial[J]. Circ Arrhythm Electrophysiol, 2017, 10(11): e005405. doi: 10.1161/CIRCEP.117.005405
  • 加载中
计量
  • 文章访问数:  44
  • HTML全文浏览量:  5
  • PDF下载量:  7
  • 被引次数: 0
出版历程
  • 收稿日期:  2021-08-11
  • 录用日期:  2021-12-22
  • 修回日期:  2021-12-08
  • 刊出日期:  2023-02-25

目录

    /

    返回文章
    返回