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目的心房肌不明原因的纤维化以及因纤维化并发的缓慢性心律失常和(或)房性快速性心律失常称为心房纤维化性心肌病(FACM)。FACM未并发心律失常且无心房增大时,如未行心房肌活检或心房肌电压标测,很难做出FACM的诊断;心房电压标测表现为局部或弥漫性电压减低或电静止区(ESA),ESA的电屏障和心脏的天然解剖学屏障是形成大折返性房性心动过速或心房扑动的病理生理基础;心房低电压区和ESA累及窦房结或房室结是形成缓慢性心律失常的病理生理基础。FACM患者发生心动过缓,有起搏器植入指征时需植入起搏器;FACM患者发生大折返性房性心动过速时可根据其折返环设计合适的消融径线,从而根治心动过速;部分FACM患者心房机械功能已经受损,受累的心房肌已无收缩功能,有发生血栓形成的风险,即使患者为窦性心律或经射频消融恢复窦性心律也需长期口服抗凝药物预防栓塞并发症的发生。
The purpose of atrial fibrosis of unknown causes and due to fibrosis complicated by arrhythmia and (or) atrial tachyarrhythmia known as atrial fibrosis cardiomyopathy (FACM). FACM is not complicated by arrhythmia and no atrial enlargement, it is difficult to make FACM diagnosis without atrial muscle biopsy or atrial myocardial voltage mapping; atrial voltage mapping manifested as local or diffuse voltage reduction or electrostriction ( ESA), the electrical barrier of ESA and the natural anatomic barrier of the heart are the pathophysiological basis for the formation of a large reentrant atrial tachycardia or atrial flutter; the atrial low-voltage area and ESA involving the sinus node or atrioventricular node are slow to form Pathophysiology of arrhythmia. FACM patients with bradycardia, implanted pacemaker implanted pacemaker implanted; FACM patients with large reentrant atrial tachycardia can be based on its reentry ring design appropriate ablation diameter, and thus radical heart Part of FACM patients with atrial mechanical function has been impaired, the affected atrial muscle has no systolic function, the risk of thrombosis, even if the patient is sinus rhythm or ablation to restore sinus rhythm also need long-term oral anticoagulant drugs Prevent the occurrence of embolism complications.