心房颤动(atrial fibrillation,AF)是室上性心律失常常见的合并症。与普通人群相比,阵发性室上性心律失常患者AF发生率显著升高,且一般表现为阵发性AF。但迄今为止,AF发生的电生理机制并不十分明朗,其机制有多种学说,如多子波折返学说、异常自律性增高学说、主导转子学说、局灶触发学说等。但不管何种学说,AF的发生必须依赖两个因素,即发生机制和维持机制,两者缺一不可。目前越来越多的证据表明,AF的机制很可能是局灶驱动伴向周围的颤动样传导,多发子波折返仅仅是AF时心房激动的一种表现形式,而不是其维持的关键因素[1]。驱动AF的局部兴奋可以使一个或多个局灶的自律性升高或触发活动,但更可能是位于心房某个固定解剖部位(特别是肺静脉前庭部位)具有完整折返环路的折返激动。本文就室上性心律失常,包 Atrial fibrillation (AF) is a common complication of supraventricular arrhythmias. Compared with the general population, patients with paroxysmal supraventricular arrhythmia AF incidence was significantly increased, and the general performance of paroxysmal AF. However, so far, the electrophysiological mechanism of AF is not very clear, the mechanism has a variety of theories, such as multi-wavelet return theory, abnormal increase self-discipline theory, the dominant rotor theory, focal trigger theory. But no matter what theory, the occurrence of AF must rely on two factors, namely, the occurrence of mechanisms and the maintenance of mechanisms, both indispensable. At present, more and more evidences show that the mechanism of AF is likely to be focal drive to peripheral fibrillation-like transmission. Multiple paroxysmal wave reentry is only a manifestation of atrial activation in AF rather than a key factor in its maintenance [ 1]. Local excitation of AF can elevate or trigger one or more focal autonomic events, but is more likely to be a reentry activation with a complete reentry loop at a fixed anatomical site of the atria (especially in the vestibular segment of the pulmonary veins). In this article, supraventricular arrhythmias, package