心房颤动导管消融研究进展

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心房颤动(简称房颤)是临床上最常见的心律失常之一,且随着年龄增长其发病率逐渐升高,严重影响患者生活质量,增加社会经济负担。目前导管消融已经成为症状性房颤患者的重要治疗手段,尤其是对于不能耐受抗心律失常药物的患者。随机对照临床研究证明对于年轻且不伴有左心房扩大的阵发性房颤患者导管消融优于药物治疗[1,2]。2014年AHA/ACC/HRS公布的房颤指南建议:对于I类或III类抗心律失常药物治疗无效或不能耐受的有症状的阵发性房颤(I类推荐)、有症状的持续性房颤( IIa类推荐)可行导管消融。对于复发的有症状的阵发性房颤患者,在权衡药物和导管消融利弊后,导管消融应作为初始节律控制的首选治疗手段( IIa类推荐)[3]。房颤发生的电生理机制包括异位激动触发及心房内存在折返基质,异位激动驱动房颤发生,心房折返是房颤发作和维持的必要条件,此外心房重构、自主神经、体液因子、遗传因素等亦参与房颤的发生及维持[3],随着对房颤发病机制的不断深入研究,房颤导管消融技术迅速发展,本文就房颤导管消融研究进展作一综述。
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