摘要
患者选择患者消融的选择由患者与医师共同决策.成功消融的概率不但与手术技术有关,也与患者的特征明显相关.手术成功率最高的理想患者是阵发性心房颤动,无基础心脏疾病和左心房扩大(见图1).阵发性心房颤动的定义是病程<7d.这类患者的成功率达80%.不过,最近10年已明确即使持续性心房颤动( >7d)和慢性心房颤动也可从心房颤动的消融中获益.另外,充血性心力衰竭或射血分数下降的患者也可选心房颤动消融(见图2).但是,基础心脏疾病较明显者消融成功概率降低.特别是左心房扩大、二尖瓣病变和慢性心力衰竭患者手术结果较差.先前认为心房颤动消融前至少有一种抗心律失常药物无效.不过,鉴于抗心律失常药物的已知毒性和消融的成功,消融术已成为初始节律控制的方案,至少适合阵发性心房颤动.
Patient Selection Patient selection for ablation is a shared decision by the patient and physician.The odds of a successful ablation not only are related to the technique of the procedure but also are critically to patient characteristics.The ideal patient with the highest likelihood of procedural success is one with paroxysmal AF,no underlying cardiac disease,and a nondilated left atrium(Figure 1).
出处
《心电与循环》
2019年第1期68-72,共5页
Journal of Electrocardiology and Circulation
