心房颤动消融术后空白期内房性心律失常与远期复发的关系

发布时间：2018-02-14 08:57

本文关键词： 综述导管消融术心房颤动房性心律　出处：《中国循环杂志》2017年11期 　论文类型：期刊论文

【摘要】：心房颤动(房颤)是常见的心律失常,主要不良事件是中枢和外周的血栓栓塞。对于有症状的阵发性房颤,导管消融可有效恢复并维持窦性心律,是其一线治疗手段。房颤导管消融术成功率为一般为60%~90%,部分患者存在复发。房颤导管消融术后短期内发生房性心律失常的机制可能包括消融位置局部炎症反应、全身炎症反应、交感神经张力增加等,而一段时间后,部分心律失常可自行或应用药物后缓解、消失,因此针对这一特殊时期,指南和专家共识将其定义为房颤消融后空白期。目前空白期定义为房颤消融术后3个月。空白期快速性房性心律失常发生率平均约为38%,早期复发并非代表消融失败。但是空白期频发房性心律失常者远期随访有较高的复发风险。因此,在空白期复发患者中识别出可能出现远期复发的患者并及早进行干预,具有重要意义。
[Abstract]:Atrial fibrillation (AF) is a common arrhythmia, the main adverse event is central and peripheral thromboembolism. For symptomatic paroxysmal atrial fibrillation, catheter ablation can effectively recover and maintain sinus rhythm. The successful rate of atrial fibrillation catheter ablation is generally 60%, and some patients have recurrence. The mechanism of atrial arrhythmia in the short term after atrial fibrillation catheter ablation may include local inflammatory reaction in ablation position and systemic inflammatory reaction. Sympathetic tension increases and so on, and after a period of time, some arrhythmias can be relieved and disappeared on their own or after the use of drugs, so for this particular period, The guidelines and expert consensus define it as a blank period after atrial fibrillation ablation. At present, blank period is defined as 3 months after atrial fibrillation ablation. The average incidence of rapid atrial arrhythmias in blank period is about 38, and early recurrence does not represent ablation loss. However, patients with frequent atrial arrhythmias in blank period had a higher risk of recurrence during long term follow-up. It is of great significance to identify the patients with long term recurrence and to intervene early in the blank recurrence.
【作者单位】：哈尔滨医科大学附属第一临床医学院;哈尔滨医科大学附属第一临床医院心内科;
【分类号】：R541.7;R541.75

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