心房颤动：我们到底知道多少？  

Atrial fibrillation：what do we actually know

作　　者：黄从新[1] 陈新[2] 

机构地区：[1]武汉大学人民医院心内科,430060 [2]中国医学科学院心血管病研究所北京协和医学院阜外心血管病医院心律失常诊治中心

出　　处：《中华心律失常学杂志》2009年第3期165-167,共3页Chinese Journal of Cardiac Arrhythmias

摘　　要：目前对心房颤动（房颤）的研究已经在各个层面展开，从基因到通道蛋白、从细胞器到大体解剖、从电生理到组织结构、从入心大静脉到心房特殊结构、从心房神经节丛到各种体液因子的影响、从药物治疗到非药物治疗，各个领域都有一批学者在执着地深入研究。为了阐明房颤的机制，探索有效的治疗方法，可谓举全世界相关研究之力。然而关于房颤，我们到底知道多少？Atrial fibrillation （AF） is one of the most emphasized issues in the past two decades. But till now, we really know little about its mechanisms. The three classical theories about AF mechanism could not totally elucidate the occurrence and development of AF. The remodeling theory including structural and electrical remodeling was used to interpret the pathological course. Based on patch-clamp studies, kinetics of a lot of ion channels such as potassium, calcium, sodium channel were involved in the development of AF. But the change of single channel can not explain the whole aspects of electrical remodeling and also can not explain the interaction of muhichannels and microcosmic circumstance. Autonomic nervous system seems to play an important role in AF, but its real effects were still controversial. Gene research of familial AF and gene therapy of AF were emerged in recent years. More efforts will be put on the mutated gene and provide candidates for gene therapy. One paper on this issue writ- ten by HUANG Cong-xin ,ZHANG Shu, MA Chang-sheng et al, on behalf of the working group of Chinese society of pacing and Electrophysiology,is worthy to read carefully. The highlights of AF therapeutics were focus on nondrug therapies, especially on radiofrequency catheter ablation （RFCA）. RFCA may be the most promise therapy to cure AF. Now, there are several kinds of RFCA including CPVI, SPVI, CFAE ablation, Ganglion plex ablation and stepwise ablation. The most accepted methods is CPVI with or without extension. The success rates of RF- CA is still not satisfied. The other question we encountered in RFCA is how to improve and optimize procedures and techniques. Also, a lot of attention is paid to drug therapy of AF. Dronedarone was supposed to replace anmiodarone with less side-effects and more efficient. Unfortunately, the clinical data did not support the hypothesis. The investigation of new anti-coagulant meets the same embarrassment. Ximelagatran could not get into market because of its hepatic toxicity. In co

关 键 词：心房颤动 非药物治疗 组织结构 通道蛋白 大体解剖 心大静脉 体液因子 神经节丛 

分 类 号：R541.7[医药卫生—心血管疾病]