2023年美国心房颤动指南解读——心房颤动导管消融  

R54Interpretation of the 2023 American College of Cardiology/American Heart Association/American College of Chest Physicians/Heart Rhythm Society atrial fi brillation guidelines-atrial fibrillation catheter ablation

作　　者：李康[1] 丁燕生[1] LI Kang;DING Yan-sheng(Department of Cardiology,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院心内科,北京100034

出　　处：《中国介入心脏病学杂志》2024年第3期164-167,共4页Chinese Journal of Interventional Cardiology

摘　　要：2023年美国心脏病学会(ACC)、美国心脏协会(AHA)、美国胸科医师学会(ACCP)和美国心律学会(HRS)心房颤动(房颤)诊断与治疗指南,提出对房颤患者尽早干预和持续治疗,强调早期节律控制的重要性。近年的研究证实无论持续性房颤还是阵发性房颤,导管消融的疗效均优于抗心律失常药物,且尽早实施节律控制策略是提高房颤导管消融成功率的重要因素。对于经选择的房颤患者,新指南将导管消融提升为节律控制的一线治疗策略。从长远来看,相对年轻的房颤患者从导管消融中获益更多。在消融策略方面,对于所有接受导管消融的房颤患者,肺静脉隔离是首要目标,其他消融终点目前证据不足。The 2023 American College of Cardiology/American Heart Association/American College of Chest Physicians/Heart Rhythm Society guidelines for the diagnosis and treatment of atrial fi brillation(AF)propose early intervention and sustained treatment for patients with AF,emphasizing the importance of early rhythm control.Recent studies have confi rmed that catheter ablation is more eff ective than antiarrhythmic drugs in both persistent and paroxysmal AF and that early implementation of rhythm control strategies is an important factor in improving the success rate of catheter ablation of AF.For selected patients with AF,the new guidelines elevate catheter ablation to a first-line strategy for rhythm control.Relatively young patients with AF benefit more from catheter ablation in the long term.Regarding ablation strategy,pulmonary vein isolation is the primary goal for all patients with AF undergoing catheter ablation,and there is insuffi cient evidence for any other ablation endpoint.

关 键 词：心房颤动 节律控制 导管消融 适应证 手术策略 

分 类 号：R54[医药卫生—心血管疾病]