Persistent Atrial Fibrillation Ablation: Ongoing Challenges Defining the Target Population and Substrate

IF 0.8 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Treatment Options in Cardiovascular Medicine Pub Date : 2023-09-15 DOI:10.1007/s11936-023-01011-5

Michael Griffin, Peter Calvert, Dhiraj Gupta

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引用次数: 0

Abstract

Abstract Purpose of Review Catheter ablation (CA) is a well-established treatment for paroxysmal atrial fibrillation (AF), but outcomes in persistent AF can be suboptimal. This review summarises recent evidence relating to the ideal patient population and target substrate for CA, and the techniques available. Recent Findings Risk scores can identify individuals with persistent AF who are more likely to benefit from CA. Pulmonary vein isolation (PVI) remains the most important ablation technique but non-pulmonary vein triggers explain the high recurrence rates in persistent AF. Novel electroanatomic mapping technologies, hybrid approaches, ethanol vein of Marshall ablation and thoracoscopic epicardial ablation are promising recent developments. Pulsed field ablation (PFA) is a new ablation modality with an excellent safety profile in trials to date; its role in persistent AF remains an area of study. Summary Improving outcomes of CA in persistent AF remains a significant research focus, with several encouraging directions for future study.

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持续性心房颤动消融:确定目标人群和基质的持续挑战

导管消融(CA)是治疗阵发性心房颤动(AF)的一种公认的治疗方法，但持续性房颤的治疗效果可能不理想。这篇综述总结了最近关于CA的理想患者群体和靶底物的证据，以及可用的技术。风险评分可以识别持续性房颤患者，他们更有可能从CA中获益。肺静脉隔离(PVI)仍然是最重要的消融技术，但非肺静脉触发解释了持续性房颤的高复发率。新的电子解剖定位技术，混合入路，马歇尔乙醇静脉消融和胸腔镜心外膜消融是最近有前途的发展。脉冲场消融(PFA)是一种新的消融方式，迄今为止在试验中具有良好的安全性;它在持续性房颤中的作用仍是一个研究领域。改善持续性房颤的CA预后仍然是一个重要的研究重点，未来的研究有几个令人鼓舞的方向。

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来源期刊

Current Treatment Options in Cardiovascular Medicine Medicine-Cardiology and Cardiovascular Medicine

CiteScore

2.00

自引率

0.00%

发文量

期刊介绍： This journal aims to review the most important, recently published treatment-related advances in cardiovascular medicine. By providing clear, insightful, balanced contributions by international experts, the journal intends to elucidate novel approaches to treatment in those affected by the spectrum of cardiovascular-related diseases and conditions. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as coronary artery disease, cerebrovascular disease and stroke, heart failure, pediatric and congenital heart disease, and valvular, myocardial, pericardial, and cardiopulmonary diseases. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. We also provide commentaries from well-known figures in the field, and an international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research.