慢性房颤消融可否规范化-马长生.pptVIP

* * From a reecent published study, which was conducted worldwide, the total SR of AF ablation was seventy percent in pts with no ADDs and eighty percent in pts with ADDs. Sub-analysis found the success rate varied with the different AF type, highest in pt with paro AF, and lowest in pts with longlasting AF. * * In an over 2-year follow-up, we had an overall success rate of 87%, with better results in paroxysmal AF (91%) but very good results even in chronic AF (83%), though. For both types of arrhythmia the proportions of patients on antiarrhythmics were very low. 波尔多，stepwise approach，以术中消融实现窦性心律为终点，随访结果 * Besides AF, organized AT could be the recurrent arrhythmia after AF ablation, from the studies published in past, majority of the recurrence were due to the reentry.The reentry could be caused by imcomplete linear ablation of residual gaps. It’s important to know that, there is no one study aimed to investigate the mechanism of late recurrence, current knowledge of late recurrent is still limited. Current understanding about the late recurrence are mostly deductive, the detail data on this remains to studied in future. Deductive Mapping Strategy for Atrial Tachycardia. Background: Atrial tachycardia (AT) occurring following catheter ablation of persistent atrial fibrillation (AF) may be challenging to map and ablate because theirmechanism and location is unpredictable and may bemultiple in an individual patient. Methods and Results: A prospective cohort of 128 consecutive patients presenting 246 AT in the context of prior AF ablation was investigated. Using activation and entrainment mapping and applying the consensus definition of AT, we evaluated a deductive diagnostic approach based on up to three steps: (1) cycle length regularity, (2) search formacroreentry (i.e., involving 2 separate atrial segments), and (3) ifmacroreentry excluded, search for focal origin giving a centrifugal activation of the atria. A total of 238/246 (97%) sustained AT (mean cycl