国家心血管病中心中国医学科学院阜外心血管病医院姚焰.ppt

国家心血管病中心 中国医学科学院 阜外心血管病医院 姚 焰;当前主要术式;阵发房颤导管消融的远期随访结果 ;持续性房颤导管消融远期随访结果;影响心房颤动消融远期成功率的因素;持续性房颤消融：单纯大环肺静脉隔离（PVI）的价值;单中心六年随访结果Six Year Follow-Up After Catheter Ablation of Atrial Fibrillation:A Palliation More Than a True Cure  ----Sorgente A, et al. Am J Cardiol, 2012;109:1179 –1186;持续性房颤消融：碎裂电位（CFAE）消融的价值;PVI+碎裂电位（CFAE）消融随机对照试验 ---- Oral H, et al. J Am Coll Cardiol, 2009 Mar.3;53(9):782-9;STAR AF StudySubstrate and Trigger Ablation for Reduction of Atrial Fibrillation (STAR AF): a randomized, multicentre, international trial ---- Verma A, et al. Eur Heart J, 2010 Jun;31(11):1344-56;持续性房颤消融：线性消融的价值;PVI+顶部/峡部线a prospective randomized comparison ---- Willems S, et al. Eur Heart J, 2006 Dec;27(23):2871-8;PVI+线性 vs PVI+CFAE对比—A Prospective Randomized Study  ---- Estner HL, et al. PACE, Aug 2011; 34(8): 939-48 ;Depicted are success rates after a single ablation procedure for  both groups.(*indicates significant difference);RASTA--不同消融策略的随机对比Randomized Ablation Strategies for the Treatment of Persistent Atrial Fibrillation: RASTA Study ---- Dixit S, et al. Circ Arrhythm Electrophysiol, 2012;Shows long term procedural efficacy in the 3 study arms;房颤的机制与组织学Mechanism and Hitology;单主波大折返理论Dominant Rotor Random Reentry;持续性房颤的主频标测;Narayan SM， JACC 2012;Narayan SM， JACC 2012;两次CARTO大环隔离术后的复发病例;PV-LA传导仅见于LIPV;LIPV 被隔离;CIS刺激诱发房颤;房颤的维持;顶部消融终止房颤 ; 启 示;心房冠状动脉与房颤消融Atrial Coronary Arteries in Areas Involved in Atrial Fibrillation Catheter Ablation ---- Pardo Meo J, et al. Circ Arrhythm Electrophysiol, 2010;3: 600-5;从左心耳前方发出，走行于左房前壁，供应窦房结，平均外径1.31±0.34mm;当窦房结动脉起源于左回旋支，尤其为第二种类型时，左心房上的冠脉分布密集而粗大;窦房结动脉走行对左房顶部消融阻滞的影响The Course of the