房颤治疗策略ppt课件.pptVIP

Treating Atrial FibrillationRichard Schilling;AF burden;ATRIAL FIBRILLATIONIncidence;Nice guidance for management of AF;Key aims of management;Diagnosis;Investigation;Stroke prevention;Rate control vs rhythm control;Rhythm control - problem;Treatment decision tree;Advantages of Warfarin over Aspirin;Advantages of Warfarin over Aspirin;rhythm vs rate control;Persistent AF rate control;Rhythm control;Rate control vs Rhythm control;What specialist treatments are available?;AV node ablation and pacing;AV node ablation and pacing;The first curative procedure Maze JL Cox et al 1991;Why does the maze work?;Radiofrequency Ablation Catheter;How is RF energy applied;RFA Lesion - Macroscopic;;Atrial fibrillation originates in the left atrium;Mechanisms for AF;Target PV trigger;Focal AF: RFA to “disconnect” PV potential;Continuous circular lesions;Catheter ablation in permanent AF;The electroanatomical approach;CT integration;Creating 3 landmark pairs;LPV locations of interest;LPV internal view;Does this have a clinical effect?;Isolation of LPV’s during AF;Practicalities of curative AF ablation;Case Control Study of 3-D mapping vs CT integration;AF ablation results;;Complications of AF ablation;Recurrence;How does ablation compare to drugs?;Ablation vs drugs;Does ablation improve prognosis?;Complications of AF ablation;AF ablation is good for your garden;AF ablation for heart failure;Preliminary results;Who should have AF ablation;Limitations of AF ablation;Conclusion