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[AHA2010]房颤经导管消融治疗的长期安全性和有效性
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 编辑:国际循环网 时间:2010/3/12 13:45:49 关键字:房颤经导管消融治疗 心房颤动 

    There are now several studies that  show that from a safety perspective  that catheter ablation of atrial fibrillation can be performed with a very low incidence of the major complications. So again from a efficacy perspective and even in multi-center studies, we see good outcomes. What we are seeing in all of the major studies is if you look at one year outcomes, ablation clearly outperforms anti-arrhythmic drugs. There are a few caveats to this. Number one is that most of these studies are in patients who have already failed using one anti-arrhythmic drug so the likelihood of them maintaining sinus rhythm with a second drug is already low. Therefore, the fact that ablation works much better is in part a reflection of the fact that drugs in general do not work very well. The second caveat  is that while this is certainly true at one year, the long-term results are less clear.  Several studies have shown that even if you have success after ablation at the end of one year, if you follow these patients out further-two years, three years, four years-you start seeing an attrition rate. Regardless, it is still better than anti-arrhythmic drugs.

    目前一些研究表明,心房颤动(房颤)导管消融术的并发症发生率很低,具有很好的安全性。从有效性上看,一些来自多中心的研究得出了较好的结果。观察达1年的大型研究显示,导管消融优于抗心律失常药物。但仍要注意几点:大部分研究的入选的是使用一种抗心律失常药物治疗失败而采用第二种药物恢复窦性心律的可能性很低的患者,因此导管消融可能是更好的选择;部分研究显示,即使观察时间达到1年,导管消融的长期结局也无法轻易明确;即便在消融术后1年手术的安全性可以保证,但随着观察时间的延长——术后2年、3年或4年时,消融术的安全性逐渐降低。但即使这样,导管消融的疗效也好于抗心律失常药。

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