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1、房颤导管消融---适应证选择房颤患病率逐年增加AdultswithAFib(millions)Year2.082.262.442.662.943.333.804.784.345.165.425.61%363753YearProportionAged80YrGo:JAMA,2001：2370中国1000万国内房颤的流行病学研究房颤患者脑中风风险17.5%瓣膜病房颤患者脑中风风险26.88%非瓣膜病房颤患者脑中风风险24.15%HuDY,ChinJInternMed2003;42:157–61.Wen-HangQI.IntJCardiol2005;105:283–7.ZhangS
2、.Heart2009Jul;95(13):1052-5.2012ESC----房颤导管消融指南成功标准:术后12个月阵发:50%持续:40%长程:30%慢性房颤消融 ---适应证的个体化策略临床病例病例271岁，女性AF病史83个月高血压糖尿病LA56mmRA56x46mmMR、TR中度返流病例143岁，男性AF病史14个月LA41mm不同特点的患者---完全相同的术式？适应证的个体化依据何在临床特征病史合并疾病心脏超声电生理特征肺静脉电位碎裂电位双心房电学差异预后与复发复发时间复发类型复发次数依据何在*Yuanglongw,XuL,etal.Theevalutionoflef
3、tandatrialatriumlinesablationforlongstandingatrialfibrillation.PACE.onlines适应证的个体化适应证的个体化220patientswithLS-AFGroupI：CPVI+CFAEsGroupII:I+Lines(roof+mitralismuths)GroupIII:II+Lines(roof+mitralismuths+thricuspidismuths)Currentablationendpoints:CPVI+CFAEs+Lines(roof+mitralismuths)(CCL)步骤1环肺静脉电隔离
4、步骤2碎裂电位消融步骤3必要的线性消融AF终止AF终止AF未终止AF未终止电复律本中心慢性房颤CCL消融策略探索CPVI+CFAEs+Lines(CCL)WangYY,LiuXu,etal.Evaluationoflinearlesionsintheleftandrightatriuminablationoflongstandingatrialfibrillation.PacingandClinicalElectrophysiology.2013.Acceptted.依据-临床特征-年龄258patientswithLS-AFCurrentablationendpoints--
5、-CCLGroupI(≤55yrs),GroupII(56–65yrs),GroupIII(≥66years)follow-upof18.1±5.1months*XiaodongZ,LiangZ,XuL,etal.Theimpactofageontheefficacyandsafetyofcatheterablation.IntJCardiol,online.SRgroupandrecurrentATagroup适应证的个体化*XiaodongZ,LiangZ,XuL,etal.Theimpactofageontheefficacyandsafetyofcatheterabla
6、tion.IntJCardiol,online.依据-临床特征-年龄适应证的个体化*XiaodongZ,LiangZ,XuL,etal.Theimpactofageontheefficacyandsafetyofcatheterablation.IntJCardiol,online.依据-临床特征-年龄适应证的个体化依据-临床特征-性别220patientswithLS-AFCurrentablationendpoints---CCL147malesand73femalesfollow-upof19±5.0months*XiaodongZ,LiangZ,XuL,etal.Eff
7、icacyandsafetyofcatheterablationforlong-standingpersistentatrialfibrillationinwomen.PACE,accepted.SRgroupandrecurrentATagroup适应证的个体化依据-临床特征-性别*XiaodongZ,LiangZ,XuL,etal.Efficacyandsafetyofcatheterablationforlong-standingpersistentatrialfibrillation
