Cắt bỏ đầu mối rung tâm nhĩ kịch phát Kỹ thuật này liên quan đến việc đâm thủng transseptal để vượt qua ống thông từ tâm nhĩ phải vào tâm nhĩ trái, và việc sử dụng ống thông đa điện cực ở Ostia của tĩnh mạch phổi để xác định các con đường dẫn vào và ra khỏi các tĩnh mạch. | Supraventricular tachycardia drugs v ablation 42 Ablation techniques have evolved extremely rapidly in recognition of these mechanisms and can be divided into those directed at ectopic triggers focal ablation and at preventing intra-atrial re-entry linear ablation . response to antiarrhythmic drugs may be improved by modifying the triggering focus. Recurrences occur because of multiple pulmonary vein triggers triggers occurring within the atria themselves or incomplete isolation of veins. Focal ablation for paroxysmal atrial fibrillation This technique involves transseptal puncture to pass catheters from the right atrium into the left atrium and the use of multi-electrode catheters in the ostia of the pulmonary veins to identify the conduction pathways into and out of these veins. The superior pulmonary veins are the most common sources of ectopic triggers and form the targets for Two approaches may be adopted - electrical isolation of the culprit veins identified from spontaneous ectopic beat activity or the anatomical approach in which as many pulmonary veins as possible are isolated in an attempt to eliminate all ectopic Initial techniques involved ablation deep within the veins and were associated with a significant incidence of pulmonary vein It is now generally accepted that radiofrequency energy should be applied at or close to the ostia to minimize this risk. Success rates for pulmonary vein ablation are currently around 60 in experienced centers with success defined as lack of symptomatic recurrence of atrial fibrillation in the medium term few long-term data are yet available . It is now recognized that pulmonary vein ectopic impulses may be involved in the maintenance of atrial fibrillation as well as its initiation. Ablation of these foci in some patients with persistent atrial fibrillation can acutely terminate the The Linear ablation Linear ablation procedures are designed to compartmentalize
