[AF-FORUM] 92S 射频消融. Dr. Morillo

[AF Symposium]

Rodriguez医生
每个中心都可以决定他们是否想要，或者说觉得训练 
的足够开展这一技术，并达到一定的成功率，很少的 
并发症。这一手术耗时很长，因为它通常需要几种方 
法的结合，有些并不是电生理医生擅长的如房间隔穿 
刺。在每个中心都会有学习曲线。我的建议只是使你 
觉得你或者你的中心是否值得开展这项技术。RAAFT试 
验将会在一个特定的房颤人群的治疗选择中判断消融 
是否优于传统药物治疗。现在，已经有几个试验提示 
消融的有效性，尤其对于阵发性房颤。这些研究主要 
的缺陷在于患者样本数有限，随访时间短，而且通常 
是患者较多的中心。你怎样把这些Pappone, Morady,  
Marchlinski, Haisaguerre, Kuck,等中心的经验应用到一些小 
中心身上还需要进一步的探索。

Carlos A. Morillo, MD, FRCPC, FACC, FHRS, FESC Professor Department
of Medicine Director Arrhythmia Service, Cardiology Division McMaster
University - Population Health Research Institute HGH-McMaster Clinic
5th Floor Room 501
237 Barton St. East
汉密尔顿, ON, 加拿大 L8L 2X2
Tel: (905) 577-8004
Fax: (905) 521-8820
email: morillo在hhsc.ca
          morillc在mcmaster.ca

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Re: [AF-FORUM] 92S Radiofrequency ablation. Dr. Morillo
Dr. Rodriguez,
Each center should decide whether they want to and feel trained
enough to conduct this procedure with a good rate of success and low
rate of complications. This is a long process, since it requires
experience with some methods that are not used routinely by
electrophysiologists, such as transseptal puncture. There is a
learning curve and it is related to the number of cases that can be
performed in each center. My advice is for you to decide if it is
worth it for you and your center to begin such an enterprise. The
RAAFT study will establish if AF ablation is superior to conventional
pharmacological treatment in a very special population of patients
with AF ablation as first-line treatment. Currently, several studies
have shown the efficacy of AF ablation, especially in patients with
paroxysmal AF. The greatest limitation of these studies is that the
sample of patients is limited, the follow-up short, and usually they
are conducted in centers with a high volume of patients. How you
transfer these results to smaller centers without the experience of
Pappone, Morady, Marchlinski, Haisaguerre, Kuck, etc., is yet to be
defined.

Carlos A. Morillo, MD, FRCPC, FACC, FHRS, FESC Professor Department
of Medicine Director Arrhythmia Service, Cardiology Division McMaster
University - Population Health Research Institute HGH-McMaster Clinic
5th Floor Room 501
237 Barton St. East
Hamilton, ON, Canada L8L 2X2
Tel: (905) 577-8004
Fax: (905) 521-8820
email: morillo在hhsc.ca
          morillc在mcmaster.ca

--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee