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Typical Atrial Flutter: Antiarrhythmic Drags or Ablation as First-Line Therapy?

机译：典型的心房颤动：抗心律失常拖累或消融作为一线治疗？

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Since Lewis postulated in 1920 that atrial flutter is due to reentrant circuit, a large body of evidence has advanced our understanding of the electrophysio-logic substrate of typical atrial flutter and has enhanced our ability to treat this arrhythmia. Rosenblueth and Garcia-Ramos [1] and Frame et al. [2, 3] first described in an animal model the critical role of the anatomical boundaries in maintaining the flutter circuit. By creating a lesion between the orifices of the venae cavae and extending the lesion to the appendage, a model of atrial flutter was developed. Interestingly, the tricuspid annulus served as the anterior barrier and the crush lesion or incision served as the posterior barrier of the macroreentrant flutter circuit. These models introduced the concept that atrial flutter is a macroreentrant circuit maintained by anatomical barriers including: (1) the tricuspid annulus; (2) the cavity of the right atrium; and (3) the induced surgical barrier that prevents short-circuiting of the macroreentrant circuit within the right atrial free wall. Boineau et al. demonstrated in a canine model that the crista terminalis could replace the crush incision as the posterior barrier of the flutter circuit [4].
机译：由于刘易斯假设在1920年，心房颤动是由于重圈电路，大量证据已经推进了我们对典型心房颤动的电泳逻辑衬底的理解，并提高了我们治疗这种心律失常的能力。 Rosenblueth和Garcia-Ramos [1]和Frame等人。 [2,3]首先在动物模型中描述了解剖学边界在保持颤振回路的关键作用。通过在静脉内孔的孔之间产生病变并将病变延伸到附件，开发了心房扑腾模型。有趣的是，三尖瓣环用作前屏障和粉碎病变或切口作为宏观颤动电路的后屏。这些模型引入了心房颤动是由解剖屏障保持的宏观障碍的概念，包括：（1）Tricuspid环; （2）右心房的腔; （3）诱导的手术屏障，其防止右心房自由壁内的宏观感应电路的短路。 Boineau等人。在犬模型中展示，即Crista端子可以将压碎切口替换为颤振电路的后屏[4]。

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