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Current status and prospects of cryoballoon ablation in first-line treatment of atrial fibrillation

Atrial fibrillation is the most common arrhythmia in clinical practice, and catheter ablation has become a first-line treatment strategy. Among them, cryoballoon ablation has become a standardized treatment for atrial fibrillation due to its advantages such as short surgical time, short learning curve, and minimal patient pain. Currently, a large amount of clinical practice and research have provided new evidence for cryoballoon ablation as a first-line treatment for atrial fibrillation. Therefore, this article provides a review of the current status of catheter ablation, the current status, challenges faced, and prospects as a first-line catheter ablation strategy for atrial fibrillation of cryoballoon ablation, with the aim of providing reference for cardiologists in clinical decision-making in the initial rhythm control of atrial fibrillation.

无射线射频消融妊娠合并室性早搏一例

心腔内超声及超声三维建模指导下行特发性左心室室性心动过速消融一例

乳头肌起源室性早搏的消融一例

新型口服抗凝剂出血并发症的治疗

近年来，新型口服抗凝剂（new oral anticoagulants，NOAC）已经逐渐成为替代华法林用于血栓栓塞性疾病的预防和治疗药物。目前经过Ⅲ期临床试验验证的 NOAC 主要包括：直接凝血酶抑制剂（达比加群）和 Xa 因子抑制剂（利伐沙班、阿哌沙班、依度沙班）。NOAC 抗凝效能比华法林强，而出血、与食品和药物相互作用的几率较低。此外，NOAC 具有更可预测的抗凝作用，剂量固定，不需常规的抗凝活性监测。自 NOAC 投入使用以来，在缺乏特异性拮抗剂逆转抗凝的情况下遭遇危及生命的出血性并发症或急诊手术已经成为临床医生关注的主要问题，该类药在有较高的出血风险的患者中使用有一定的限制。新的特异性抗体（如：Idarucizumab、Andexanetα、Ciraparantag）试验结果数据喜人，并可能很快投入临床使用。该文回顾分析了解 NOAC 的药物代谢动力学、出血性并发症的发生率及预后、逆转抗凝的方法以及特异拮抗剂的最新进展。

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