<International Circulation>: Over the past decade, atrial fibrillation (AF) ablation was performed by the wide encirclement of the pulmonary veins (PV).
<International Circulation>: In your experience, have you found that there is a patient preference or stigma against ablation as opposed to medical therapy in the same way as a Chinese patient would rather have PCI than bypass surgery? Is there a stigma in people’s minds with regard to the technical aspects of ablation?
《国际循环》:以您的经验,目前是否有患者相对于药物治疗而言倾向或排斥射频消融手术治疗?就像中国患者普遍倾向于PCI手术多于冠脉搭桥手术一样。
Dr Day: Certainly in our experience, the younger and more active patients would prefer to avoid at any cost taking medication. Often when taking these medications and particularly anti-arrhythmic medications, depending on what study you are looking at again, one in three patients will discontinue an anti-arrhythmic due to one or more side effects. So particularly the young and the active patients do not want to take medications. They do not like the way these medications might make them feel from time to time so there is a strong bias towards proceeding with an ablative approach. Conversely, perhaps the elderly patient who is already taking a handful of medications, adding another to their regimen is not that big a deal so they are more willing to proceed with a more conservative approach.
Dr Day: 以我们的实践经验而言,年轻或积极治疗的患者拒绝应用高花费的药物治疗,用药特别是抗心律失常药物取决于研究的层面,约1/3的患者因其副作用难以坚持服用抗心律失常药物。年轻或积极的患者不喜欢药物治疗担心的感觉而倾向于选用射频消融手术。相反,老年患者用药较多,再加一种抗心律失常药物未尝不可,因此他们更倾向于保守的药物治疗。