International Circulation: Early atrial tachycardia is a significant adverse effect after catheter ablation of atrial fibrillation. What is the strategy to deal with this arrhythmia after the ablation of AF?

　　《国际循环》：心房颤动导管消融后早期出现房性心动过速，是房颤导管消融的重要并发症。如果处理这种新发生的心律失常呢?

　　John Day教授: 预防心房颤动消融后房性心动过速主要的方法是在肺静脉前庭和消融线上不要遗留裂隙。The most important thing is to leave no gaps and to make sure that the ablation is complete. If this can be done， then the likelihood of atrial tachycardia can be reduced. However， even if you leave no gaps and have a very complete ablation， patients still may develop atrial tachycardia. Fortunately about half of the atrial tachycardias go away during follow-up. In our experience the other half will require a second ablation.

　　International Circulation: Can you explain the mechanism of this new onset of early atrial tachycardia?

　　John Day: There are probably several mechanisms. In other words， there are gaps in the ablation lines where atrial tachycardias can develop. Also， sometimes we can see some early tachycardias during the healing phase but then over time， as there is a remodeling， many of these tachycardias go away. Overall the most likely mechanism is gaps. But then sometimes even if there are no gaps， people can develop new circuits， particularly around the mitral valve. If we can avoid gaps we can minimize the risk.

　　John Day教授: 心房颤动(房颤)消融后房性心动过速的机制可能有几种。在消融线上有裂隙存在，在此部位房性心动过速就可能发生。此外，有时我们在痊愈期间也能看到一些早期心动过速，但是随着时间推移，随着重构的发生，那些心动过速会消失。还有可能是新的回路，尤其是二尖瓣周围。预防这类心动过速主要的方法是在肺静脉前庭和消融线上不要遗留裂隙，并且消融彻底。如果做到这样，那么房性心动过速的可能性就可以被降低。然而，即使你无裂隙遗留，消融也非常彻底，患者仍有发生房性心动过速的可能。幸运的是一半的房性心动过速在随访中消失，另外一半患者将需要第二次消融手术。