Skip to main content
SpringerLink
Log in

Anatomically Guided Catheter Ablation for Atrial Fibrillation

  • Chapter
Atrial Fibrillation

Part of the book series: Contemporary Cardiology ((CONCARD))

Abstract

In recent years, radio-frequency catheter ablation has emerged as an effective treatment option for patients with paroxysmal and chronic atrial fibrillation (AF). Based on advances in the understanding of the pathogenesis of AF, catheter ablation has evolved primarily into two general approaches: (1) ablation strategies that create a predetermined set of lesions usually at or around specific anatomical landmarks (anatomically guided ablation) and (2) ablation strategies that attempt to identify and eliminate specific mechanisms that initiate and perpetuate AF (tailored ablation). A tailored ablation strategy also has been combined with anatomically guided ablation. In this chapter, anatomically guided ablation is discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. 1. Moe GK. A conceptual model of atrial fibrillation. J Electrocardiol. 1968;1:145–146.

    Article  CAS  PubMed  Google Scholar 

  2. 2. Cox JL, Schuessler RB, Lappas DG, Boineau JP. An 8 1/2-year clinical experience with surgery for atrial fibrillation. Ann Surg. 1996;224:267–273; discussion 273–265.

    Article  CAS  PubMed  Google Scholar 

  3. 3. Haissaguerre M, Jais P, Shah DC, Takahashi A, Hocini M, Quiniou G, Garrigue S, Le Mouroux A, Le Metayer P, Clementy J. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med. 1998;339:659–666.

    Article  CAS  PubMed  Google Scholar 

  4. 4. Oral H, Knight BP, Ozaydin M, Chugh A, Lai SW, Scharf C, Hassan S, Greenstein R, Han JD, Pelosi F Jr, Strickberger SA, Morady F. Segmental ostial ablation to isolate the pulmonary veins during atrial fibrillation: feasibility and mechanistic insights. Circulation. 2002;106:1256–1262.

    Article  PubMed  Google Scholar 

  5. 5. Oral H, Ozaydin M, Tada H, Chugh A, Scharf C, Hassan S, Lai S, Greenstein R, Pelosi F Jr, Knight BP, Strickberger SA, Morady F. Mechanistic significance of intermittent pulmonary vein tachycardia in patients with atrial fibrillation. J Cardiovasc Electrophysiol. 2002;13:645–650.

    Article  PubMed  Google Scholar 

  6. 6. Haissaguerre M, Shah DC, Jais P, Hocini M, Yamane T, Deisenhofer I, Chauvin M, Garrigue S, Clementy J. Electrophysiological breakthroughs from the left atrium to the pulmonary veins. Circulation. 2000;102:2463–2465.

    CAS  PubMed  Google Scholar 

  7. 7. Oral H, Knight BP, Tada H, Ozaydin M, Chugh A, Hassan S, Scharf C, Lai SW, Greenstein R, Pelosi F Jr, Strickberger SA, Morady F. Pulmonary vein isolation for paroxysmal and persistent atrial fibrillation. Circulation. 2002;105:1077–1081.

    Article  PubMed  Google Scholar 

  8. 8. Nathan H, Eliakim M. The junction between the left atrium and the pulmonary veins. An anatomic study of human hearts. Circulation. 1966;34:412–422.

    CAS  PubMed  Google Scholar 

  9. 9. Lin WS, Tai CT, Hsieh MH, Tsai CF, Lin YK, Tsao HM, Huang JL, Yu WC, Yang SP, Ding YA, Chang MS, Chen SA. Catheter ablation of paroxysmal atrial fibrillation initiated by non-pulmonary vein ectopy. Circulation. 2003;107:3176–3183.

    Article  PubMed  Google Scholar 

  10. 10. Davidenko JM, Pertsov AV, Salomonsz R, Baxter W, Jalife J. Stationary and drifting spiral waves of excitation in isolated cardiac muscle. Nature. 1992;355:349–351.

    Article  CAS  PubMed  Google Scholar 

  11. 11. Gray RA, Pertsov AM, Jalife J. Spatial and temporal organization during cardiac fibrillation. Nature. 1998;392:75–78.

    Article  CAS  PubMed  Google Scholar 

  12. 12. Jalife J. Rotors and spiral waves in atrial fibrillation. J Cardiovasc Electrophysiol. 2003;14:776–780.

    Article  PubMed  Google Scholar 

  13. 13. Jalife J, Berenfeld O, Mansour M. Mother rotors and fibrillatory conduction: a mechanism of atrial fibrillation. Cardiovasc Res. 2002;54:204–216.

    Article  CAS  PubMed  Google Scholar 

  14. 14. Mansour M, Mandapati R, Berenfeld O, Chen J, Samie FH, Jalife J. Left-to-right gradient of atrial frequencies during acute atrial fibrillation in the isolated sheep heart. Circulation. 2001;103:2631–2636.

    CAS  PubMed  Google Scholar 

  15. 15. Sanders P, Berenfeld O, Hocini M, Jais P, Vaidyanathan R, Hsu LF, Garrigue S, Takahashi Y, Rotter M, Sacher F, Scavee C, Ploutz-Snyder R, Jalife J, Haissaguerre M. Spectral analysis identifies sites of high-frequency activity maintaining atrial fibrillation in humans. Circulation. 2005;112:789–797.

    Article  PubMed  Google Scholar 

  16. 16. Cheung DW. Electrical activity of the pulmonary vein and its interaction with the right atrium in the guinea-pig. J Physiol. 1981;314:445–456.

    CAS  PubMed  Google Scholar 

  17. 17. Hirose M, Carlson MD, Laurita KR. Cellular mechanisms of vagally mediated atrial tachyarrhythmia in isolated arterially perfused canine right atria. J Cardiovasc Electrophysiol. 2002;13:918–926.

    Article  PubMed  Google Scholar 

  18. 18. Kneller J, Zou R, Vigmond EJ, Wang Z, Leon LJ, Nattel S. Cholinergic atrial fibrillation in a computer model of a two-dimensional sheet of canine atrial cells with realistic ionic properties. Circ Res. 2002;90:E73–E87.

    Article  CAS  PubMed  Google Scholar 

  19. 19. Marron K, Wharton J, Sheppard MN, Fagan D, Royston D, Kuhn DM, de Leval MR, Whitehead BF, Anderson RH, Polak JM. Distribution, morphology, and neuro-chemistry of endocardial and epicardial nerve terminal arborizations in the human heart. Circulation. 1995;92:2343–2351.

    CAS  PubMed  Google Scholar 

  20. 20. Bettoni M, Zimmermann M. Autonomic tone variations before the onset of paroxysmal atrial fibrillation. Circulation. 2002;105:2753–2759.

    Article  PubMed  Google Scholar 

  21. 21. Coumel P. Autonomic influences in atrial tachyarrhythmias. J Cardiovasc Electrophysiol. 1996;7:999–1007.

    Article  CAS  PubMed  Google Scholar 

  22. 22. Huang JL, Wen ZC, Lee WL, Chang MS, Chen SA. Changes of autonomic tone before the onset of paroxysmal atrial fibrillation. Int J Cardiol. 1998;66:275–283.

    Article  CAS  PubMed  Google Scholar 

  23. 23. Armour JA, Murphy DA, Yuan BX, Macdonald S, Hopkins DA. Gross and microscopic anatomy of the human intrinsic cardiac nervous system. Anat Rec. 1997;247:289–298.

    Article  CAS  PubMed  Google Scholar 

  24. 24. Oral H, Chugh A, Scharf C, Hall B, Cheung P, Veerareddy S, Daneshvar GF, Pelosi F Jr, Morady F. Pulmonary vein isolation for vagotonic, adrenergic, and random episodes of paroxysmal atrial fibrillation. J Cardiovasc Electrophysiol. 2004;15:402–406.

    Article  PubMed  Google Scholar 

  25. 25. Schauerte P, Scherlag BJ, Pitha J, Scherlag MA, Reynolds D, Lazzara R, Jackman WM. Catheter ablation of cardiac autonomic nerves for prevention of vagal atrial fibrillation. Circulation. 2000;102:2774–2780.

    CAS  PubMed  Google Scholar 

  26. 26. Scherlag BJ, Yamanashi W, Patel U, Lazzara R, Jackman WM. Autonomically induced conversion of pulmonary vein focal firing into atrial fibrillation. J Am Coll Cardiol. 2005;45:1878–1886.

    Article  PubMed  Google Scholar 

  27. 27. Pappone C, Santinelli V, Manguso F, Vicedomini G, Gugliotta F, Augello G, Mazzone P, Tortoriello V, Landoni G, Zangrillo A, Lang C, Tomita T, Mesas C, Mastella E, Alfieri O. Pulmonary vein denervation enhances long-term benefit after circumferential ablation for paroxysmal atrial fibrillation. Circulation. 2004;109:327–334.

    Article  PubMed  Google Scholar 

  28. 28. Melo J, Voigt P, Sonmez B, Ferreira M, Abecasis M, Rebocho M, Timoteo A, Aguiar C, Tansal S, Arbatli H, Dion R. Ventral cardiac denervation reduces the incidence of atrial fibrillation after coronary artery bypass grafting. J Thorac Cardiovasc Surg. 2004;127:511–516.

    Article  PubMed  Google Scholar 

  29. 29. Cummings JE, Gill I, Akhrass R, Dery M, Biblo LA, Quan KJ. Preservation of the anterior fat pad paradoxically decreases the incidence of postoperative atrial fibrillation in humans. J Am Coll Cardiol. 2004;43:994–1000.

    Article  PubMed  Google Scholar 

  30. 30. Scanavacca M, Pisani CF, Hachul D, Lara S, Hardy C, Darrieux F, Trombetta I, Negrao CE, Sosa E. Selective atrial vagal denervation guided by evoked vagal reflex to treat patients with paroxysmal atrial fibrillation. Circulation. 2006;114:876–885.

    Article  PubMed  Google Scholar 

  31. 31. Qureshi AM, Prieto LR, Latson LA, Lane GK, Mesia CI, Radvansky P, White RD, Marrouche NF, Saad EB, Bash DL, Natale A, Rhodes JF. Transcatheter angioplasty for acquired pulmonary vein stenosis after radiofrequency ablation. Circulation. 2003;108:1336–1342.

    Article  PubMed  Google Scholar 

  32. 32. Saad EB, Rossillo A, Saad CP, Martin DO, Bhargava M, Erciyes D, Bash D, Williams-Andrews M, Beheiry S, Marrouche NF, Adams J, Pisano E, Fanelli R, Potenza D, Raviele A, Bonso A, Themistoclakis S, Brachmann J, Saliba WI, Schweikert RA, Natale A. Pulmonary vein stenosis after radiofrequency ablation of atrial fibrillation: functional characterization, evolution, and influence of the ablation strategy. Circulation. 2003;108:3102–3107.

    Article  PubMed  Google Scholar 

  33. 33. Shah D, Haissaguerre M, Jais P, Hocini M, Yamane T, Macle L, Choi KJ, Clementy J. Left atrial appendage activity masquerading as pulmonary vein potentials. Circulation. 2002;105:2821–2825.

    Article  PubMed  Google Scholar 

  34. 34. Shah D, Burri H, Sunthorn H, Gentil-Baron P. Identifying far-field superior vena cava potentials within the right superior pulmonary vein. Heart Rhythm. 2006;3:898–902.

    Article  PubMed  Google Scholar 

  35. 35. Sacher F, Monahan KH, Thomas SP, Davidson N, Adragao P, Sanders P, Hocini M, Takahashi Y, Rotter M, Rostock T, Hsu LF, Clementy J, Haissaguerre M, Ross DL, Packer DL, Jais P. Phrenic nerve injury after atrial fibrillation catheter ablation: characterization and outcome in a multicenter study. J Am Coll Cardiol. 2006;47:2498–2503.

    Article  PubMed  Google Scholar 

  36. 36. Dong J, Vasamreddy CR, Jayam V, Dalal D, Dickfeld T, Eldadah Z, Meininger G, Halperin HR, Berger R, Bluemke DA, Calkins H. Incidence and predictors of pulmonary vein stenosis following catheter ablation of atrial fibrillation using the anatomic pulmonary vein ablation approach: results from paired magnetic resonance imaging. J Cardiovasc Electrophysiol. 2005;16:845–852.

    Article  PubMed  Google Scholar 

  37. 37. Oral H, Scharf C, Chugh A, Hall B, Cheung P, Good E, Veerareddy S, Pelosi F Jr, Morady F. Catheter ablation for paroxysmal atrial fibrillation: segmental pulmonary vein ostial ablation vs left atrial ablation. Circulation. 2003;108:2355–2360.

    Article  PubMed  Google Scholar 

  38. 38. Pappone C, Oreto G, Rosanio S, Vicedomini G, Tocchi M, Gugliotta F, Salvati A, Dicandia C, Calabro MP, Mazzone P, Ficarra E, Di Gioia C, Gulletta S, Nardi S, Santinelli V, Benussi S, Alfieri O. Atrial electroanatomic remodeling after circumferential radiofrequency pulmonary vein ablation: efficacy of an anatomic approach in a large cohort of patients with atrial fibrillation. Circulation. 2001;104:2539– 2544.

    Article  CAS  PubMed  Google Scholar 

  39. 39. Lemola K, Sneider M, Desjardins B, Case I, Chugh A, Hall B, Cheung P, Good E, Han J, Tamirisa K, Bogun F, Pelosi F Jr, Kazerooni E, Morady F, Oral H. Effects of left atrial ablation of atrial fibrillation on size of the left atrium and pulmonary veins. Heart Rhythm. 2004;1:576–581.

    Article  PubMed  Google Scholar 

  40. 40. Scharf C, Sneider M, Case I, Chugh A, Lai SW, Pelosi F Jr, Knight BP, Kazerooni E, Morady F, Oral H. Anatomy of the pulmonary veins in patients with atrial fibrillation and effects of segmental ostial ablation analyzed by computed tomography. J Cardiovasc Electrophysiol. 2003;14:150–155.

    Article  PubMed  Google Scholar 

  41. 41. Oral H, Pappone C, Chugh A, Good E, Bogun F, Pelosi F Jr, Bates ER, Lehmann MH, Vicedomini G, Augello G, Agricola E, Sala S, Santinelli V, Morady F. Circumferential pulmonary-vein ablation for chronic atrial fibrillation. N Engl J Med. 2006;354:934–941.

    Article  CAS  PubMed  Google Scholar 

  42. 42. Lemola K, Oral H, Chugh A, Hall B, Cheung P, Han J, Tamirisa K, Good E, Bogun F, Pelosi F Jr, Morady F. Pulmonary vein isolation as an end point for left atrial circumferential ablation of atrial fibrillation. J Am Coll Cardiol. 2005;46:1060–1066.

    Article  PubMed  Google Scholar 

  43. 43. Ouyang F, Bansch D, Ernst S, Schaumann A, Hachiya H, Chen M, Chun J, Falk P, Khanedani A, Antz M, Kuck KH. Complete isolation of left atrium surrounding the pulmonary veins: new insights from the double-Lasso technique in paroxysmal atrial fibrillation. Circulation. 2004;110:2090–2096.

    Article  PubMed  Google Scholar 

  44. 44. Ouyang F, Ernst S, Chun J, Bansch D, Li Y, Schaumann A, Mavrakis H, Liu X, Deger FT, Schmidt B, Xue Y, Cao J, Hennig D, Huang H, Kuck KH, Antz M. Electrophysiological findings during ablation of persistent atrial fibrillation with electroanatomic mapping and double Lasso catheter technique. Circulation. 2005;112:3038–3048.

    Article  PubMed  Google Scholar 

  45. 45. Marrouche NF, Martin DO, Wazni O, Gillinov AM, Klein A, Bhargava M, Saad E, Bash D, Yamada H, Jaber W, Schweikert R, Tchou P, Abdul-Karim A, Saliba W, Natale A. Phased-array intracardiac echocardiography monitoring during pulmonary vein isolation in patients with atrial fibrillation: impact on outcome and complications. Circulation. 2003;107:2710–2716.

    Article  PubMed  Google Scholar 

  46. 46. Verma A, Marrouche NF, Natale A. Pulmonary vein antrum isolation: intracardiac echocardiography-guided technique. J Cardiovasc Electrophysiol. 2004;15:1335–1340.

    Article  PubMed  Google Scholar 

  47. 47. Chugh A, Oral H, Good E, Han J, Tamirisa K, Lemola K, Elmouchi D, Tschopp D, Reich S, Igic P, Bogun F, Pelosi F Jr, Morady F. Catheter ablation of atypical atrial flutter and atrial tachycardia within the coronary sinus after left atrial ablation for atrial fibrillation. J Am Coll Cardiol. 2005;46:83–91.

    Article  PubMed  Google Scholar 

  48. 48. Pappone C, Manguso F, Vicedomini G, Gugliotta F, Santinelli O, Ferro A, Gulletta S, Sala S, Sora N, Paglino G, Augello G, Agricola E, Zangrillo A, Alfieri O, Santinelli V. Prevention of iatrogenic atrial tachycardia after ablation of atrial fibrillation: a prospective randomized study comparing circumferential pulmonary vein ablation with a modified approach. Circulation. 2004;110:3036–3042.

    Article  PubMed  Google Scholar 

  49. 49. Chugh A, Oral H, Lemola K, Hall B, Cheung P, Good E, Tamirisa K, Han J, Bogun F, Pelosi F Jr, Morady F. Prevalence, mechanisms, and clinical significance of mac-roreentrant atrial tachycardia during and following left atrial ablation for atrial fibrillation. Heart Rhythm. 2005;2:464–471.

    Article  PubMed  Google Scholar 

  50. 50. Pappone C, Oral H, Santinelli V, Vicedomini G, Lang CC, Manguso F, Torracca L, Benussi S, Alfieri O, Hong R, Lau W, Hirata K, Shikuma N, Hall B, Morady F. Atrio-esophageal fistula as a complication of percutaneous transcatheter ablation of atrial fibrillation. Circulation. 2004;109:2724–2726.

    Article  PubMed  Google Scholar 

  51. 51. Scanavacca MI, D'Avila A, Parga J, Sosa E. Left atrial-esophageal fistula following radiofrequency catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2004;15:960–962.

    Article  PubMed  Google Scholar 

  52. 52. Lemola K, Sneider M, Desjardins B, Case I, Han J, Good E, Tamirisa K, Tsemo A, Chugh A, Bogun F, Pelosi F Jr, Kazerooni E, Morady F, Oral H. Computed tomographic analysis of the anatomy of the left atrium and the esophagus: implications for left atrial catheter ablation. Circulation. 2004;110: 3655–3660.

    Article  PubMed  Google Scholar 

  53. Dixit S, Gerstenfeld EP, Callans DJ, Cooper JM, Lin D, Russo AM, Verdino RJ, Patel VV, Kimmel SE, Ratcliffe SJ, Hsia HH, Nayak HM, Zado E, Ren JF, Marchlinski FE. Comparison of Cool tip vs 8-mm tip catheter in achieving electrical isolation of pulmonary veins for long-term control of atrial fibrillation: a prospective randomized pilot study. J Cardiovasc Electrophysiol. 2006.

    Google Scholar 

  54. 54. Good E, Oral H, Lemola K, Han J, Tamirisa K, Igic P, Elmouchi D, Tschopp D, Reich S, Chugh A, Bogun F, Pelosi F Jr, Morady F. Movement of the esophagus during left atrial catheter ablation for atrial fibrillation. J Am Coll Cardiol. 2005;46:2107–2110.

    Article  PubMed  Google Scholar 

  55. 55. Han J, Good E, Morady F, Oral H. Images in cardiovascular medicine. Esophageal migration during left atrial catheter ablation for atrial fibrillation. Circulation. 2004;110:e528.

    Article  PubMed  Google Scholar 

  56. 56. Gaita F, Riccardi R, Calo L, Scaglione M, Garberoglio L, Antolini R, Kirchner M, Lamberti F, Richiardi E. Atrial mapping and radiofrequency catheter ablation in patients with idiopathic atrial fibrillation. Electrophysiological findings and ablation results. Circulation. 1998;97:2136–2145.

    CAS  PubMed  Google Scholar 

  57. 57. Jais P, Shah DC, Takahashi A, Hocini M, Haissaguerre M, Clementy J. Long-term follow-up after right atrial radiofrequency catheter treatment of paroxysmal atrial fibrillation. Pacing Clin Electrophysiol. 1998;21:2533–2538.

    Article  CAS  PubMed  Google Scholar 

  58. 58. Haissaguerre M, Jais P, Shah DC, Gencel L, Pradeau V, Garrigues S, Chouairi S, Hocini M, Le Metayer P, Roudaut R, Clementy J. Right and left atrial radiofrequency catheter therapy of paroxysmal atrial fibrillation. J Cardiovasc Electrophysiol. 1996;7:1132–1144.

    Article  CAS  PubMed  Google Scholar 

  59. 59. Haissaguerre M, Gencel L, Fischer B, Le Metayer P, Poquet F, Marcus FI, Clementy J. Successful catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 1994;5:1045–1052.

    Article  CAS  PubMed  Google Scholar 

  60. 60. Swartz JF, Plellersels G, Silvers J, Patten L, Cervantez D. A catheter based curative approach to atrial fibrillation in humans. Circulation. 1994;90:1–335.

    Google Scholar 

  61. 61. Kottkamp H, Hindricks G, Autschbach R, Krauss B, Strasser B, Schirdewahn P, Fabricius A, Schuler G, Mohr FW. Specific linear left atrial lesions in atrial fibrillation: intraoperative radiofrequency ablation using minimally invasive surgical techniques. J Am Coll Cardiol. 2002;40:475–480.

    Article  PubMed  Google Scholar 

  62. 62. Gaita F, Gallotti R, Calo L, Manasse E, Riccardi R, Garberoglio L, Nicolini F, Scaglione M, Di Donna P, Caponi D, Franciosi G. Limited posterior left atrial cryoablation in patients with chronic atrial fibrillation undergoing valvular heart surgery. J Am Coll Cardiol. 2000;36:159–166.

    Article  CAS  PubMed  Google Scholar 

  63. 63. Gaita F, Riccardi R, Caponi D, Shah D, Garberoglio L, Vivalda L, Dulio A, Chiecchio A, Manasse E, Gallotti R. Linear cryoablation of the left atrium vs pulmonary vein cryoisolation in patients with permanent atrial fibrillation and valvular heart disease: correlation of electroanatomic mapping and long-term clinical results. Circulation. 2005;111:136–142.

    Article  PubMed  Google Scholar 

  64. 64. Todd DM, Skanes AC, Guiraudon G, Guiraudon C, Krahn AD, Yee R, Klein GJ. Role of the posterior left atrium and pulmonary veins in human lone atrial fibrillation: electrophysiological and pathological data from patients undergoing atrial fibrillation surgery. Circulation. 2003;108:3108–3114.

    Article  PubMed  Google Scholar 

  65. 65. Mohr FW, Fabricius AM, Falk V, Autschbach R, Doll N, Von Oppell U, Diegeler A, Kottkamp H, Hindricks G. Curative treatment of atrial fibrillation with intraopera-tive radiofrequency ablation: short-term and midterm results. J Thorac Cardiovasc Surg. 2002;123:919–927.

    Article  PubMed  Google Scholar 

  66. 66. Doll N, Borger MA, Fabricius A, Stephan S, Gummert J, Mohr FW, Hauss J, Kottkamp H, Hindricks G. Esophageal perforation during left atrial radiofrequency ablation: is the risk too high? J Thorac Cardiovasc Surg. 2003;125:836–842.

    Article  PubMed  Google Scholar 

  67. 67. Kottkamp H, Tanner H, Kobza R, Schirdewahn P, Dorszewski A, Gerds-Li JH, Carbucicchio C, Piorkowski C, Hindricks G. Time courses and quantitative analysis of atrial fibrillation episode number and duration after circular plus linear left atrial lesions: trigger elimination or substrate modification: early or delayed cure? J Am Coll Cardiol. 2004;44:869–877.

    PubMed  Google Scholar 

  68. 68. Tanner H, Hindricks G, Kobza R, Dorszewski A, Schirdewahn P, Piorkowski C, Gerds-Li JH, Kottkamp H. Trigger activity more than 3 years after left atrial linear ablation without pulmonary vein isolation in patients with atrial fibrillation. J Am Coll Cardiol. 2005;46:338–343.

    Article  PubMed  Google Scholar 

  69. 69. Ernst S, Ouyang F, Lober F, Antz M, Kuck KH. Catheter-induced linear lesions in the left atrium in patients with atrial fibrillation: an electroanatomic study. J Am Coll Cardiol. 2003;42:1271–1282.

    Article  PubMed  Google Scholar 

  70. 70. Oral H, Chugh A, Good E, Igic P, Elmouchi D, Tschopp DR, Reich SS, Bogun F, Pelosi F Jr, Morady F. Randomized comparison of encircling and nonencircling left atrial ablation for chronic atrial fibrillation. Heart Rhythm. 2005;2:1165–1172.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Cardiac Electrophysiology, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA

    Hakan Oral (Associate Professor, Director)

  2. University of Michigan Health System, Ann Arbor, MI, USA

    Fred Morady (McKay Professor of Cardiovascular Disease, Professor of Medicine)

Authors
  1. Hakan Oral
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fred Morady
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA

    Andrea Natale MD (Executive Medical Director of the Texas Cardiac Arrhythmia Institute, Consulting Professor) (Executive Medical Director of the Texas Cardiac Arrhythmia Institute, Consulting Professor)

  2. Division of Cardiology, Stanford University, Palo Alto, CA, USA

    Andrea Natale MD (Executive Medical Director of the Texas Cardiac Arrhythmia Institute, Consulting Professor) (Executive Medical Director of the Texas Cardiac Arrhythmia Institute, Consulting Professor)

  3. University of Michigan, Ann Arbor, MI, USA

    José Jalife MD (Professor of Internal Medicine, The Cyrus and Jane Farrehi Professor of Cardiovascular Research, Professor of Molecular and Integrative Physiology) (Professor of Internal Medicine, The Cyrus and Jane Farrehi Professor of Cardiovascular Research, Professor of Molecular and Integrative Physiology)

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Humana Press, a part of Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Oral, H., Morady, F. (2008). Anatomically Guided Catheter Ablation for Atrial Fibrillation. In: Natale, A., Jalife, J. (eds) Atrial Fibrillation. Contemporary Cardiology. Humana Press. https://doi.org/10.1007/978-1-59745-163-5_16

Download citation

  • DOI: https://doi.org/10.1007/978-1-59745-163-5_16

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-856-0

  • Online ISBN: 978-1-59745-163-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation