Abstract
Catheter ablation for atrial fibrillation (AF) has emerged as an effective treatment for paroxysmal AF. However, permanent AF ablation success rates are dramatically lower, thus fostering an interest in alternate and adjunctive strategies, such as targeting the complex fractionated atrial electrograms (CFAEs), CFAE in addition to pulmonary vein antrum isolation (PVAI), ablation of AF nests guided by real-time spectral mapping, and ablation of AF nests in addition to PVAI.
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References
1. Corley SD, Epstein AE, DiMarco JP, Domanski MJ, Geller N, Greene HL, Josephson RA, Kellen JC, Klein RC, Krahn AD, Mickel M, Mitchell LB, Nelson JD, Rosenberg Y, Schron E, Shemanski L, Waldo AL, Wyse DG. Relationships between sinus rhythm, treatment, and survival in the Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) study. Circulation 2004;109(12):1509–1513. Epub March 8, 2004.
2. Marrouche N, Saliba W, Schweikert R, Bhagarva M, Saad E, Burkhardt D, Joseph G, Martin D, Themistoclakis S, Raviele A, Natale A. Feasibility and complications of electrical disconnection of the superior vena cava guided by circular mapping in patients with symptomatic atrial fibrillation. Pacing Clin Electrophysiol. 2003;26(4):750.
3. Verma A, Marrouche NF, Natale A. Pulmonary vein antrum isolation: intracardiac echocardiography guided technique. J Cardiovasc Electrophysiol. 2004;11:1335–1340.
4. Bhargava M, Marrouche N, Martin D, Burghardt D, Khaykin Y, Joseph G, Rossillo A, Saad E, Schweikert R, Saliba W, Tchou P, Natale A. Chronic cure rate after pulmonary vein isolation in patients with nonparoxysmal atrial fibrillation: impact of a second ablation. J Am Coll Cardiol. 2004;43(5):133A.
5. Konings KT, Smeets JL, Penn OC, Wellens HJ, Allessie MA. Configuration of unipolar atrial electrograms during electrically induced atrial fibrillation in humans. Circulation. 1997;95(5):1231–1241.
6. Jais P, Haissaguerre M, Shah DC, Chouairi S, Clementy J. Regional disparities of endocardial atrial activation in paroxysmal atrial fibrillation. Pacing Clin Electrophysiol. 1996;19(11 pt 2):1998–2003.
7. Nademanee K, McKenzie J, Kosar E, Schwab M, Sunsaneewitayakul B, Vasavakul T, Khunnawat C, Ngarmukos T. A new approach for catheter ablation of atrial fibrillation: mapping of the electrophysiologic substrate. J Am Coll Cardiol. 2004; 43(11):2044–2053.
8. Oral H, Chugh A, Lemola K, Cheung P, Hall B, Good E, Han J, Tamirisa K, Bogun F, Pelosi F Jr, Morady F. Noninducibility of atrial fibrillation as an end point of left atrial circumferential ablation for paroxysmal atrial fibrillation: a randomized study. Circulation. 2004;110(18):2797–2801.
9. 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(11):1165–1172.
10. Oral H, Chugh A, Good E, Sankaran S, Reich SS, Igic P, Elmouchi D, Tschopp D, Crawford T, Dey S, Wimmer A, Lemola K, Jongnarangsin K, Bogun F, Pelosi F Jr, Morady F. A tailored approach to catheter ablation of paroxysmal atrial fibrillation. Circulation. 2006;113(15):1824–1831. Epub April 10, 2006.
11. Haissaguerre M, Sanders P, Hocini M, Takahashi Y, Rotter M, Sacher F, Rostock T, Hsu LF, Bordachar P, Reuter S, Roudaut R, Clementy J, Jais P. Catheter ablation of long-lasting persistent atrial fibrillation: Critical structures for termination. J Cardiovasc Electrophysiol. 2005;16(11):1125–1137.
12. Rostock T, Rotter M, Sanders P, Takahashi Y, Jais P, Hocini M, Hsu LF, Sacher F, Clementy J, Haissaguerre M. High-density activation mapping of fractionated electrograms in the atria of patients with paroxysmal atrial fibrillation. Heart Rhythm. 2006;3(1):27–34.
13. Nakagawa H, Jackman W, Scherlag B, Yokoyama K, Wu R, Oza S, Shukla H, Beckman K, Po S., Lockwood D, Herring, Lazzara R. Relationship of complex fractionated atrial electrograms during atrial fibrillation to the location of cardiac automatic ganglionated plexi in patients with atrial fibrillation. Circulation. 2005;112(17):II–746.
14. Pachon M JC, Pachon M EI, Pachon M JC, Lobo TJ, Pachon MZ, Vargas RN, Pachon DQ, Lopez M FJ, Jatene AD. A new treatment for atrial fibrillation based on spectral analysis to guide the catheter RF-ablation. Europace. 2004;6(6):590–601.
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© 2008 Humana Press, a part of Springer Science+Business Media, LLC
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Arruda, M., Elayi, C., Pachon, J.C., Natale, A. (2008). Hybrid Strategies for Ablation of Permanent AF. In: Natale, A., Jalife, J. (eds) Atrial Fibrillation. Contemporary Cardiology. Humana Press. https://doi.org/10.1007/978-1-59745-163-5_18
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DOI: https://doi.org/10.1007/978-1-59745-163-5_18
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