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Hybrid Strategies for Ablation of Permanent AF

Targeting AF Nest in Sinus Rhythm and CFAE in AF

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Atrial Fibrillation

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

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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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© 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

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-856-0

  • Online ISBN: 978-1-59745-163-5

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