Analysis of 40 patients with persistent atrial fibrillation undergoing catheter ablation therapy

Objective To study the optimal catheter ablation strategy for persistent atrial fibrillation(AF) and the strategy for management of recurrent atrial tachyarrhythmia.Methods Forty consecutive patients with persistent AF undergoing catheter ablation therapy from March 2005 to August 2007 were analysed,including 12 patients in 2005,12 patients in 2006 and 16 patients in 2007.The procedures were guided by CARTO mapping system and circle catheter and all patients underwent circumferential pulmonary-vein ablation(CPVA).Linear ablation along mitral isthmus and cavotricuspid isthmus was performed routinely in patients in 2006 and 2007,but only in a part of patients in 2005 according to their atrial arrhythmia before or during the procedure.Linear ablation along atrial side of coronary sinus was performed in 2007.When AF remained,ablation targeting complex fractional atrial electrograms(CFAE),roof line or left atrial appendage was performed in 2006 and 2007.Results Eight patients with recurrent AF or atrial tachycardia underwent second ablation and 5 of them succeeded.The patients were followed up for(17.6±10.4) months.The total success rate was 82.5%.Conclusions Linear lesions and CFAE ablation in addition to CPVA in patients with persistent AF significantly improved rate of sinus rhythm.