Ablation for the treatment of atrial fibrillation and atrial flutter

Objective The aim of this study is to assess whether ablation of circumferential pulmonary vein with complex fractionated atrial electrograms is more effective in patients with atrial fibrillation(AF),and to explore the relationship of atrial fibrillation and atrial flutter(AFL).Methods Sixty-three patients with AF were divided into two groups(paroxysmal atrial fibrillation group,n=32 and persistent atrial fibrillation group,n=31).All pulmonary veins(PVs)were isolated completely by two circular spectacle-liked radiofrequency ablation lines under the model of atrial and pulmonary vein by Ensite NvaX system.During repeat ablation,complex,fractionated atrial electrograms(CFAEs)were mapped and eliminated providing sinus rhythm still not be maintained.And redo-isthmus ablation were necessary for 22 patients with atrial flutter.Results PVs was isolated in all patients.As compared with the patients in persistent atrial fibrillation group,more patients had not terminated until CFAEs eliminated(P0.01),and the rates of persistent fibrillation stopped were related to the episode duration(P0.05).The success of Ablation of circumferential pulmonary vein and complex fractionated treating AF and AFL was 84.4% and 80.6% respectively(P=0.697),By multivariate logistic regression analysis including all the variables evaluated at baseline,the history of APL was only an independent predictor(P=0.007)in this model.Conclusions Ablation of circumferential pulmonary vein with complex fractionated atrial electrograms is more effective in patients with atrial fibrillation,and the trigger and maintaining between AF and AFL may have some common mechanism.