Catheter ablation therapy for atrial fibrillation: current advancements in strategies.
Curing atrial fibrillation (AF) by catheter ablation has significantly improved patient morbidity and mortality. The circumferential pulmonary vein isolation technique is established as the principal procedure, with a high cure rate and acceptable safety, for paroxysmal AF, but new adjunctive ablation strategies targeting the AF substrates and sources for long-standing persistent/chronic AF have been developed. These new techniques include linear ablation, complex fractionated atrial electrogram guided ablation, dominant frequency map-guided ablation, ganglionated plexi ablation and disconnection of the coronary sinus and superior vena cava to ablate the AF substrates and sources. The long-term usefulness of the established technique and these innovative adjunctive approaches for the treatment of AF remains to be investigated.
Iesaka
Yoshito
Y
Cardiology Division, Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Japan. iesaka@mtg.biglobe.ne.jp
Otomo
Kiyoshi
K
Nagata
Yasutoshi
Y
Uno
Kikuya
K
D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D054326:Coronary Sinus / Q000503:physiopathology / Q000601:surgery; D022062:Electrophysiologic Techniques, Cardiac; D006801:Humans; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014683:Vena Cava, Superior / Q000503:physiopathology / Q000601:surgery