[Radiofrequency catheter ablation of permanent atrial fibrillation under guidance of Carto merge technique].
OBJECTIVE
To investigate the effectiveness and advantages of the Carto merge technique in guiding radiofrequency catheter ablation (RFCA) of permanent atrial fibrillation (AF).


METHODS
A total of 15 patients with permanent AF underwent RFCA under guidance of the Carto merge technique. The virtual electroanatomical map of the left atrium (LA) and pulmonary veins (PVs) were reconstructed with Carto system during the procedure. Then the electroanatomical map was integrated with 3-D images of cardiac magnetic resonance angiography to form Carto merge map. Circumferential pulmonary vein ablation was performed first until complete PVs electric isolation confirmed by lasso catheter. If AF was not terminated, lesion lines on roof of LA, mitral isthmus, and tricuspid isthmus were produced. Finally direct current (DC) cardioversion were given if sinus rhythm did not return.


RESULTS
AF were terminated spontaneously during RFCA in 2 patients, and by DC cardioversion in the remaining 13 patients. Persistent AF recurred on 24 hours, first week, and 5th week, respectively in three patients. The remaining 12 patients were all free of AF during follow-up (1-10 months). The success rate was 80% in the study.


CONCLUSIONS
Carto merge technique can effectively guide RFCA of permanent AF. When combined with single Lasso mapping, it can simplify the mapping and enhance the success rate of RFCA of permanent AF.
Fang
Pi-hua
PH
Center of Arrhythmia Diagnosis and Treatment, Cardiovascular Institute and Fuwai Hospital, CAMS and PUMC, Beijing 100037, China. fangph@sina.com
Ren
Zhen-fang
ZF
Ma
Fu-sheng
FS
Chu
Jian-min
JM
Ma
Jian
J
Zhang
Shu
S
D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D006801:Humans