title: [Catheter ablation of persistent and long-standing persistent atrial fibrillation. Strategies and results].
abstract: Catheter ablation for paroxysmal atrial fibrillation is a meanwhile established therapy option, which is most frequently performed using radiofrequency ablation. Mid-term success rate of 70 % are achievable with a single ablation procedure. However, the mechanistics of persistent atrial fibrillation are less well understood and catheter ablation is a far more challenging procedure. Different ablation approaches are being performed to treat persistent atrial fibrillation ranging from sole pulmonary vein isolation to additional ablation of fractionated electrograms aiming for termination of atrial fibrillation. Thus far, it has not been investigated which strategy is most successful in treating persistent atrial fibrillation. After extended ablation of atrial fibrillation, occurrence of organized atrial arrhythmias is not uncommon and can be successfully ablated. These consecutive arrhythmias can be considered as a next step towards stable sinus rhythm after repeat ablation. Improvement of mapping methods as well as a better understanding of mechanisms of atrial fibrillation may increase success rate of catheter ablation of persistent atrial fibrillation and may also help to improve success rate of these complex procedures.
authors.affiliation: Klinik für Kardiologie mit Schwerpunkt Elektrophysiologie, Universitäres Herzzentrum Hamburg, Martinistrasse 52, Hamburg, Germany. dsteven@uke.de
authors.forename: Daniel
authors.initials: D
authors.lastname: Steven
authors.forename: Arian
authors.initials: A
authors.lastname: Sultan
authors.forename: Benjamin
authors.initials: B
authors.lastname: Schäffer
authors.forename: Helge
authors.initials: H
authors.lastname: Servatius
authors.forename: Boris
authors.initials: B
authors.lastname: Hoffmann
authors.forename: Jakob
authors.initials: J
authors.lastname: Lüker
authors.forename: Stephan
authors.initials: S
authors.lastname: Willems
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D002908:Chronic Disease; D003452:Cryosurgery / Q000009:adverse effects / Q000379:methods*; D019317:Evidence-Based Medicine; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D011667:Pulmonary Veins / Q000601:surgery*; D016896:Treatment Outcome