title: The efficacy of ablation based on the combined use of the dominant frequency and complex fractionated atrial electrograms for non-paroxysmal atrial fibrillation.
abstract: This study aimed to evaluate an approach for an endpoint of non-inducibility using a combined high-dominant frequency (DF) and continuous complex fractionated atrial electrogram (CFAE) ablation following circumferential pulmonary vein isolation (PVI) in a sequential fashion, including linear ablation as compared to PVI alone.
  
  
  
  A total of 84 non-paroxysmal patients with atrial fibrillation (AF) were investigated retrospectively. The AF patients were divided into two groups: patients with PVI following a combined high-DF and continuous CFAE ablation with linear ablation (substrate modification group, n=59) and those with PVI alone (n=25). DF sites of ≥8Hz and then continuous CFAE sites defined by fractionation intervals of ≤50ms were modified after PVI. The ablation endpoint was non-inducibility. Atrial tachyarrhythmias (ATs) could not be induced in 54 of 59 (92%) patients after a sequential ablation, and in 18 of 25 (64%) with PVI alone. The ATs freedom without antiarrhythmic drugs in the substrate modification group was significantly greater than that in those with PVI alone after 1 procedure during 12 months of follow-up (78.6% vs. 53.8%, log-rank test p=0.039).
  
  
  
  This sequential approach using a substrate based ablation was associated with a better clinical long-term outcome as compared to PVI alone.
authors: The Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan. Electronic address: kkumagai4917@yahoo.co.jp.
authors: Koji
authors: K
authors: Kumagai
authors: The Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan.
authors: Masahiro
authors: M
authors: Nakano
authors: The Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan.
authors: Daisuke
authors: D
authors: Kutsuzawa
authors: The Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan.
authors: Yoshiaki
authors: Y
authors: Yamaguchi
authors: The Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan.
authors: Kentaro
authors: K
authors: Minami
authors: The Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan.
authors: Shigeru
authors: S
authors: Oshima
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology* / Q000601:surgery; D017115:Catheter Ablation / Q000379:methods*; D022062:Electrophysiologic Techniques, Cardiac / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Ablation; Atrial fibrillation; Dominant frequency; Pulmonary vein isolation