title: Persistent atrial fibrillation ablation: conventional versus driver-guided strategy.
abstract: While pulmonary vein isolation for paroxysmal atrial fibrillation (AF) is highly effective, catheter ablation for persistent AF remains a challenge with varying clinical success reported. Several ablation techniques have been proposed to target persistent AF, with the additional ablation of complex fractionated electrograms and linear lesions shown to provide incremental success to pulmonary vein isolation alone. Recently, several studies have suggested the presence of localized drivers (re-entrant or focal) in AF. By targeting these drivers, clinical outcomes may be maintained while minimizing the extent of ablation. This article will focus on the conventional stepwise ablation approach for persistent AF versus driver-guided ablation with the use of newer mapping technologies.
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, Université Victor Segalen Bordeaux II and INSERM U1045 - L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France.
authors.forename: Han S
authors.initials: HS
authors.lastname: Lim
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, Université Victor Segalen Bordeaux II and INSERM U1045 - L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Sacher
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, Université Victor Segalen Bordeaux II and INSERM U1045 - L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France.
authors.forename: Stephan
authors.initials: S
authors.lastname: Zellerhoff
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, Université Victor Segalen Bordeaux II and INSERM U1045 - L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Jesel
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, Université Victor Segalen Bordeaux II and INSERM U1045 - L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France.
authors.forename: Ashok J
authors.initials: AJ
authors.lastname: Shah
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, Université Victor Segalen Bordeaux II and INSERM U1045 - L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Komatsu
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, Université Victor Segalen Bordeaux II and INSERM U1045 - L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France.
authors.forename: Matthew
authors.initials: M
authors.lastname: Daly
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, Université Victor Segalen Bordeaux II and INSERM U1045 - L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Denis
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, Université Victor Segalen Bordeaux II and INSERM U1045 - L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Derval
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, Université Victor Segalen Bordeaux II and INSERM U1045 - L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France.
authors.forename: Mélèze
authors.initials: M
authors.lastname: Hocini
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, Université Victor Segalen Bordeaux II and INSERM U1045 - L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Jaïs
authors.affiliation: Hôpital Cardiologique du Haut-Lévêque, Université Victor Segalen Bordeaux II and INSERM U1045 - L'Institut de Rythmologie et Modeling Cardiaque, Bordeaux, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Haïssaguerre
mesh_terms: D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D006801:Humans
keywords: atrial fibrillation; catheter ablation; drivers; localized sources; noninvasive mapping; persistent; stepwise approach