| Objective This paper summarizes the current evidence in high-density mapping-guided catheter ablation of atrial fibrillation and then compares the effectiveness and safety of the addition of spatial-temporal dispersion guided ablation to pulmonary vein isolation with that of stepwise ablation.Method 122 patients who underwent spatial-temporal dispersion mapping guided catheter ablation at Shanghai Chest Hospital from July 2017 to April 2018 and 122 atrial fibrillation type-matched patients who underwent stepwise ablation during the same period were enrolled.Results 244 patients were followed for a median of 316(96-562)days and the dispersion-guided group had a lower rate of recurrent atrial arrhythmia than the stepwise group,(15.0% vs 29.0%,log-rank p = 0.01).Among the patient who had recurrences,the proportion of patients with AT/AFL is higher for the dispersion group(66.7% vs 32.5%,p = 0.02).The dispersion-guided group also had a significantly higher rate of in-procedure termination compared with the stepwise group(97.51% vs 38.52%,p < 0.01),but is more time-consuming(184.48 min vs 165.16 min,p < 0.01).High-dispersion areas are widely distributed in the LA,with LA roof,LA bottom,an LA inferoposterial wall being the most frequent areas.Conclusion For patients with atrial fibrillation undergoing catheter ablation,an approach of spatialtemporal dispersion in addition to pulmonary vein isolation is superior to stepwise ablation. |
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