Mechanisms And Radiofrequency Catheter Ablation Of Atrial Fibrillation

BackgroundsCatheter ablation of atrial fibrillation (AF) has been one of the focus targets in electrophysiology since the end of 20^th century. However, AF had still not been overcome. Such is still under dispute: (1) Was there any ablation procedure that can cure all kinds of AF? (2) Which should be the preferred target to be ablated, the focal triggers, or the substrates of atria? (3) What were the successful rates and long-term outcomes of catheter ablation of AF on earth? (4) What were the incidences and mechanisms of complications? (5) What were the determinant factors of recurrence of atrial tachyarrhythmias. Thus, "focal ablation", circumferential pulmonary vein ablation (CPVA) guided by three-dimensional (3-D) electroanatomic mapping (pure anatomic approach), and CPVA by Lasso catheter and 3-D electroanatomic mapping were applied by our group these several years trying to give answers to these questions.MethodsThere were 190 patients with AF enrolled to this study, including 32 cases of special kind of AF and 158 cases of typical one with distinct fibrillatory wave (f wave). Characters of these 32 cases of special kind of AF included: (1) Arrhythmias presented as repetitive short-burst onset of AF. It could onset spontaneously during the ablation procedure. (2) The activation sequences of multiple sites inside the atria were organized and regular, though the A-A intervals were absolutely irregular.Treatment strategies to the special kind of AF were eliminating the focal triggers of AF identified by seeking the earliest activation site in the atria with electrophysiological study (EPS).CPVA guided by 3-D electroanatomic mapping were used to treat the typical AF. The initial...