Mapping of Atrial Fibrillation: Comparing Complex Fractionated Atrial Electrograms, Voltage Maps, Dominant Frequency Maps and Ganglionic Plexi

Abstract

Catheter-based radio-frequency ablation is an effective therapy for controlling atrial fibrillation (AF) in appropriately selected patients. While anatomic pulmonary vein isolation is typically sufficient for individuals with paroxysmal AF, adjunctive substrate modification within the body of the left atrium is often necessary in individuals with persistant AF. Several cardiac mapping strategies can be used to accurately target ablation for improved efficacy and limit unnecessary ablation for improved safety. These include identification of complex fractionated atrial electrograms, measurement of voltage in sinus rhythm and AF, assessment of dominant frequency and localization of ganglionic plexi. This chapter will compare these overlapping methodologies and provide recommendations with regard to their utilization.