Radiofrequency Catheter Ablation in Unusual Mechanisms of Atrial Fibrillation:

Abstract

The observations indicate that AF may be linked to "focal" mechanisms that can be treated by RF catheter ablation.

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

“…197,430,431,432,433 Direct catheter ablation of the triggers was limited by the infrequency with which AF initiation could be reproducibly triggered. To overcome these limitations, an ablation approach was introduced 433 that was designed to electrically isolate the PVs.…”

Catheter ablation of atrial fibrillation

“…20 A subsequent update of their results in 38 patients, who had chronic AF and had failed treatment with multiple antiarrhythmic medications, revealed an 87% chronic success rate for their biatrial catheter ablation procedure. 20 Almost simultaneously with the work carried out by Swartz et al, Haïssaguerre et al 19 described successful catheter ablation with two geometrical linear lesions restricted to the right atrium for a patient with paroxysmal AF. 19 The same investigators subsequently assessed the efficacy of linear catheter ablation limited to the right atrium in 45 patients with frequent, daily episodes of drug-refractory paroxysmal AF.…”

“…20 Almost simultaneously with the work carried out by Swartz et al, Haïssaguerre et al 19 described successful catheter ablation with two geometrical linear lesions restricted to the right atrium for a patient with paroxysmal AF. 19 The same investigators subsequently assessed the efficacy of linear catheter ablation limited to the right atrium in 45 patients with frequent, daily episodes of drug-refractory paroxysmal AF. 21 The acute success rate of their right-atrial procedure was 40%, while the chronic success rate was 13% without drugs, and up to 53% in combination with antiarrhythmic therapy.…”

“…[19][20][21][22] Critical parts of the atria are isolated using transmural linear lesions created by delivering RF energy through a catheter, resulting in areas of atrial tissue between the lesions that are no longer large enough to support reentry, thus preventing the perpetuation of AF. Although this technique achieves the same endpoint as that for the surgical maze procedure, it has the advantage of being less invasive and possessing fewer complications.…”

“…19,20 Swartz et al reported that the creation of linear lesions in the right and left atrium resulted in a progressive increase in the organization of atrial activity until sinus rhythm was restored. 20 A subsequent update of their results in 38 patients, who had chronic AF and had failed treatment with multiple antiarrhythmic medications, revealed an 87% chronic success rate for their biatrial catheter ablation procedure.…”