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  • Title: The efficacy of ablation based on the combined use of the dominant frequency and complex fractionated atrial electrograms for non-paroxysmal atrial fibrillation.
    Author: Kumagai K, Nakano M, Kutsuzawa D, Yamaguchi Y, Minami K, Oshima S.
    Journal: J Cardiol; 2016 Jun; 67(6):545-50. PubMed ID: 26297331.
    Abstract:
    BACKGROUND: This study aimed to evaluate an approach for an endpoint of non-inducibility using a combined high-dominant frequency (DF) and continuous complex fractionated atrial electrogram (CFAE) ablation following circumferential pulmonary vein isolation (PVI) in a sequential fashion, including linear ablation as compared to PVI alone. METHODS AND RESULTS: A total of 84 non-paroxysmal patients with atrial fibrillation (AF) were investigated retrospectively. The AF patients were divided into two groups: patients with PVI following a combined high-DF and continuous CFAE ablation with linear ablation (substrate modification group, n=59) and those with PVI alone (n=25). DF sites of ≥8Hz and then continuous CFAE sites defined by fractionation intervals of ≤50ms were modified after PVI. The ablation endpoint was non-inducibility. Atrial tachyarrhythmias (ATs) could not be induced in 54 of 59 (92%) patients after a sequential ablation, and in 18 of 25 (64%) with PVI alone. The ATs freedom without antiarrhythmic drugs in the substrate modification group was significantly greater than that in those with PVI alone after 1 procedure during 12 months of follow-up (78.6% vs. 53.8%, log-rank test p=0.039). CONCLUSION: This sequential approach using a substrate based ablation was associated with a better clinical long-term outcome as compared to PVI alone.
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