Successful Focal Catheter Ablation of Focal CFAE (Complex Fractionated Atrial Electrogram) in Right Atrium in Paroxysmal and Persistent Atrial Fibrillation

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Background & Objectives: Nademanee et al. described CFAE (complex fractionated atrial electrogram) were mainly found in the interatrial septum, pulmonary veins, roof of left atrium, left posteroseptal mitral annulus and coronary sinus ostium, but rarely in right atrium (RA) in atrial fibrillation (af). We attempted to evaluate the efficacy of focal catheter ablation (CA) of focal CFAE in RA in paroxysmal and persistent af. Methods: Three patients (3 males, mean age 65 years) with drug refractory af (2 paroxysmal, 1 persistent) who underwent mapping of CFAE during af and had focal CFAE in RA were studied. Focal CA of focal CFAE in RA were performed to evaluate whether eliminate CFAE and/or convert to sinus rhythm. Results: In all 3 patients, focal CFAE were found in posterior, lateral, inferoposterior wall in RA, respectively. Focal CA of focal CFAE in RA resulted in termination of af. At the 10–45 months follow-up, all patients were free of arrhythmia and symptoms. Conclusion: Mapping of CFAE represent electrophysiologic substrate of af and focal CA of focal CFAE in RA can successfully eliminate af.
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