Ablation of Persistent Atrial Fibrillation by PVI Pulse Two Different Adjunctive Strategies

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Introduction: Ablation of persistent atrial fibrillation (AF) is highly variable, with different strategies and outcome. We sought to compare the efficacy of an ablation strategy focused on elimination of complex fractionated atrial electrograms (CFEs) in left atrium (LA) pulse pulmonary veins isolation (PVI) with that of an approach performed with linear lesions in LA pulse PVI. Methods: Ten symptomatic patients with persistent AF, refractory to AADs, were divided into two groups. Five patients (group A; 63.6±10.6 years, 3 males) underwent a ablation procedure consisted in PVI and CFEs ablation. Five patients (group B; 71.8±8.7 years, 3 males) consisted in PVI and linear lesions (LA roof, the left side of the roof line to the mitral annulus, the right side of the roof line to the right side of the mitral annulus and then along the endocardial side of CS from proximal to distal, conduction block was not evaluated) in the LA. Results: All patients completed ablation procedure. One complication (stroke) occurred in the group B. After a mean follow up of 9±1.6 months, 4 (80%) patients of group A and 4 (80%) patients of group B were free from AF recurrences. Conclusions: In patients with persistent AF, PVI pulse LA ablation of CFEs and PVI pulse linear lesions were equal effectiveness in term of success rate.