Linear Ablation Versus Focal Ablation of Complex Fractionated Atrial Electrograms in Persistent Atrial Fibrillation

Comparison of Linear Ablation Versus Focal Ablation of Complex Fractionated Atrial Electrograms After Pulmonary Vein Isolation in Patients With Persistent Atrial Fibrillation: A Prospective & Randomized Controlled Study

The end point of catheter ablation at complex fractionated atrial electrograms (CFAE) was not established yet. Furthermore, incomplete CFAE ablation may have a potential to develop atrial tachyarrhythmias (AT). The investigators hypothesized that linear ablation extending the clusters of CFAE would be a better strategy than focal ablation at the individual CFAE sites.

Inclusion Criteria:

• patients age 18 or greater
• persistent atrial fibrillation
• candidates for AF ablation based on AF that is symptomatic and refractory to at least one antiarrhythmic medication
• at least one episode of AF must have been documented by ECG or Holter within 12 months of randomization in the trial
• continuous anticoagulation with warfarin (INR 2-3) for >4 weeks prior to the ablation
• patients must be able and willing to provide written informed consent to participate in the clinical trial

Exclusion Criteria:

• paroxysmal or permanent atrial fibrillation
• patients with AF felt to be secondary to an obvious reversible cause
• inadequate anticoagulation as defined in the inclusion criteria
• left atrial thrombus on TEE prior to procedure
• contraindications to systemic anticoagulation with heparin or coumadin
• previously undergone atrial fibrillation ablation
• patients who are or may potentially be pregnant