ECGI in Patients With Persistent Atrial Fibrillation

Identification of AF Triggers, Initiators and Perpetuators by Electro Cardio-Graphic Imaging (ECGI) in Patients With Persistent Atrial Fibrillation

To determine the values and limitations of ECGI in guiding ablation and risk stratification in patients with persistent atrial fibrillation.

The patient population will include symptomatic persistent AF patients (N=50). The total of fifty patients will be studied to determine:

• The values and limitations of ECGI in identifying atrial fibrillation (AF) triggers, AF initiators and AF perpetuators as targets sites for catheter ablations in patients with persistent AF.
• The mechanisms of residual atrial tachycardia/flutter (Res-AT/AFl) after AF substrate ablations by targeting complex fractionated atrial electrograms (CFAE).
• If there is a relationship between primary CFAE sites and driver sites or other distinct patterns from the ECGI mapping system.
• The rate of AF termination to sinus rhythm after ablation at target sites identified by ECGI

Inclusion Criteria:

• Patients are diagnosed as persistent AF. Persistent AF was defined as continuous AF from 7 days to 12 months and long- lasting AF beyond twelve months.
• Patients who are symptomatic
• Patients who are willing to sign consent and be followed post procedure in an out- patient arrhythmia clinic

Exclusion Criteria:

• Patients under 18 years or over 85 years of age.
• Patients with chronic alcoholism.
• Recent myocardial infarction within one month of the study.
• Significant debilitating diseases or a terminal disease.
• Patients with documented left atrial thrombus.
• Medical or mental conditions precluding a long-term follow-up.