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This study evaluates the efficacy of high-density mapping guided atrial substrate ablation for persistent atrial fibrillation. 1/5 of the patients with persistent atrial fibrillation undergo pulmonary veins isolation, 2/5 of them pulmonary veins and box isolation while others undergo atrial substrate ablation apart from pulmonary veins and box isolation.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Circumferential PV isolation | Active Comparator | Circumferential PV isolation only |
|
| Circumferential PV and BOX isolation | Experimental | Circumferential PV and BOX isolation |
|
| circumferential PV and BOX isolation with substrate ablation | Experimental | Atrial substrate ablation apart from circumferential PV and BOX isolation |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CPVI | Procedure | Circumferential PV isolation only |
| |
| Measure | Description | Time Frame |
|---|---|---|
| sinus rhythm maintenance rate | Holter is performed 12months after the procedure and heart rhythm is recorded. | 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| left ventricular ejection fraction | LVEF is evaluated by echocardiography 12months after the procedure. | 12 months |
| Stroke or embolic events | History of stroke or embolic events is taken at each follow-up during the period of 12 months after procedure, and if necessary, radiographic examinations will be performed. |
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Inclusion Criteria:
Exclusion Criteria:
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| ID | Term |
|---|---|
| D001281 | Atrial Fibrillation |
| D064752 | Atrial Remodeling |
| ID | Term |
|---|---|
| D001145 | Arrhythmias, Cardiac |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D010335 | Pathologic Processes |
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| CPVI+BOX |
| Procedure |
Circumferential PV and BOX isolation |
|
| CPVI+BOX+SUB | Procedure | Atrial substrate ablation apart from circumferential PV and BOX isolation |
|
| 12 months |
| Atrial fibrosis | Atrial substrate mapping is performed before and after catheter ablation in one day to evaluate the atrial fibrosis. | 1 day |
| D013568 |
| Pathological Conditions, Signs and Symptoms |
| D020763 | Pathological Conditions, Anatomical |