Catheter ablation of atrial fibrillation guided by electrogram fractionation and dominant frequency analysis

Catheter ablation is an established therapeutic option for certain patients with atrial fibrillation (AF), but the reported success rates of anatomically oriented ablation techniques are low compared with those for other ablation indications, particularly for persistent AF. Electrophysiologically oriented ablation techniques have emerged over the last decade that aim at modifying the arrhythmogenic substrate to the extent that it cannot maintain fibrillatory activity. Electrogram-guided ablation procedures are the most common substrate-targeted ablation approaches and can be broadly divided into procedures that target atrial sites with particular electrogram characteristics in either the time domain (complex fractionated electrograms) or frequency components in the frequency domain (dominant frequencies). The concept of electrogram-based catheter ablation of AF by identifying complex fractionated electrograms and dominant frequency sites is valid only if these sites are temporally stable.