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Related Experiment Video

Updated: May 16, 2026

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

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Sequential biatrial linear defragmentation approach for persistent atrial fibrillation.

Shinsuke Miyazaki¹, Hiroshi Taniguchi, Yuki Komatsu

¹Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Ibaraki, Japan. mshinsuke@k3.dion.ne.jp

|December 6, 2012

Summary

This study found that sequential pulmonary vein isolation and biatrial ablation for persistent atrial fibrillation (AF) is feasible. While initial AF termination was achieved in 51%, 74% of patients were arrhythmia-free after repeat procedures.

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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

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Published on: December 11, 2017

Area of Science:

Cardiology
Electrophysiology
Cardiac Ablation

Background:

Persistent atrial fibrillation (AF) ablation strategies and procedural endpoints remain debated.
Optimizing ablation techniques for persistent AF is crucial for patient outcomes.

Purpose of the Study:

To assess the feasibility of a sequential defragmentation approach for persistent AF ablation.
To evaluate the efficacy of pulmonary vein antrum isolation followed by linear ablation of complex fractionated electrograms.

Main Methods:

135 patients with persistent AF underwent sequential ablation: pulmonary vein isolation, then linear ablation in specific left and right atrial regions targeting complex fractionated electrograms.
Ensuing atrial tachycardias (ATs) were mapped and ablated.
The endpoint was AF termination.

Main Results:

AF termination was achieved in 51% of patients during the initial procedure.
At a median of 19 months, 78% of patients experienced recurrence, necessitating repeat procedures.
After a mean of 1.7 procedures, 74% of patients were free from atrial tachyarrhythmia at 15-month follow-up.

Conclusions:

Sequential pulmonary vein antrum isolation and biatrial substrate modification is a feasible strategy for persistent AF.
This approach involves linear ablation in predetermined regions with complex fractionated atrial electrograms.
While initial success rates vary, repeat procedures can lead to long-term arrhythmia freedom.