A patient-tailored catheter ablation approach targeting patient-specific low voltage or fibrotic substrate identified by high-resolution mapping can lead to improved outcomes in persistent AF.
Does high-resolution mapping and patient-tailored catheter ablation improve outcomes in patients with persistent AF?
High-resolution mapping with multipolar catheters allows for patient-tailored ablation strategies targeting fibrotic substrates, potentially improving outcomes in persistent AF.
Ablation of AF through electrical isolation of the pulmonary veins is a well-established technique and a cornerstone in the ablation of AF, although there are a variety of techniques and ablation strategies now available. However, high numbers of patients are returning to hospital after ablation procedures such as pulmonary vein isolation (PVI). Scar tissue (as identified by contact voltage mapping) is found to be present in many of these patients, especially those with persistent AF and even those with paroxysmal AF. This scarring is associated with poor outcomes after PVI. Cardiac mapping is necessary to locate triggers and substrate so that an ablation strategy can be optimised. Multipolar mapping catheters offer more information regarding the status of the tissue than standard ablation catheters. A patient-tailored catheter ablation approach, targeting the patient-specific low voltage/fibrotic substrate can lead to improved outcomes.
Andronache et al. (Thu,) conducted a review in Persistent atrial fibrillation. High-resolution mapping and patient-tailored catheter ablation was evaluated. A patient-tailored catheter ablation approach targeting patient-specific low voltage or fibrotic substrate identified by high-resolution mapping can lead to improved outcomes in persistent AF.