A novel ablation strategy for refractory atrial fibrillation based on the fractionated signal area in the atrial muscle

Figures

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  Figure 1. Voltage map and fractionated signal areas in atrial muscle (FAAM) map. A, B: Voltage map of left atrium showed broad low-voltage area in anterior wall and posterior roof wall. Non–pulmonary vein foci that could be detected (yellow arrows) were located within FAAM of peaks slider 6.0. C, D: Voltage map of right atrium showed almost-normal voltage. Sinus node (white arrows) and atrioventricular node (red arrows) were located near or within FAAM of peaks slider 5.0.

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  Figure 2. Atrial electrograms during ablation of fractionated signal areas in atrial muscle (FAAM) in left atrium. A: Atrial fibrillation (AF) was terminated by ablation on FAAM. B: After ablating of FAAM in bilateral atrium, we induced sustained AF via rapid atrial pacing (50 ms/30 mA/5 s) at the high right atrium during isoproterenol infusion, and AF spontaneously returned to sinus.

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  Figure 3. Fractionated signal areas in atrial muscle (FAAM) map and ablation points. FAAM of peaks slider 6.0 were highlighted in left atrium (A, B) and right atrium (C, D). Blue points show ablation points within the FAAM ablated. Non–pulmonary vein foci are indicated by yellow arrows. Sinus node (white arrows) and atrioventricular node (red arrows) were not located within FAAM of peaks slider 6.0.