Introduction: This study aimed to evaluate an approach of circumferential pulmonary vein isolation (PVI) followed by a dominant frequency (DF) and complex fractionated electrogram (CFE) site ablation.
Methods: : Fifty consecutive AF patients (23 paroxysmal and 27 non-paroxysmal) underwent ablation using NavX. When AF continued after the circumferential PVI, high DF sites of =8 Hz and then continuous left atrial (LA) CFE sites defined by fractionated intervals (FI) of =50ms including the coronary sinus and right atrium were targeted.
Results: AF terminated at high DF sites in 11 (22%) patients and continuous CFE sites in 1 (2%). However, AF could be induced in only 8% of patients after the procedure. The mean LA DF value before ablation was significantly lower in those without recurrence. The freedom from AF recurrence was 96%, 89% and 44% in paroxysmal, persistent and long-standing persistent AF patients, respectively, after 1 procedure over a mean follow-up of 12.0±0.2 months.
Conclusions: A combined high DF and continuous CFE site ablation in all chambers after circumferential PVI may be effective in the paroxysmal and persistent AF patients.