Trials on atrial fibrillation mapping and ablation

Catheter ablation of persistent atrial fibrillation (AF) is associated with a non-irrelevant probability of atrial arrhythmia recurrence and therefore clinical failure. Narayan et al. demonstrated that identification and consequent ablation of rotors and focal impulses in addition to conventional ablation ensures better outcome in terms of arrhythmia recurrence compared with only wide antral circumferential ablation. Compared with the seminal work of Narayan et al., the group of Haissaguerre demonstrated that the number of drivers increases proportionally with duration of AF and that they are very unstable, demonstrating significant spatial meandering but a certain periodicity in their location which allowed identification of anatomical targets for catheter ablation. The authors concluded that non-invasive mapping of AF through body surface mapping can help in identifying the arrhythmogenic regions which drive AF and therefore help in shortening the length of catheter ablation in patients with persistent and long-standing persistent AF.