Catheter ablation procedure
Patients with paroxysmal AF routinely underwent circumferential
pulmonary vein isolation (CPVI). In nonparoxysmal AF patients, the
STABLE-SR strategy was used to target the fibrotic areas; this strategy
has been well described and was previously
published.24 In brief, all nonparoxysmal AF patients
underwent CPVI and cavotricuspid isthmus (CTI) ablation. Then, we
performed electrical cardioversion to restore sinus rhythm. An A-Focus
catheter (St. Jude Medical, St Paul, MN) was used to generate a
high-density bipolar map of the left atrium. In the low-voltage zone,
all tissue was homogenized. In the transitional zones, complex
electrograms were eliminated. Dechanneling line was performed if
necessary. If AF continued after cardioversion, we performed linear
ablation, including the left atrium roof line and the mitral isthmus
line. Ablation of complex fractional electrograms was performed to
terminate AF if necessary.