Abstract：Objective To observe the effects of pulmonary vein isolation(PVI) associated with complex fractionated atrial electrograms(CFAE) ablation on patients with persistent atrial fibrillation(AF).Methods Twenty-three patients with persistent AF were enrolled in the study. All of them had been treated by PVI and linear ablation in left atrium, among whom 12 cases were additionally given CFAE ablation. During a one-year follow-up, several indexes were compared between the two groups, including the duration of operation, X-ray exposure time, ablation time, surgical complications, internal diameter and thrombus of left atrium, success rate of once operation, etc.Results Compared with PVI group, the total time of operation ［(176±22) min vs. (252±35) min］, X-ray exposure time［(34±7.6) min vs. (42±9.1) min］, and ablation time［(63±8) min vs. (94±11) min］ was significantly increased in PVI+CFAE group(P＜0.05). The differences of surgical complications, and the influences on internal diameter and thrombus of left atrium were not statistically significant. The success rate of once operation in PVI associated with CFAE ablation group was significantly higher than that in PVI group (75% vs. 64%; P＜0.05). Conclusion In the treatment of persistent atrial fibrillation, although PVI associated with CFAE ablation lengthens the time of operation, X-ray exposure time, and ablation time, it will not increase the incidence of complications and can elevate the success rate of once operation in atrial fibrillation ablation.
\[1\] Wann LS, Curtis AB, January CT, et al. 2011 ACCF /AHA/HRS focused update on the management of patients with atrial fibrillation(updating the 2006 guideline) : a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guideline\[J\]. Circulation,2011,123(1): 104-123.\[2\] Hummel J, Michaud G, Hoyt R, et al. Phased RF ablation in persistent atrial fibrillation\[J\]. Heart Rhythm,2014,11(2):202-209.\[3\] Nademanee K, McKenzie J, Kosar E, et al. A new approach for catheter ablation of atrial fibrillation: mapping of the electrophysiologic substrate\[J\].J Am Coll Cardiol,2004,43(11): 2044-2053.\[4\] Stiles MK, Brooks AG, Kuklik P. et al．Highdensity mapping of atrial fibrillation in humans: relationship between highfrequency activation and electrogram fractionation\[J\]．J Cardiovasc Electrophysiol，2008，19 (12) : 1245-1253.\[5\] Ghoraani B, Dalvi R, Gizurarson S,et al. Localized rotational activation in the left atrium during human atrial fibrillation: relationship to complex fractionated atrial electrograms and lowvoltage zones\[J\].Heart Rhythm,2013,10(12):1830-1838.\[6\] Estner HL, Hessling G, Ndrepepa G, et al. Electrogramguided substrate ablation with or without pulmonary vein isolation in patients with persistent atrial fibrillation\[J\].Europace，2008,10(11) :1281-1287.\[7\] Oral H，Chugh A，Good E，et al．Radiofrequency catheter ablation of chronic atrial fibrillation guided by complex electrograms\[J\].Circulation，2007，115( 20) : 2606 -2612.\[8\] 刘心怡.房颤碎裂电位消融术对左房结构和功能的影响\[D\].福州：福建医科大学，2012:25-26.\[9\] Wi J, Lee HJ, Uhm JS, et al. Complex fractionated atrial electrograms related to left atrial wall thickness\[J\]. J Cardiovasc Electrophysiol,2014,25(11):1141-1149.
2014, Vol. 23 
