Catheter ablation of atrial fibrillation: State-of-the-art techniques and future perspectives

Journal of Cardiovascular Medicine

Volumn 13, Issue 2, 2012, Pages 108-124

  Santangeli, Pasquale ^a   Di Biase, Luigi ^a,c   Burkhardt, David J ^a   Horton, Rodney ^a   Sanchez, Javier ^a   Bai, Rong ^a,d   Pump, Agnes ^a   Perez, Marco ^b   Wang, Paul J ^b   Natale, Andrea ^a   Al Ahmad, Amin ^b  

^a TEXAS CARDIAC ARRHYTHMIA INSTITUTE   (United States)

^b STANFORD UNIVERSITY   (United States)

^c UNIVERSITY OF FOGGIA   (Italy)

^d HUAZHONG UNIVERSITY OF SCIENCE AND TECHNOLOGY   (China)

Author keywords

atrial fibrillation; catheter ablation; randomized trials; techniques

Indexed keywords

ANTIARRHYTHMIC AGENT;

BALLOON CATHETER; CATHETER ABLATION; CRYOABLATION; DEFIBRILLATOR; EVIDENCE BASED PRACTICE; FOLLOW UP; HEART ATRIUM FIBRILLATION; HEART FAILURE; HIGH INTENSITY FOCUSED ULTRASOUND; HOSPITALIZATION; HUMAN; LASER SURGERY; MORTALITY; PULMONARY VEIN ISOLATION; RANDOMIZED CONTROLLED TRIAL (TOPIC); REVIEW; ROBOTICS; STROKE;

ANTI-ARRHYTHMIA AGENTS; ATRIAL APPENDAGE; ATRIAL FIBRILLATION; CATHETER ABLATION; EVIDENCE-BASED MEDICINE; HUMANS; PATIENT SELECTION; PULMONARY VEINS; RECURRENCE; STROKE; TREATMENT OUTCOME;

EID: 84856109095     PISSN: 15582027     EISSN: 15582035     Source Type: Journal    
DOI: 10.2459/JCM.0b013e32834f2371     Document Type: Review

References (101)

1. Miyasaka Y, Barnes ME, Gersh BJ, et al. Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence. Circulation 2006; 114:119-125.
2. Bhargava M, Di Biase L, Mohanty P, et al. Impact of type of atrial fibrillation and repeat catheter ablation on long-term freedom from atrial fibrillation: results from a multicenter study. Heart Rhythm 2009; 6:1403-1412.
3. Themistoclakis S, Corrado A, Marchlinski FE, et al. The risk of thromboembolism and need for oral anticoagulation after successful atrial fibrillation ablation. J Am Coll Cardiol 2010; 55:735-743.
4. Wazni OM, Marrouche NF, Martin DO, et al. Radiofrequency ablation vs. antiarrhythmic drugs as first-line treatment of symptomatic atrial fibrillation: a randomized trial. JAMA 2005; 293:2634-2640. (Pubitemid 40744248)
5. Wilber DJ, Pappone C, Neuzil P, et al. Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation: a randomized controlled trial. JAMA 2010; 303:333-340.
6. Krittayaphong R, Raungrattanaamporn O, Bhuripanyo K, et al. A randomized clinical trial of the efficacy of radiofrequency catheter ablation and amiodarone in the treatment of symptomatic atrial fibrillation. J Med Assoc Thai 2003; 86 (Suppl 1):S8-S16. (Pubitemid 36909283)
7. Stabile G, Bertaglia E, Senatore G, et al. Catheter ablation treatment in patients with drug-refractory atrial fibrillation: a prospective, multicentre, randomized, controlled study (Catheter Ablation For The Cure Of Atrial Fibrillation Study). Eur Heart J 2006; 27:216-221. (Pubitemid 43069040)
8. Oral H, Pappone C, Chugh A, et al. Circumferential pulmonary-vein ablation for chronic atrial fibrillation. N Engl J Med 2006; 354:934-941.
9. Pappone C, Augello G, Sala S, et al. A randomized trial of circumferential pulmonary vein ablation versus antiarrhythmic drug therapy in paroxysmal atrial fibrillation: the APAF Study. J Am Coll Cardiol 2006; 48:2340-2347. (Pubitemid 44856763)
10. Calo L, Lamberti F, Loricchio ML, et al. Left atrial ablation versus biatrial ablation for persistent and permanent atrial fibrillation: a prospective and randomized study. J Am Coll Cardiol 2006; 47:2504-2512. (Pubitemid 43866384)
11. Jais P, Cauchemez B, Macle L, et al. Catheter ablation versus antiarrhythmic drugs for atrial fibrillation: the A4 study. Circulation 2008; 118:2498-2505.
12. Khan MN, Jais P, Cummings J, et al. Pulmonary-vein isolation for atrial fibrillation in patients with heart failure. N Engl J Med 2008; 359:1778-1785.
13. Packer D. Catheter Ablation vs. Antiarrhythmi Drug Therapy for Atrial Fibrillation (CABANA). Presented at the ACC 2010 Annual Meeting. Atlanta, GA; 2010.
14. Packer D. Sustained treatment of paroxysmal atrial fibrillation (STOPAF). Presented at the ACC 2010 Annual Meeting. Atlanta, GA; 2010.
15. Nielsen J, Johannessen A, Raatikainen P, Hindricks G, Walfridsson H, Kongstad O, Pehrson S, Englund A, Hartikainen J, Mortensen L, Hansen P. A Randomized Multicenter Comparison of Radiofrequency Ablation and Antiarrhythmic Drug Therapy as First-Line Treatment in 294 Patients with Paroxysmal Atrial Fibrillation. Presented a the AHA 2011 Scientific Session (LBCT.03). http://my.americanheart.org/idc/groups/ahamahpublic/@ wcm/@sop/@scon/documents/ downloadable/ ucm-433720.pdf. [Accessed November 2011].
16. Oral H, Scharf C, Chugh A, et al. Catheter ablation for paroxysmal atrial fibrillation: segmental pulmonary vein ostial ablation versus left atrial ablation. Circulation 2003; 108:2355-2360. (Pubitemid 37413542)
17. Nakagawa H, Scherlag BJ, Lockwood DJ, et al. Localization of left atrial autonomic ganglionated plexuses using endocardial and epicardial high frequency stimulation in patients with atrial fibrillation. Heart Rhythm 2005; 2005:S10.
18. Pappone 0C, Santinelli V, Manguso F, et al. Pulmonary vein denervation enhances long-term benefit after circumferential ablation for paroxysmal atrial fibrillation. Circulation 2004; 109:327-334. (Pubitemid 38133899)
19. Marrouche NF, Martin DO, Wazni O, et al. Phased-array intracardiac echocardiography monitoring during pulmonary vein isolation in patients with atrial fibrillation: impact on outcome and complications. Circulation 2003; 107:2710-2716. (Pubitemid 36667245)
20. Pachon MJ, Pachon ME, Lobo TJ, et al. A new treatment for atrial fibrillation based on spectral analysis to guide the catheter RF-ablation. Europace 2004; 6:590-601. (Pubitemid 40378704)
21. Haissaguerre M, Jais P, Shah DC, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med 1998; 339:659-666. (Pubitemid 28402090)
22. Elayi CS, Di Biase L, Barrett C, et al. Atrial fibrillation termination as a procedural endpoint during ablation in long-standing persistent atrial fibrillation. Heart Rhythm 2010; 7:1216-1223.
23. Nademanee K, McKenzie J, Kosar E, et al. A new approach for catheter ablation of atrial fibrillation: mapping of the electrophysiologic substrate. J Am Coll Cardiol 2004; 43:2044-2053. (Pubitemid 38686799)
24. Wann LS, Curtis AB, January CT, et al. 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 Guidelines. Heart Rhythm 2011; 8:157-176.
25. Chen MS, Marrouche NF, Khaykin Y, et al. Pulmonary vein isolation for the treatment of atrial fibrillation in patients with impaired systolic function. J Am Coll Cardiol 2004; 43:1004-1009. (Pubitemid 38352980)
26. Efremidis M, Sideris A, Xydonas S, et al. Ablation of atrial fibrillation in patients with heart failure: reversal of atrial and ventricular remodelling. Hellenic J Cardiol 2008; 49:19-25. (Pubitemid 351499657)
27. Gentlesk PJ, Sauer WH, Gerstenfeld EP, et al. Reversal of left ventricular dysfunction following ablation of atrial fibrillation. J Cardiovasc Electrophysiol 2007; 18:9-14. (Pubitemid 44952735)
28. Hsu LF, Jais P, Sanders P, et al. Catheter ablation for atrial fibrillation in congestive heart failure. N Engl J Med 2004; 351:2373-2383.
29. Tondo C, Mantica M, Russo G, et al. Pulmonary vein vestibule ablation for the control of atrial fibrillation in patients with impaired left ventricular function. Pacing Clin Electrophysiol 2006; 29:962-970. (Pubitemid 44392884)
30. Catheter Ablation Versus Antiarrhythmic Drug Therapy for Atrial Fibrillation Trial (CABANA). http://www.clinicaltrials.gov/ct2/ show/NCT00911508?term=CABANA&rank=1. [Accessed January 2011].
31. Early Treatment of Atrial Fibrillation for Stroke Prevention Trial (EAST). http://www.clinicaltrials.gov/ct2/show/NCT01288352. [Accessed July 2011].
32. Ablation vs. Amiodarone for Treatment of AFib in Patients With CHF and an ICD (AATAC-HF). http://www.clinicaltrials.gov/ct2/show/ NCT00729911?term= AATAC&rank=1. [Accessed January 2011].
33. Catheter Ablation Versus Standard Conventional Treatment in Patients With Left Ventricular Dysfunction and Atrial Fibrillation (CASTLE-AF). http://www.clinicaltrials.gov/ct2/show/ NCT00643188?term=CASTLE+AF&rank=1. [Accessed January 2011].
34. Study of Ablation Versus antiaRrhythmic Drugs in Persistent Atrial Fibrillation (SARA). http://clinicaltrials.gov/ct2/show/ NCT00863213?term= SARA&rank=1. [Accessed January 2011].
35. First Line Radiofrequency Ablation Versus Antiarrhythmic Drugs for Atrial Fibrillation Treatment (The RAAFT Study). http://www.clinicaltrials.gov/ ct2/show/NCT00392054?term=RAAFT&rank=1. [Accessed January 2011].
36. Di Biase L, Burkhardt JD, Mohanty P, et al. Periprocedural stroke and management of major bleeding complications in patients undergoing catheter ablation of atrial fibrillation: the impact of periprocedural therapeutic international normalized ratio. Circulation 2010; 121:2550-2556.
37. Santangeli P, Di Biase L, Pelargonio G, et al. Ablation of atrial fibrillation under therapeutic INR reduces periprocedural complications: time to change the guidelines? Heart Rhythm 2011; 8:S86.
38. Di Biase L, Conti S, Mohanty P, et al. General anesthesia reduces the prevalence of pulmonary vein reconnection during repeat ablation when compared with conscious sedation: Results from a randomized study. Heart Rhythm 2011; 8:368-372.
39. Goode JS Jr, Taylor RL, Buffington CW, Klain MM, Schwartzman D. Highfrequency jet ventilation: utility in posterior left atrial catheter ablation. Heart Rhythm 2006; 3:13-19. (Pubitemid 43071883)
40. Di Biase L, Elayi CS, Fahmy TS, et al. Atrial fibrillation ablation strategies for paroxysmal patients: randomized comparison between different techniques. Circ Arrhythm Electrophysiol 2009; 2:113-119.
41. Gerstenfeld EP, Guerra P, Sparks PB, Hattori K, Lesh MD. Clinical outcome after radiofrequency catheter ablation of focal atrial fibrillation triggers. J Cardiovasc Electrophysiol 2001; 12:900-908. (Pubitemid 32751900)
42. Haissaguerre M, Shah DC, Jais P, et al. Electrophysiological breakthroughs from the left atrium to the pulmonary veins. Circulation 2000; 102:2463-2465.
43. Kanagaratnam L, Tomassoni G, Schweikert R, et al. Empirical pulmonary vein isolation in patients with chronic atrial fibrillation using a threedimensional nonfluoroscopic mapping system: long-term follow-up. Pacing Clin Electrophysiol 2001; 24:1774-1779. (Pubitemid 34066782)
44. Chen SA, Hsieh MH, Tai CT, et al. Initiation of atrial fibrillation by ectopic beats originating from the pulmonary veins: electrophysiological characteristics, pharmacological responses, and effects of radiofrequency ablation. Circulation 1999; 100:1879-1886.
45. Saad EB, Marrouche NF, Natale A. Ablation of atrial fibrillation. Curr Cardiol Rep 2002; 4:379-387.
46. Marrouche NF, Dresing T, Cole C, et al. Circular mapping and ablation of the pulmonary vein for treatment of atrial fibrillation: impact of different catheter technologies. J Am Coll Cardiol 2002; 40:464-474. (Pubitemid 34833161)
47. Verma A, Marrouche NF, Natale A. Pulmonary vein antrum isolation: intracardiac echocardiography-guided technique. J Cardiovasc Electrophysiol 2004; 15:1335-1340. (Pubitemid 39612646)
48. Khaykin Y, Skanes A, Champagne J, et al. A randomized controlled trial of the efficacy and safety of electroanatomic circumferential pulmonary vein ablation supplemented by ablation of complex fractionated atrial electrograms versus potential-guided pulmonary vein antrum isolation guided by intracardiac ultrasound. Circ Arrhythm Electrophysiol 2009; 2:481-487.
49. Corrado A, Bonso A, Madalosso M, et al. Impact of systematic isolation of superior vena cava in addition to pulmonary vein antrum isolation on the outcome of paroxysmal, persistent, and permanent atrial fibrillation ablation: results from a randomized study. J Cardiovasc Electrophysiol 2010; 21:1-5.
50. Karch MR, Zrenner B, Deisenhofer I, et al. Freedom from atrial tachyarrhythmias after catheter ablation of atrial fibrillation: a randomized comparison between 2 current ablation strategies. Circulation 2005; 111:2875-2880. (Pubitemid 40814179)
51. Chugh A, Oral H, Good E, et al. Catheter ablation of atypical atrial flutter and atrial tachycardia within the coronary sinus after left atrial ablation for atrial fibrillation. J Am Coll Cardiol 2005; 46:83-91 (Pubitemid 40905134)
52. Arruda M, Mlcochova H, Prasad SK, et al. Electrical isolation of the superior vena cava: an adjunctive strategy to pulmonary vein antrum isolation improving the outcome of AF ablation. J Cardiovasc Electrophysiol 2007; 18:1261-1266. (Pubitemid 350115776)
53. Elayi CS, Verma A, Di Biase L, et al. Ablation for longstanding permanent atrial fibrillation: results from a randomized study comparing three different strategies. Heart Rhythm 2008; 5:1658-1664.
54. Li WJ, Bai YY, Zhang HY, et al. Additional ablation of complex fractionated atrial electrograms (CFAEs) after pulmonary vein isolation (PVAI) in patients with atrial fibrillation: a meta-analysis. Circ Arrhythm Electrophysiol 2011; 4:143-148.
55. Webb S, Kanani M, Anderson RH, Richardson MK. Brown NA: Development of the human pulmonary vein and its incorporation in the morphologically left atrium. Cardiol Young 2001; 11:632-642. (Pubitemid 33768609)
56. Oral H, Chugh A, Good E, et al. Randomized comparison of encircling and nonencircling left atrial ablation for chronic atrial fibrillation. Heart Rhythm 2005; 2:1165-1172. (Pubitemid 41614159)
57. Konings KT, Smeets JL, Penn OC, Wellens HJ, AllessieMA. Configuration of unipolar atrial electrograms during electrically induced atrial fibrillation in humans. Circulation 1997; 95:1231-1241. (Pubitemid 27097835)
58. Haissaguerre M, Hocini M, Sanders P, et al. Catheter ablation of longlasting persistent atrial fibrillation: clinical outcome and mechanisms of subsequent arrhythmias. J Cardiovasc Electrophysiol 2005; 16:1138-1147.
59. Haissaguerre M, Sanders P, Hocini M, et al. Catheter ablation of longlasting persistent atrial fibrillation: critical structures for termination. J Cardiovasc Electrophysiol 2005; 16:1125-1137.
60. O'Neill MD, Wright M, Knecht S, et al. Long-term follow-up of persistent atrial fibrillation ablation using termination as a procedural endpoint. Eur Heart J 2009; 30:1105-1112.
61. Hayward RM, Upadhyay GA, Mela T, et al. Pulmonary vein isolation with complex fractionated atrial electrogram ablation for paroxysmal and nonparoxysmal atrial fibrillation: a meta-analysis. Heart Rhythm 2011; 8:994-1000.
62. Scherlag BJ, Yamanashi W, Patel U, Lazzara R, Jackman WM. Autonomically induced conversion of pulmonary vein focal firing into atrial fibrillation. J Am Coll Cardiol 2005; 45:1878-1886. (Pubitemid 40779871)
63. Nakagawa H, Jackman WM, Scherlag BJ, et al. Relationship of complex fractionated atrial electrograms during atrial fibrillation to the location of cardiac automatic ganglionated plexi in patients with atrial fibrillation. Circulation 2005; 112:II-746.
64. Zipes DP, Mihalick MJ, Robbins GT. Effects of selective vagal and stellate ganglion stimulation of atrial refractoriness. Cardiovasc Res 1974; 8:647-655.
65. Scherlag BJ, Yamanashi WS, Schauerte P, et al. Endovascular stimulation within the left pulmonary artery to induce slowing of heart rate and paroxysmal atrial fibrillation. Cardiovasc Res 2002; 54:470-475. (Pubitemid 34327926)
66. Scanavacca M, Pisani CF, Hachul D, et al. Selective atrial vagal denervation guided by evoked vagal reflex to treat patients with paroxysmal atrial fibrillation. Circulation 2006; 114:876-885. (Pubitemid 44337130)
67. Katritsis DG, Giazitzoglou E, Zografos T, et al. Rapid pulmonary vein isolation combined with autonomic ganglia modification: a randomized study. Heart Rhythm 2011; 8:672-678.
68. Arruda M, Natale A. The adjunctive role of nonpulmonary venous ablation in the cure of atrial fibrillation. J Cardiovasc Electrophysiol 2006; 17:S37-S43.
69. Verma A, Saliba WI, Lakkireddy D, et al. Vagal responses induced by endocardial left atrial autonomic ganglion stimulation before and after pulmonary vein antrum isolation for atrial fibrillation. Heart Rhythm 2007; 4:1177-1182. (Pubitemid 47324115)
70. Hwang C, Wu TJ, Doshi RN, Peter CT, Chen PS. Vein of Marshall cannulation for the analysis of electrical activity in patients with focal atrial fibrillation. Circulation 2000; 101:1503-1505. (Pubitemid 30180884)
71. Jais P, Haissaguerre M, Shah DC, et al. A focal source of atrial fibrillation treated by discrete radiofrequency ablation. Circulation 1997; 95:572-576. (Pubitemid 27063030)
72. Valderrabano M, Liu X, Sasaridis C, et al. Ethanol infusion in the vein of Marshall: adjunctive effects during ablation of atrial fibrillation. Heart Rhythm 2009; 6:1552-1558.
73. Valderrabano M, Chen HR, Sidhu J, et al. Retrograde ethanol infusion in the vein of Marshall: regional left atrial ablation, vagal denervation and feasibility in humans. Circ Arrhythm Electrophysiol 2009; 2:50-56.
74. Verma A, Wazni OM, Marrouche NF, et al. Preexistent left atrial scarring in patients undergoing pulmonary vein antrum isolation: an independent predictor of procedural failure. J Am Coll Cardiol 2005; 45:285-292. (Pubitemid 40094739)
75. Di Biase L, Burkhardt JD, Mohanty P, et al. Left atrial appendage: an underrecognized trigger site of atrial fibrillation. Circulation 2010; 122:109-118.
76. Pappone C, Vicedomini G, Manguso F, et al. Robotic magnetic navigation for atrial fibrillation ablation. J Am Coll Cardiol 2006; 47:1390-1400.
77. Di Biase L, Fahmy TS, Patel D, et al. Remote magnetic navigation: human experience in pulmonary vein ablation. J Am Coll Cardiol 2007; 50:868-874. (Pubitemid 47268747)
78. Miyazaki S, Shah AJ, Xhaet O, et al. Remote magnetic navigation with irrigated tip catheter for ablation of paroxysmal atrial fibrillation. Circ Arrhythm Electrophysiol 2010; 3:585-589.
79. Chun KR, Wissner E, Koektuerk B, et al. Remote-controlled magnetic pulmonary vein isolation using a new irrigated-tip catheter in patients with atrial fibrillation. Circ Arrhythm Electrophysiol 2010; 3:458-464.
80. Pappone C, Vicedomini G, Frigoli E, et al. Irrigated-tip magnetic catheter ablation of AF: a long-term prospective study in 130 patients. Heart Rhythm 2011; 8:8-15.
81. Wazni OM, Barrett C, Martin DO, et al. Experience with the Hansen robotic system for atrial fibrillation ablation - lessons learned and techniques modified: Hansen in the real world. J Cardiovasc Electrophysiol 2009; 20:1193-1196.
82. Saliba W, Reddy VY, Wazni O, et al. Atrial fibrillation ablation using a robotic catheter remote control system: initial human experience and longterm follow-up results. J Am Coll Cardiol 2008; 51:2407-2411. (Pubitemid 351815165)
83. Di Biase L, Wang Y, Horton R, et al. Ablation of atrial fibrillation utilizing robotic catheter navigation in comparison to manual navigation and ablation: single-center experience. J Cardiovasc Electrophysiol 2009; 20:1328-1335.
84. Schmidt B, Tilz RR, Neven K, et al. Remote robotic navigation and electroanatomical mapping for ablation of atrial fibrillation: considerations for navigation and impact on procedural outcome. Circ Arrhythm Electrophysiol 2009; 2:120-128.
85. Hlivak P, Mlcochova H, Peichl P, et al. Robotic navigation in catheter ablation for paroxysmal atrial fibrillation: midterm efficacy and predictors of postablation arrhythmia recurrences. J Cardiovasc Electrophysiol 2011; 22:534-540.
86. Di Biase L, Davies W, Horton R, et al. Acute complication rate with the robotic navigation for catheter of atrial fibrilation: the worldwide experience. Circulation 2008; 118:S978-S979.
87. Cabrera JA, Murillo M, Climent V, et al. Relationship between the left recurrent laryngeal nerve and left atrium: A postmortem study in patients with and without atrial fibrillation. Heart Rhythm 2011; 8:S413.
88. Natale A, Pisano E, Shewchik J, et al. First human experience with pulmonary vein isolation using a through-the-balloon circumferential ultrasound ablation system for recurrent atrial fibrillation. Circulation 2000; 102:1879-1882.
89. Metzner A, Chun KR, Neven K, et al. Long-term clinical outcome following pulmonary vein isolation with high-intensity focused ultrasound balloon catheters in patients with paroxysmal atrial fibrillation. Europace 2010; 12:188-193.
90. Reddy VY, Neuzil P, Themistoclakis S, et al. Visually-guided balloon catheter ablation of atrial fibrillation: experimental feasibility and first-inhuman multicenter clinical outcome. Circulation 2009; 120:12-20.
91. Dukkipati SR, Neuzil P, Skoda J, et al. Visual balloon-guided point-by-point ablation: reliable, reproducible, and persistent pulmonary vein isolation. Circ Arrhythm Electrophysiol 2010; 3:266-273.
92. Boersma LV, Wijffels MC, Oral H, Wever EF, Morady F. Pulmonary vein isolation by duty-cycled bipolar and unipolar radiofrequency energy with a multielectrode ablation catheter. Heart Rhythm 2008; 5:1635-1642.
93. Kistler PM. Multielectrode ablation for paroxysmal atrial fibrillation: pulmonary vein isolation made easy? Heart Rhythm 2008; 5:1643-1644.
94. Di Biase L, Natale A, Barrett C, et al. Relationship between catheter forces, lesion characteristics, 'popping,' and char formation: experience with robotic navigation system. J Cardiovasc Electrophysiol 2009; 20:436-440.
95. Nakagawa H, Kautzner J, Natale A, et al. Electrogram amplitude and impedance are poor predictors of electrode-tissue contact force in ablation of atrial fibrillation. Heart Rhythm 2010; 7:S65.
96. Kuck KH. TOCCATA European Clinical Study: first multiclinical study using irrigated ablation catheters with an integrated contact force sensor. Presented at Boston Atrial Fibrillation Symposium, 2010.
97. Neuzil P, Shah D, Herrera C, et al. Does catheter contact force during RF ablation relate to AF recurrence rate? Presented at Cardiostim 2010.
98. Khaykin Y, Marrouche NF, Saliba W, et al. Pulmonary vein antrum isolation for treatment of atrial fibrillation in patients with valvular heart disease or prior open heart surgery. Heart Rhythm 2004; 1:33-39. (Pubitemid 38647246)
99. Di Biase L, Mohanty P, Raviele A, et al. Preliminary results from AATAC: ablation vs. amiodarone for the treatment of persistent and long standing persistent atrial fibrillation in patients with congestive heart failure. Circulation 2010; 122:A17358.
100. Atrial Fibrillation Management in Congestive Heart Failure With Ablation (AMICA). http://clinicaltrials.gov/ct2/show/NCT00652522. [Accessed June 2011].
101. Catheter Ablation Versus Medical Rate Control for Atrial Fibrillation in Patients With Heart Failure (ARC-HF). http://clinicaltrials.gov/ct2/show/ NCT00878384. [Accessed June 2011].