Challenge and Strategy of Therapy in Patients with Chronic Atrial Fibrillation

Among other topics, this article discusses showing that catheter ablation guided by complex fractionated atrial electrograms (CFAE) is a viable alternative treatment for atrial fibrillation (AF) in the elderly, and reviewed some of these ablation strategies with a focus on 3D automated CFAE-guided right atrium ablation. The article also presents results from a prospective randomized study that assessed the comparative efficacy of a stepwise ablation approach and a simplified approach consisting of two circumferential pulmonary vein antrum isolations and three linear atrial ablations in patients with persistent AF.