Atrial Fibrillation Ablation, 2011 Update E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 355

Veröffentlichungsjahr: 2011

Beschreibung

This concise text presents best practices for all aspects of atrial fibrillation ablation as outlined in the new version of the VeniceChart International Consensus document, which is presented in conjunction with the biannual Venice Arrhythmias conference. In addition to discussing the latest in a-fib ablation research, this 2011 update covers all the key areas of therapy and patient management, including: * Techniques and technologies * Procedural endpoints * Patient management pre-, peri- and post-ablation * Prevention and treatment of complications * Definition of success and long-term results With contributions from the world's recognized thought leaders in this field, this book is a highly valuable source of information not only for specialists in electrophysiology, but also for general cardiologists, fellows in cardiology and others interested in this dynamic and increasingly important topic.

Leseprobe

Contents

Cover

Title Page

Copyright

Advertisement

Preface

List of contributors

VeniceChart task force composition

VeniceChart Task Force Co-Chairmen

VeniceChart Task Force Working Groups

List of abbreviations

CHAPTER 1: Anatomy of structures relevant to atrial fibrillation ablation

Introduction

Left atrium

Pulmonary veins

Atrial septum/fossa ovalis

Superior vena cava

Left atrial appendage

Left atrial ridge and ligament of Marshall

Mitral isthmus

Interatrial conduction pathways alternative to Bachmann's bundle

Ganglionated plexi

Phrenic nerves

Esophagus

Conclusions

CHAPTER 2: Pathophysiology of atrial fibrillation

Introduction

Diseases associated with AF and the role of fibrosis

Genetic factors and ion channel diseases

Electrophysiological mechanisms

CHAPTER 3: Techniques and technologies for atrial fibrillation catheter ablation

PV isolation

Segmental/ostial PV isolation

Circumferential PV ablation

Circumferential/antral PVI

New tools and techniques to perform PV isolation

Electrogram-based ablation or CFAE ablation

Linear lesions

Autonomic GP ablation

Localization of left atrial GP by endocardial high-frequency stimulation

Catheter ablation of left atrial GP

Ablation of AF nests guided by real-time spectral mapping in sinus rhythm

Sequential ablation strategy

Future technologies

CHAPTER 4: Endpoints of catheter ablation for atrial fibrillation

PV isolation

Electrogram-based ablation or CFAEs ablation

Linear lesions

Autonomic GP ablation

Coronary sinus and other thoracic veins ablation

CHAPTER 5: Patient management pre-, during-, and postablation

Preablation management

Informed consent and preablation fasting

Management during ablation

Postprocedural management

Rhythm outcome

Antiarrhythmic therapy

Late surveillance

CHAPTER 6: Periprocedural and long-term anticoagulation

Introduction

Preablation anticoagulation and TEE

Anticoagulation during the ablation procedure

Postablation anticoagulation

CHAPTER 7: Periprocedural and late complications

Cardiac tamponade

Thromboembolic events

PV stenosis

PN injury

Atrioesophageal fistula

Periesophageal vagal injury

Vascular complications

Acute coronary artery injury

Air emboli

Catheter entrapment in the MV or PV

Organized left atrial tachyarrhythmias after AF ablation

Adverse impact on atrial contractility

Radiation exposure during catheter ablation of AF

CHAPTER 8: Short- and long-term efficacy of catheter ablation procedures for atrial fibrillation

Introduction

Definition of success

Acute efficacy of AF ablation

Mid- to long-term efficacy of AF ablation

Very long-term efficacy of AF ablation

Efficacy in nonparoxysmal AF

Mechanisms of AF ablation failure

Conclusion

CHAPTER 9: Indications to atrial fibrillation ablation and cost-effectiveness

Indications to catheter ablation of AF

Cost-effectiveness of catheter ablation

CHAPTER 10: Clinical trials on atrial fibrillation/ future perspectives

Catheter ablation compared with AADs as technique to maintain sinus rhythm

QoL, symptoms, and hospitalization

Meta-analyses of randomized trials comparing catheter ablation and AAD treatment

Effect on survival and TEs

Complications

Economic aspects

Perspectives onto measuring QoL in AF trials

Perspectives onto ongoing trials on catheter ablation of AF

Trials focused on mortality, hospitalizations, and stroke

Trials testing the effectiveness of catheter ablation early in the treatment of AF

Trials of AF ablation in patients with heart failure

Trials of AF ablation in patients with persistent and long-standing persistent AF

CHAPTER 11: Surgical approach/ablation

Historical aspects

Development of the CMP

Surgical ablation technology

Indications

Surgical techniques and outcomes

PVI, expanded lesion sets, hybrid

CHAPTER 12: Hospital equipment and facilities, personnel, training requirements, and competences

Hospital equipment, facilities, and technological requirements

Training and knowledge

Technical competence

Management of complications

Follow-up

Index

This edition first published 2011, © 2011 by John Wiley & Sons, Ltd.

Wiley-Blackwell is an imprint of John Wiley & Sons, formed by the merger of Wiley's global Scientific, Technical and Medical business with Blackwell Publishing.

Registered office: John Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

Editorial offices: 9600 Garsington Road, Oxford, OX4 2DQ, UK

The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

111 River Street, Hoboken, NJ 07030-5774, USA

For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell.

The right of the author to be identified as the author of this work has been asserted in accordance with the UK Copyright, Designs and Patents Act 1988.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher.

Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought.

The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting a specific method, diagnosis, or treatment by physicians for any particular patient. The publisher and the author make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of fitness for a particular purpose. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. Readers should consult with a specialist where appropriate. The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read. No warranty may be created or extended by any promotional statements for this work. Neither the publisher nor the author shall be liable for any damages arising herefrom.

Library of Congress Cataloging-in-Publication Data is available for this title

A catalogue record for this book is available from the British Library.

This book is published in the following electronic formats: ePDF 9781119963837; Wiley Online Library 9781119963868; ePub 9781119963844; Mobi 9781119963851

Preface

This book represents the extended version of the VeniceChart International Consensus Document on Atrial Fibrillation Ablation, 2011 Update, and includes the recent technological developments and progress on atrial fibrillation (AF) since our last edition. AF ablation has become a well-etablished, widespread treatment not only for patients with paroxysmal AF but also for patients with persistent and long-lasting persistent AF and is recognized by the most recent European and American guidelines on AF management.

As the list of contributors shows, many renowned experts have contributed to the preparation of the VeniceChart International Consensus Document and to the realization of this book. We are deeply indebted to all of them because without their enthusiasm and personal effort this volume would not have been possible. We also wish to acknowledge the unparalleled editorial work of Nick Godwin, Cathryn Gates, and Elisabeth Dodds of Wiley-Blackwell Publishers, as well as the invaluable dedication and assistance of Rita Reggiani, Raffaella Pieri, and Ludovica Fontana of Adria Congrex. Our heartfelt thanks go to our colleagues at the Texas Cardiac Arrhythmia Institute, in Austin, Texas, and at Ospedale Dell'Angelo, in Venice-Mestre, for the preparation and realization of both the VeniceChart International Consensus Document and the VeniceArrhythmias 2011 Workshop. In particular, we thank Drs Aldo Bonso, David J. Burkhardt, Andrea Corrado, Luigi Di Biase, Gianni Gasparini, Franco Giada, Michela Madalosso, Antonio Rossillo, Pasquale Santangeli, and Sakis Themistoclakis.

Last but not least, our gratitude goes to our families, without whose patience and continuous support we could not have accomplished this task. We are profoundly thankful to our wives, Carmen and Marina, our children, Francesca, Michele, Veronica, Eleonora, and grandchild Edoardo.

Andrea NataleAntonio Raviele

List of contributors

Pedro Adragao, MD Cardiology Department Hospital Santa Cruz Carnaxide, Portugal

Etienne Aliot, MD Cardio-vascular Diseases Department CHU de Brabois, Vandoeuvre-lès-Nancy, France

Maurits Allessie, MD Cardiovascular Research Institute Maastricht Maastricht, The Netherlands

Charles Antzelevitch, MD Masonic Medical Research Laboratory Utica, NY, USA

Thomas Arentz, MD Rhythmology Department Herz-Zentrum Bad Krozingen, Germany

Conor Barrett, MD Cardiac Arrhythmia Service Massachusetts General Hospital Boston, MA, USA

Cristina Basso, MD Cardiovascular Pathology Department University of Padua Medical School Padua, Italy

Stefano Benussi, MD Cardiac Surgery Department San Raffaele Hospital Milan, Italy

Antonio Berruezo, MD Cardiology Department Clinic Hospital Barcelona, Spain

Emanuele Bertaglia, MD Cardiology Department ULSS 13 Mirano Mirano, Italy

Carina Blomström-Lundqvist, MD Cardiology Department University Hospital in Uppsala Uppsala, Sweden

Aldo Bonso, MD Cardiovascular Department Dell'Angelo Hospital Venice-Mestre, Italy

Johannes Brachmann, MD Cardiology Department II Med Klinik Klinikum Coburg Coburg, Germany

Josep Brugada, MD Cardiology Department Thorax Institute, Clinic of Barcelona Barcelona, Spain

David J. Burkhardt, MD Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin, TX, USA

José A. Cabrera, MD Arrhythmia Unit, Cardiology Department Quirón Hospital, Universidad Europea de Madrid Madrid, Spain

Hugh Calkins, MD Cardiology and Electrophysiology Department The Johns Hopkins Hospital Baltimore, MD, USA

David Callans, MD Cardiovascular Disease Department Hospital of the University of Pennsylvania Philadelphia, PA, USA

A. John Camm, MD Cardiac and Vascular Sciences St. George's Hospital Medical School London, UK

Riccardo Cappato, MD Electrophysiology Department Policlinico S. Donato San Donato Milanese, Italy

Shih-Ann Chen, MD Cardiology Department Veterans General Hospital Taipei, Taiwan

Stuart J. Connolly, MD Cardiology Department McMaster University Hamilton, ON, Canada

Andrea Corrado, MD Cardiology Department Dell'Angelo Hospital Venice-Mestre, Italy

Ralph Damiano Jr., MD Cardiothoracic Surgery Department Washington University in St. Louis-School of Medicine St. Louis, MO, USA

Roberto De Ponti, MD Cardiology Department Circolo Hospital and Macchi Foundation Varese, Italy

Paolo Della Bella, MD Cardiology Department San Raffaele Hospital Milan, Italy

Luigi Di Biase, MD Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin, TX, USA

Paul Dorian, MD Cardiology Department St. Michael's Hospital Toronto, ON, Canada

James R. Edgerton, MD Cardiothoracic Surgery Department The Heart Hospital Dallas, TX, USA

Sabine Ernst, MD National Heart and Lung Institute Royal Brompton and Harefield Hospital Imperial CollegeLondon, UK

Jeronimo Farré, MD Cardiology Department Jiménez Díaz-Capio Foundation Madrid, Spain

Fiorenzo Gaita, MD Internal Medicine Department University of Turin Turin, Italy

Edward B. Gerstenfeld, MD Cardiac Electrophysiology Department University of California San Francisco, CA, USA

Michel Haïssaguerre, MD Cardiology Department Hôpital Haut-Lévêque, CHU de Bordeaux Bordeaux, France

Gerhard Hindricks, MD Herzzentrum Leitender Arzt Universität Leipzig Leipzig, Germany

Siew Y. Ho, MD Cardiac Morphology Department Royal Brompton Hospital Imperial College, London, UK

Mélèze Hocini, MD Cardiology Department Hôpital Haut-Lévêque, CHU de Bordeaux Bordeaux, France

Stefan H. Hohnloser, MD Electrophysiology Department J.W. Goethe University Frankfurt, Germany

Rodney P. Horton, MD Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin, TX, USA

Yoshito Iesaka, MD Tsuchiura Kyodo Hospital Tsuchiura City, Japan

Warren M. Jackman, MD Heart Rhythm Institute Oklahoma City, OK, USA

Pierre Jaïs, MD Cardiology Department Hôpital Haut-Lévêque, CHU de Bordeaux Bordeaux, France

José Jalife, MD University of Michigan Ann Arbor, MI, USA

Luc J. Jordaens, MD Thoraxcenter, Clinical Electrophysiology Department Erasmus MC Rotterdam, The Netherlands

Jonathan M. Kalman, MD Cardiology Department Royal Melbourne and Western Hospitals Melbourne, Australia

Josef Kautzner, MD Cardiology Department Institute for Clinical and Experimental Medicine Prague, Czech Republic

David Keane, MD Cardiology Department St. Vincent's University Hospital Dublin, Ireland

Young-Hoon Kim, MD Cardiology and Electrophysiology Department Korea University Medical Center Seoul, South Korea

Paulus Kirchhof, MD School of Clinical & Experimental Medicine University of Birmingham Birmingham, UK

Hans Kottkamp, MD Herz-Zentrum Hirslanden Clinic Zürich, Switzerland

Karl H. Kuck, MD Cardiology Department Asklepios Klinik St. Georg Hamburg, Germany

Chu-Pak Lau, MD Cardiology Department University of Hong Kong-Queen Mary Hospital Hong Kong

Samuel Lévy, MD Cardiology Department CHU Hôpital Nord Marseille, France

Gregory Y.H. Lip, MD University Department of Medicine City HospitalBirmingham, UK

Jos G. Maessen, MD Cardiothoracic Surgery Department University of Maastricht Maastricht, The Netherlands

Helmut Mair, MD Cardiac Surgery Department University of Munich Munich, Germany

Domenico Mangino, MD Cardiovascular Department Dell'Angelo Hospital Venice-Mestre, Italy

Moussa Mansour, MD Cardiac Arrhythmia Department Massachusetts General Hospital Boston, MA, USA

Francis E. Marchlinski, MD Cardiovascular Division Hospital of the University of Pennsylvania Philadelphia, PA, USA

José L. Merino, MD Cardiology Department La Paz University Hospital Madrid, Spain

Gregory F. Michaud, MD Center for Advanced Management of Atrial Fibrillation Brigham and Women's Hospital Boston, MA, USA

Carlos A. Morillo, MD Arrhythmia & Pacing Department Hamilton General Hospital Hamilton, ON, Canada

Hiroshi Nakagawa, MD Heart Rhythm Institute University of Oklahoma Health Sciences Center Oklahoma City, OK, USA

Andrea Natale, MD Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin, TX, USA

Hakan Oral, MD Cardiovascular Medicine Department University of MichiganAnn Arbor, MI, USA

Douglas L. Packer, MD Heart Rhythm Services Mayo Clinic Health Systems/St. Mary's Hospital Rochester, NY, USA

Carlo Pappone, MD Arrhythmology Department Villa Maria Cecilia Hospital Cotignola, Italy

Eric N. Prystowsky, MD Clinical Electrophysiology Laboratory St. Vincent Indianapolis Hospital Indianapolis, IN, USA

Antonio Raviele, MD Cardiovascular Department Arrhythmia Center & Center for Atrial Fibrillation Dell'Angelo Hospital Venice-Mestre, Italy

Vivek Y. Reddy, MD Cardiac Arrhythmia Department The Zena and Michael A. Wiener Cardiovascular Institute New York, NY, USA

Matthew Reynolds, MD Beth Israel Deaconess Medical Center Harvard Clinical Research Institute Boston, MA, USA

Antonio Rossillo, MD Cardiovascular Department Dell'Angelo Hospital Venice-Mestre, Italy

Eduardo Saad, MD Center for Atrial Fibrillation Pro-Cardiaco Hospital Rio de Janeiro, Brazil

Javier E. Sanchez, MD Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin, TX, USA

Prashanthan Sanders, MD Centre for Heart Rhythm Disorders Royal Adelaide Hospital North Terrace, Adelaide, Australia

Pasquale Santangeli, MD Texas Cardiac Arrhythmia Institute St. David's Medical Center Austin, TX, USA

Vincenzo Santinelli, MD Arrhythmology Department Villa Maria Cecilia Hospital Cotignola, Italy

Mauricio Scanavacca, MD Heart Institute University of Sao Paulo Medical School Sao Paulo, Brazil

Martin J. Schalij, MD Cardiology Department Leiden Hospital Leiden, The Netherlands

Melvin M. Scheinman, MD Cardiac Electrophysiology Department University of California San Francisco, CA, USA

Richard J. Schilling, MD Cardiology Department St Bartholomew's Hospital London, UK

Robert A. Schweikert, MD Cardiology Department Akron General Medical Center Akron, OH, USA

Dipen Shah, MD Cardiology Cantonal Hospital of Geneva Geneva, Switzerland

Kalyanam Shivkumar, MD UCLA Cardiac Arrhythmia Center David Geffen School of Medicine at UCLA Los Angeles, CA, USA

Jasbir Sra, MD Aurora Cardiovascular Services Aurora Sinai Medical Center Milwaukee, WI, USA

Sakis Themistoclakis, MD Cardiovascular Department Dell'Angelo Hospital Mestre, Italy

Claudio Tondo, MD Arrhythmology Department Centro Cardiologico Monzino Milan, Italy

Isabelle C. van Gelder, MD Cardiology Department University Medical Center Groningen Groningen, The Netherlands

Panos E. Vardas, MD Cardiology Department Heraklion University Hospital Heraklion, Greece

Atul Verma, MD Cardiology Department Southlake Regional Health Center Toronto, ON, Canada

Albert L. Waldo, MD Harrington-McLaughlin Heart & Vascular Institute Division of Cardiovascular Medicine University Hospitals Case Medical Center Cleveland, OH, USA

David J. Wilber, MD Cardiology Department Loyola University Medical Center Chicago, IL, USA

Stephan Willems, MD Cardiology and Electrophysiology Department Herzzentrum Hamburg GmbH University Hamburg, Germany

Erik Wissner, MD Cardiology Department Asklepios Klinik St. Georg Hamburg, Germany

Francesca Zuffada, MD Arrhythmology Department Villa Maria Cecilia Hospital Cotignola, Italy

VeniceChart task force composition

VeniceChart Task Force Co-Chairmen

Andrea Natale, MD, FACC, FESC, FHRS

Antonio Raviele, MD, FESC, FHRS

VeniceChart Task Force Working Groups

Anatomy of structures relevant to atrial fibrillation ablation

Siew Y. Ho, MD—Working Group Chairman

Cristina Basso, MD

José A. Cabrera, MD

Andrea Corrado, MD

Jeronimo Farré, MD

Josef Kautzner, MD

Roberto De Ponti, MD—Working Group Liaison Member

Pathophysiology of atrial fibrillation

José Jalife, MD—Working Group Chairman

Maurits Allessie, MD

Charles Antzelevitch, MD

Yoshito Iesaka, MD

Warren M. Jackman, MD

Melvin M. Scheinman, MD

Shih-Ann Chen, MD—Working Group Liaison Member

Techniques and technologies for atrial fibrillation catheter ablation

Karl H. Kuck, MD—Working Group Chairman

Pedro Adragao, MD

David J. Burkhardt, MD

Pierre Jaïs, MD

David Keane, MD

Hiroshi Nakagawa, MD

Robert A. Schweikert, MD

Jasbir Sra, MD

Vivek K. Reddy, MD—Working Group Liaison Member

Endpoints of catheter ablation for atrial fibrillation

Michel Haïssaguerre, MD—Working Group Chairman

Conor Barrett, MD

Luigi Di Biase, MD

Sabine Ernst, MD

Fiorenzo Gaita, MD

Javier E. Sanchez, MD

Prashanthan Sanders, MD

Richard J. Schilling, MD

Stephan Willems, MD—Working Group Liaison Member

Patient management pre-, during-, and postablation

David J. Wilber, MD—Working Group Chairman

Etienne Aliot, MD

Edward B. Gerstenfeld, MD

Chu-Pak Lau, MD

Martin J. Schalij, MD

Dipen Shah, MD

Hans Kottkamp, MD—Working Group Liaison Member

Periprocedural and long-term anticoagulation

Stuart J. Connolly, MD—Working Group Chairman

David Callans, MD

Mélèze Hocini, MD

Gregory Y.H. Lip, MD

Gregory F. Michaud, MD

Albert L. Waldo, MD

Sakis Themistoclakis, MD—Working Group Liaison Member

Periprocedural and late complications

Francis E. Marchlinski, MD—Working Group Chairman

Thomas Arentz, MD

Rodney P. Horton, MD

Hakan Oral, MD

Antonio Rossillo, MD

Eduardo Saad, MD

Mauricio Scanavacca, MD

Riccardo Cappato, MD—Working Group Liaison Member

Short- and long-term efficacy of catheter ablation procedures for atrial fibrillation

Hugh Calkins, MD—Working Group Chairman

Emanuele Bertaglia, MD

Antonio Berruezo, MD

Aldo Bonso, MD

Jonathan M. Kalman, MD

Moussa Mansour, MD

Atul Verma, MD—Working Group Liaison Member

Indications to atrial fibrillation ablation and cost-effectiveness

Eric N. Prystowsky, MD—Working Group Chairman

Josep Brugada, MD

Samuel Lévy, MD

Matthew Reynolds, MD

Vincenzo Santinelli, MD

Panos E. Vardas, MD

Francesca Zuffada, MD

Carlo Pappone, MD—Working Group Liaison Member

Clinical trials on atrial fibrillation/future perspectives

A. John Camm, MD—Working Group Chairman

Carina Blomström-Lundqvist, MD

Paul Dorian, MD

Stefan H. Hohnloser, MD

Carlos A. Morillo, MD

Pasquale Santangeli, MD

Isabelle C. van Gelder, MD

Erik Wissner, MD

Paulus Kirchhof, MD—Working Group Liaison Member

Surgical approach/ablation

Ralph Damiano Jr.—Working Group Chairman

Stefano Benussi, MD

Young-Hoon Kim, MD

Jos G. Maessen, MD

Helmut Mair, MD

Domenico Mangino, MD

Kalyanam Shivkumar, MD

James R. Edgerton—Working Group Liaison Member

Hospital equipment and facilities, personnel, training requirements, and competences

Douglas L. Packer, MD—Working Group Chairman

Johannes Brachmann, MD

Paolo Della Bella, MD

Luc J. Jordaens, MD

José L. Merino, MD

Claudio Tondo, MD

Gerhard Hindricks, MD—Working Group Liaison Member

List of abbreviations

2D two-dimensional 3D three-dimensional 7-d HM 7-day Holter monitoring AA antiarrhythmic AADs antiarrhythmic drugs AATACAblation versus Amiodarone for Treatment of Afib in patients with CHF ACC American College of Cardiology ACGME American Accreditation Council of Graduate Medical Education ACT activated clotting time ADVICEAD enosine following pulmonary Vein Isolation to target dormant Conduction Elimination AF atrial fibrillation AF-CHF atrial fibrillation and congestive heart failure AFL atrial flutter AFNETAtrial Fibrillation competence NETwork AFSS atrial fibrillation severity scale AHA American Heart Association AMICAAtrial fibrillation Management In Congestive heart failure with Ablation APAFAblation for Paroxysmal Atrial Fibrillation APD action potential duration ARC-HFAblation versus medical Rate Control for atrial fibrillation in patients with Heart Failure AVN AV node AVRT/AVNRT atrioventricular reciprocating tachycardia/atrioventricular nodal reciprocating tachycardia CABANACatheter ABlation versus ANtiarrhythmic drug therapy for Atrial Fibrillation CABG coronary artery bypass grafting CACAFCatheter Ablation for the Cure of Atrial Fibrillation CAF chronic atrial fibrillation CECC conventional extra-corporeal circulation CFAE complex fractionated atrial electrogram CFE complex fractionated electrograms CHADSCongestive heart failure Hypertension Age Diabetes Stroke CHF congestive heart failure CMC circular mapping catheter CMP Cox-maze procedure CO cross over CPVA circumferential pulmonary vein ablation CS coronary sinus CT computed tomography CTE crista terminalis CV cardiovascular DC direct current DFs dominant frequencies EAM electroanatomic mapping EASTEarly treatment of Atrial fibrillation for Stroke prevention Trial ECG electrocardiography ECM extracellular matrix EGMs electrograms EHRA European Heart Rhythm Association ELR external loop recorder ESC European Society of Cardiology FAPs fractionated atrial potentials FFT fast Fourier transform GCV great cardiac vein GNs ganglions GP ganglionated plexi GWAS genome-wide association studies HCM hypertrophic cardiomyopathy HFS high-frequency stimulation HiFU high-intensity frequency-focused ultrasound HRS high-rate stimulation IAS interatrial septum ICD/CRT-D implantable cardioverter defibrillator/cardiac resynchronization therapy + defibrillator ICE intracardiac echocardiography ICER incremental cost-effectiveness ratio ICS intercostal space ICV inferior caval vein INHS Italian National Health Service INR international normalized ratio ITT intention to treat LA left atrium LAA left atrial appendage LAEF LA ejection fraction LARFA left atrium radiofrequency ablation LAT/FL left atrial tachycardia/flutter LI left inferior LIPV left inferior pulmonary vein LMWH low molecular weight heparin LPA left pulmonary artery LS left superior LSPV left superior pulmonary vein LVEF left ventricular ejection fraction LVF left ventricular function MCOT mobile continuous outpatient telemetry MECC minimized extra-corporeal circulation MLWHF Minnesota living with heart failure MMPs matrix metalloproteinases MPO myeloperoxidase MR magnetic resonance MRI magnetic resonance imaging MV mitral valve NA not available NR not reported NSR normal sinus rhythm OAC oral anticoagulation OS orifice PAF paroxysmal atrial fibrillation PFO patent foramen ovale PLA posterior left atrium PM pacemaker PN phrenic nerve PVAI pulmonary vein antrum isolation PVI pulmonary vein isolation PVs pulmonary veins QALY quality-adjusted life year QoL quality of life RA right atrium RAA right atrial appendage RAAFTRadiofrequency Ablation versus Antiarrhythmic drugs for atrial Fibrillation Treatment RAS renin-angiotensin system RF radiofrequency RFA radiofrequency ablation RFCA radiofrequency catheter ablation RI right inferior RIPV right inferior pulmonary vein RPA right pulmonary artery RS right superior RSPV right superior pulmonary vein SAN sino-atrial node SARAStudy of Ablation versus antiaRrhythmic drugs in persistent Atrial fibrillation SHD structural heart disease SNS sympathetic nervous system SVC superior vena cava SVCI Superior vena cava isolation TCL tachycardia cycle length TEE transesophageal echocardiogram TEs thromboembolic events TGF transforming growth factor TIA transient ischemic attack TSP transseptal puncture TTE transthoracic echocardiography TTEM transtelephonic electrocardiographic monitoring VASc vascular disease age VPSI vasovagal pacemaker study XLL extra linear lesions in left atrium