Abstract 10997: Catheter Ablation of Non-paroxysmal Atrial Fibrillation Using Sinus Rhythm Defragmentation Plus Low Voltage Zone Homogenization After Pulmonary Vein Isolation: 30 Months’ Outcome From Nonrandomized Comparison With Stepwise Approach

Introduction: The high prevalence of postprocedural atrial tachycardia (AT) reduces the absolute arrhythmia-free success rate of extensive ablation strategies to treat non-paraxysmal atrial fibrillation (NPAF). We hypothesized that a strategy of targeting low voltage zones (LVZ) and sites with abnormal electrograms during sinus rhythm (SR-AEs) in the left atrium (LA) after circumferential pulmonary vein isolation (CPVI) and cavotricuspid isthmus (CTI) ablation in NPAF patients is superior to the widely practiced step-wise approach for NPAF ablation. Methods and Results: 86 consecutive patients with NPAF (persistent or longstanding) were enrolled in study group. Following CPVI, CTI ablation and cardioversion to SR, high density mapping of LA was performed. Areas with LVZ and SR-AE were targeted for further homogenization and elimination respectively. 78 consecutive sex- and age- matched NPAF patients who were treated with the stepwise approach served as the historical control group. AF recurrence was asses...