Not all rotors, effective ablation targets for nonparoxysmal atrial fibrillation, are included in areas suggested by conventional indirect indicators of atrial fibrillation drivers: ExTRa Mapping project

Abstract

Abstract Background Effects of nonparoxysmal atrial fibrillation (non‐PAF) ablation targeting complex fractionated atrial electrogram (CFAE) areas and/or low voltage areas (LVAs) are still controversial. Methods and Results A recently developed online real‐time phase mapping system (ExTRa Mapping) was used to conduct LVA mapping and simultaneous ExTRa and CFAE mapping in 28 non‐PAF patients after pulmonary vein isolation (PVI). Nonpassively activated areas, in the form of meandering rotors and/or multiple wavelets assumed to contain non‐PAF drivers, partly overlapped with CFAE/LVAs but not always coincided with them. Conclusion Real‐time rotor imaging, rather than conventional indirect indicators only, might be very useful for detecting non‐PAF drivers.

Keywords

• atrial fibrillation
• catheter ablation
• driver
• mapping
• rotor