The stepwise ablation approach for persistent atrial fibrillation

Abstract

Persistent atrial fibrillation (AF) ablation remains a challenge with variable clinical success reported. Several techniques have been proposed to provide incremental benefit to PVI, including ablation of complex fractionated electrograms (CFE), linear ablation, and ablation of localized sources maintaining AF. The stepwise ablation approach combines the techniques of PVI, electrogram-based ablation, and linear lesions to achieve a cumulative effect with the procedural end point of AF termination. This chapter summarizes the technique, clinical outcomes, recovery of cardiac function, recurrence of atrial tachycardias (ATs), and current limitations of the stepwise ablation strategy in persist..