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Termination of persistent AF (PerAF) often requires extensive ablation, including ablation at sites of complex fractionated atrial electrograms (CFAEs) and high dominant frequency and/or multiple linear ablations in addition to pulmonary vein isolation (PVI). Unfortunately, a recent study showed no reduction in the incidence of recurrent AF when either linear ablation or CFAE ablation was performed in addition to PVI in patients with PerAF. However, rotor ablation, driver ablation, and tailored atrial substrate modification based on low-voltage areas (LVAs) in addition to PVI have prevented AF recurrence in many patients with PerAF . These reported successes prompted us to examine spatial relations between LVAs and rotor and/or driver sites.

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Spatial Relations between the Standard Deviation of Complex Fractionated Atrial Electrogram Intervals and Low-Voltage Areas in Patients with Atrial Fibrillation