Ablating atrial fibrillation: A translational science perspective for clinicians

Heart Rhythm. 2016 Sep;13(9):1868-77. doi: 10.1016/j.hrthm.2016.05.026. Epub 2016 May 27.

Abstract

Although considerable progress has been made in developing ablation approaches to cure atrial fibrillation (AF), outcomes are still suboptimal, especially for persistent and long-lasting persistent AF. In this topical review, we review the arrhythmia mechanisms, both reentrant and nonreentrant, that are potentially relevant to human AF at various stages/settings. We describe arrhythmia mapping techniques used to distinguish between the different mechanisms, with a particular focus on the detection of rotors. We discuss which arrhythmia mechanisms are likely to respond to ablation, and the challenges and prospects for improving upon current ablation strategies to achieve better outcomes.

Keywords: Ablation; Arrhythmia; Atrial fibrillation; Automaticity; Fibrosis; Reentry; Rotor; Triggered activity.

Publication types

  • Review

MeSH terms

  • Atrial Fibrillation / physiopathology*
  • Atrial Fibrillation / surgery*
  • Catheter Ablation / methods*
  • Heart Conduction System / surgery*
  • Humans
  • Translational Research, Biomedical*