[Radiofrequency ablation of chronic atrial fibrillation by combined isolation of pulmonary veins and anatomical modification of arrhythmia substrate].

Primary procedure of radiofrequency ablation (RFA) of chronic atrial fibrillation (AF) using nonfluoroscopic mapping system was carried out in 49 patients (mean age 52.2 +/- 11.3 years, 6 women). Etiology of AF was coronary artery disease, cardiosclerosis after myocarditis, dilated cardiomyopathy in 32, 11 and 2 patients, respectively. AF was idiopathic in 4 patients. History of chronic AF varied from 6 months to 17 years (mean 1.8 years). During follow-up for 14 +/- 5 months total efficacy of RFA was 86%. Redo procedures of endocardial electrophysiological study EPS and RFA were performed in 3 cases because of atypical atrial flutter in 2, 3, and 6 months after initial intervention, and in 1 case because of focal left atrial tachycardia (2 months after initial procedure of EPS and RFA for AF). After repetitive sessions because of atypical atrial flutter and focal left atrial tachycardia efficacy was 98%. There were no complications related to the operations.