Catheter ablation of paroxysmal atrial fibrillation using high-density mapping-guided substrate modification.

BACKGROUND

This study aimed to evaluate the effect of substrate modification in paroxysmal atrial fibrillation (AF) patients prior to circumferential pulmonary vein isolation (CPVI).

METHODS

Patients without left atrial low-voltage and/or scar areas were defined as Group A. Patients with left atrial low-voltage and/or scar areas underwent regular CPVI (Group B) or substrate modification after CPVI (Group C). The procedural success rate and differences in the left atrial diameter (LAD) among groups were compared at 1 year postoperatively.

RESULTS

The procedural success rate in Group C was comparable to that in Group A (P > 0.05) and was significantly higher than that in Group B (P < 0.01). The LAD of patients in Groups A and C significantly decreased at 1 year postoperatively compared to that prior to the surgery (P < 0.05). However, no significant difference was noted in Group B.

CONCLUSIONS

Our study demonstrated that substrate modification could contribute to the single catheter ablation surgery success rate in patients with paroxysmal AF and narrow LAD.