Outcomes of Non-Paroxysmal AF Undergoing Ablation Guided by a Novel High-Density Panoramic Cycle-Length Mapping System

Abstract

Background: Catheter ablation is a current therapeutic approach for atrial fibrillation (AF). However, the efficacy for non-paroxysmal AF remains suboptimal. Objective: We hypothesize that the novel panoramic cycle-length mapping (CLM) system can guide the pulmonary vein (PV) isolation and additional potential AF drivers. Methods: A total of 31 patients with non-paroxysmal AF referred for ablation guided by a new high-density panoramic CLM system were prospectively enrolled. We then retrospectively screened the patients with non-paroxysmal AF undergoing the conventional method during the contemporary period (conventional group). They were matched with a 1:2 ratio (31 patients in Group 1 receiving the CLM-guided approach, and 62 patients in Group 2 receiving the conventional method). Results: During a mean follow-up of 23.2 months, patients in Group 1 had fewer recurrent atrial arrhythmias (p = 0.037), mainly driven by a reduction in recurrent AF. There was no difference in recurrent atrial tachycardia or atrial flutter. In multivariate analysis, the application of the CLM module was the only independent factor for recurrent atrial arrhythmias after RFCA of non-paroxysmal AF. Conclusions: Identification of the potential drivers in non-paroxysmal AF is crucial. Compared to the conventional method, ablation guided by a new high-density CLM system might result in better outcomes for patients with non-paroxysmal AF.