Substrate Ablation Guided by High Density Mapping in Atrial Fibrillation

Completed

Interventions: Procedure: Routine substrate ablation without pulmonary vein Isolation
Procedure: Routine conventional ablation with pulmonary vein Isolation

Brief Summary: To evaluate a new AF Substrate mapping method based on automatic high density CFAE detection with a multipolar catheter (Pentaray) and the " SCI 30-40 " setting of CARTO CFAE algorithm.

Detailed Description: This study is observational :

This substrate ablation method is performed routinely in the centers involved in the study so, patients were not assigned by the investigators to undergo a specific procedure because of the study, in all cases patient would have beneficiate from this substrate mapping ablation method.

We assessed procedural and follow up outcomes of this subatrate ablation group and compared them with an historical control group undergoing conventional ablation.

Recruitment & Eligibility

Inclusion Criteria

Patient from 18 to 85, with AF* (paroxysmal, and persistent AF) and indication of AF ablation (including redos)* *In accordance with the recommendation of European Society of Cardiology (2010).

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
Studied	Routine substrate ablation without pulmonary vein Isolation	Between September 2013 and July 2014, 105 patients were enrolled in 3 centers performing routinely Atrial Fibrillation ablation guided by spatio-temporal electrogram dispersion without pulmonary vein Isolation
Control	Routine conventional ablation with pulmonary vein Isolation	The validation set included a cohort of 47 patients with symptomatic drug-refractory AF who underwent ablation using a conventional approach.

Primary Outcome Measures

Name	Time	Method
Percentage of Patient With Atrial Fibrillation Termination at the End of the Procedure	up to 240 min	percentage of patient in sinus rhythm or in atrial tachycardia at the end of the procedure

Secondary Outcome Measures

Name	Time	Method
Maximum Sustained AF Duration	from first AF episode to baseline	duration of the longest AF epiodes in months before ablation
% of Patients With Sinus Rhythm Conversion During the Procedure	180 min
Radiofrequency Time (Min)	up to 300 min
Mean LA Volume	baseline	Left Atrial volume before ablation in ml
Percentage of Patients Free From Atrial Fibrillation 18 Months Post Ablation	18 Months post ablation	% of patients in sinus rhythm or in atrial tachycardia assessed by ECG and/ot 24h-Holter monitoring and clinical examination during follow-up.
Number of Patients With Major Adverse Events During and up to 18 Months After Procedure	18 months post ablation	Adverse events
Spontaneous AF at the Beginning of the Procedure	baseline	Spontaneous AF at the beginning of the procedure