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Cardiology Research and Practice
Volume 2011, Article ID 376969, 9 pages
Review Article

Current Ablation Strategies for Persistent and Long-Standing Persistent Atrial Fibrillation

Laboratory of Invasive Cardiac Electrophysiology, Evangelismos General Hospital of Athens, 10676 Athens, Greece

Received 29 October 2010; Revised 7 December 2010; Accepted 10 January 2011

Academic Editor: Adrian Baranchuk

Copyright © 2011 Konstantinos P. Letsas et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Atrial fibrillation (AF) is associated with an increased risk of cardiac and overall mortality. Restoration and maintenance of sinus rhythm is of paramount importance if it can be accomplished without the use of antiarrhythmic drugs. Catheter ablation has evolved into a well-established treatment option for patients with symptomatic, drug-refractory AF. Ablation strategies which target the pulmonary veins are the cornerstone of AF ablation procedures, irrespective of the AF type. Ablation strategies in the setting of persistent and long-standing persistent AF are more complex. Many centers follow a stepwise ablation approach including pulmonary vein antral isolation as the initial step, electrogram-based ablation at sites exhibiting complex fractionated atrial electrograms, and linear lesions. Up to now, no single strategy is uniformly effective in patients with persistent and long-standing persistent AF. The present study reviewed the efficacy of the current ablation strategies for persistent and long-standing persistent AF.