Low-Dose Ibutilide Combined with Catheter Ablation of Persistent Atrial Fibrillation: Procedural Impact and Clinical Outcome

Figure 2

Examples of ablation targets. (a) Surface ECG lead V1, intracardiac recordings from an ablation catheter (abl), and a mapping catheter within the coronary sinus (CS). Note that, after circumferential pulmonary vein isolation (CPVI) and ibutilide, the atrial activity with CS had become very organized; however, an area on the anterior wall of the left atrium (LA) still presented with continuous, low-voltage (0.134 mV), and fractionated atrial electrograms. (b) Surface ECG lead V1 and intracardiac recording from an ablation catheter and CS 3-4 electrodes. After CPVI and ibutilide, the local atrial fibrillation cycle length (AFCL) was 107 ms on the lower part of the posterior wall of the LA, whereas the AFCL recorded by the adjacent CS catheter was more rapid (151 ms) (top). After ablation, the local AFCLs at the ablation site and CS were prolonged to 155 and 167 ms, respectively (bottom).

(a)

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