9
Ablation
strategies to be
considered for use
in conjunction
with PV isolation
Posterior wall isolation might be
considered for initial or repeat ablation of
persistent or long-standing persistent AF.
2B C-LD
Administration of high-dose isoproterenol
to screen for and then ablate non-PV
triggers may be considered during initial or
repeat AF ablation procedures in patients
with paroxysmal, persistent, or long-
standing persistent AF.
2B C-LD
Dominant excitation frequency (DF)-
based ablation strateg y is of unknown
usefulness for AF ablation.
2B C-LD
e usefulness of creating linear ablation
lesions in the right or le atrium as an
initial or repeat ablation strateg y for
persistent or long-standing persistent AF
is not well established.
2B B-NR
e usefulness of linear ablation lesions in
the absence of macroreentrant atrial flutter
is not well established.
2B C-LD
e usefulness of mapping and ablation
of areas of abnormal myocardial tissue
identified with voltage mapping or MR
imaging as an initial or repeat ablation
strateg y for persistent or long standing
persistent AF is not well established.
2B B-R
e usefulness of ablation of complex
fractionated atrial electrograms as an
initial or repeat ablation strateg y for
persistent and long- standing persistent AF
is not well established.
2B B-R
e usefulness of ablation of rotational
activity as an initial or repeat ablation
strateg y for persistent and long-standing
persistent AF is not well established.
2B B-NR
e usefulness of ablation of autonomic
ganglia as an initial or repeat ablation
strateg y for paroxysmal, persistent, and
long-standing persistent AF is not well
established.
2B B-NR
Table 3. Atrial Fibrillation Ablation: Strategies, Techniques,
and Endpoints (cont'd)
Recommendations COR LOE