Trials and Travails of Electrogram-Guided Ablation of Chronic Atrial Fibrillation

Catheter-based ablation has revolutionized arrhythmiamanagement by offering the most definitive treatmentfor virtually all types of tachyarrhythmias. The rea-sons behind the success of ablation are many, but chief among them is the ability of the electrophysiologist to identify underlying mechanisms and to precisely localize and eliminate the tachycardia foci or circuits. Armed with many new tools to map and ablate these arrhythmias, electrophysi-ologists gain experience and become more proficient in the procedure, resulting in a shortened procedure time, increased rates of success, and decreased rates of complications. As a result, catheter ablation is gradually but inexorably replacing pharmacological approach as the first-line therapy for just about all supraventricular tachyarrhythmias except atrial fi-brillation (AF). Article p 2606 Unlike ablation for other types of supraventricula