Summary
Conclusion
Non-invasive AF mapping is feasible and guides ablation by providing panoramic beat-to-beat mapping to understand dynamic AF mechanisms. Driver-guided ablation promises equivalent clinical results with less RF time compared with stepwise ablation. Repeat AF mapping post-ablation may provide insights into the impact of ablation on drivers, emergence of residual or possibly new drivers and thereby improve this strategy of AF management.
Clinical Perspective
- Localised reentrant and focal drivers play an important role in perpetuating atrial fibrillation (AF).
- Non-invasive body surface mapping visualises AF drivers in panoramic beat-to-beat mapping and enables understanding of dynamic AF mechanisms.
- Driver-guided ablation achieves similar AF termination rate with a relatively lesser ex-tent of ablation than the stepwise approach, which may improve the clinical outcome in persistent AF.
- When AF persists after driver ablation, repeat mapping allows assessment of the impact of ablation on the drivers and detection of emerging or previously subdued drivers, which continue to maintain AF.
