ANATOMY-GUIDED LINEAR ATRIAL LESIONS FOR RADIOFREQUENCY CATHETER ABLATION OF ATRIAL-FIBRILLATION

The surgical atrial maze procedure has provided proof that atrial fibr illation can be cured by performing atrial incisions based on anatomic al and electrophysiological principles. Preliminary reports of attempt s at radiofrequency catheter ablation of atrial fibrillation utilizing an anatomy-based ''linear incision'' method have shown the feasibilit y of the method. However, postprocedural atrial fibrillation recurrenc e has been common and in addition new, uniform tachycardias have devel oped in some patients. Both of these outcomes may be in part due to in complete or inconsistent lesion deployment. This article details the u se of the CARTO system for deploying anatomy guided linear atrial lesi ons for the purpose of curing atrial fibrillation. The procedure is co mprised of three phases, which are discussed in detail: (1) baseline m ap; (2) lesion deployment and; (3) lesion assessment. Using a single s tandard ablation electrode, lesions can be deployed safely, and comple te lesions can be confirmed. Paradigms for right and left atrial incis ions are proposed.