2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation

Hugh Calkins, Gerhard Hindricks, Riccardo Cappato, Young-Hoon Kim, Eduardo B Saad, Luis Aguinaga, Joseph G Akar, Vinay Badhwar, Josep Brugada, John Camm, Peng-Sheng Chen, Shih-Ann Chen, Mina K Chung, Jens Cosedis Nielsen, Anne B Curtis, D Wyn Davies, John D Day, André d'Avila, N M S Natasja de Groot, Luigi Di Biase, Mattias Duytschaever, James R Edgerton, Kenneth A Ellenbogen, Patrick T Ellinor, Sabine Ernst, Guilherme Fenelon, Edward P Gerstenfeld, David E Haines, Michel Haissaguerre, Robert H Helm, Elaine Hylek, Warren M Jackman, Jose Jalife, Jonathan M Kalman, Josef Kautzner, Hans Kottkamp, Karl Heinz Kuck, Koichiro Kumagai, Richard Lee, Thorsten Lewalter, Bruce D Lindsay, Laurent Macle, Moussa Mansour, Francis E Marchlinski, Gregory F Michaud, Hiroshi Nakagawa, Andrea Natale, Stanley Nattel, Ken Okumura, Douglas Packer, Evgeny Pokushalov, Matthew R Reynolds, Prashanthan Sanders, Mauricio Scanavacca, Richard Schilling, Claudio Tondo, Hsuan-Ming Tsao, Atul Verma, David J Wilber, Teiichi Yamane, Hugh Calkins, Gerhard Hindricks, Riccardo Cappato, Young-Hoon Kim, Eduardo B Saad, Luis Aguinaga, Joseph G Akar, Vinay Badhwar, Josep Brugada, John Camm, Peng-Sheng Chen, Shih-Ann Chen, Mina K Chung, Jens Cosedis Nielsen, Anne B Curtis, D Wyn Davies, John D Day, André d'Avila, N M S Natasja de Groot, Luigi Di Biase, Mattias Duytschaever, James R Edgerton, Kenneth A Ellenbogen, Patrick T Ellinor, Sabine Ernst, Guilherme Fenelon, Edward P Gerstenfeld, David E Haines, Michel Haissaguerre, Robert H Helm, Elaine Hylek, Warren M Jackman, Jose Jalife, Jonathan M Kalman, Josef Kautzner, Hans Kottkamp, Karl Heinz Kuck, Koichiro Kumagai, Richard Lee, Thorsten Lewalter, Bruce D Lindsay, Laurent Macle, Moussa Mansour, Francis E Marchlinski, Gregory F Michaud, Hiroshi Nakagawa, Andrea Natale, Stanley Nattel, Ken Okumura, Douglas Packer, Evgeny Pokushalov, Matthew R Reynolds, Prashanthan Sanders, Mauricio Scanavacca, Richard Schilling, Claudio Tondo, Hsuan-Ming Tsao, Atul Verma, David J Wilber, Teiichi Yamane

No abstract available

Keywords: Ablation; Anticoagulation; Arrhythmia; Atrial fibrillation; Atrial flutter; Atrial tachycardia; Catheter ablation; Stroke; Surgical ablation.

Figures

Figure 1
Figure 1
Anatomical drawings of the heart relevant to AF ablation. This series of drawings shows the heart and associated relevant structures from four different perspectives relevant to AF ablation. This drawing includes the phrenic nerves and the esophagus. A: The heart viewed from the anterior perspective. B: The heart viewed from the right lateral perspective. C: The heart viewed from the left lateral perspective. D: The heart viewed from the posterior perspective. E: The left atrium from the posterior perspective. Illustration: Tim Phelps © 2017 Johns Hopkins University, AAM.
Figure 2
Figure 2
This figure includes six CT or MR images of the left atrium and pulmonary veins viewed from the posterior perspective. Common and uncommon variations in PV anatomy are shown. A: Standard PV anatomy with 4 distinct PV ostia. B: Variant PV anatomy with a right common and a left common PV. C: Variant PV anatomy with a left common PV with a short trunk and an anomolous PV arising from the right posterior left atrial wall. D and E: Variant PV anatomy with a common left PV with a long trunk. F: Variant PV anatomy with a massive left common PV.
Figure 3
Figure 3
Schematic drawing showing various hypotheses and proposals concerning the mechanisms of atrial fibrillation. A: Multiple wavelets hypothesis. B: Rapidly discharging automatic foci. C: Single reentrant circuit with fibrillatory conduction. D: Functional reentry resulting from rotors or spiral waves. E: AF maintenance resulting from dissociation between epicardial and endocardial layers, with mutual interaction producing multiplying activity that maintains the arrhythmia.
Figure 4
Figure 4
Structure and mechanisms of atrial fibrillation. A: Schematic drawing of the left and right atria as viewed from the posterior perspective. The extension of muscular fibers onto the PVs can be appreciated. Shown in yellow are the five major left atrial autonomic ganglionic plexi (GP) and axons (superior left GP, inferior left GP, anterior right GP, inferior right GP, and ligament of Marshall). Shown in blue is the coronary sinus, which is enveloped by muscular fibers that have connections to the atria. Also shown in blue is the vein and ligament of Marshall, which travels from the coronary sinus to the region between the left superior PV and the left atrial appendage. B: The large and small reentrant wavelets that play a role in initiating and sustaining AF. C: The common locations of PV (red) and also the common sites of origin of non-PV triggers (shown in green). D: Composite of the anatomic and arrhythmic mechanisms of AF. Adapted with permission from Calkins et al. Heart Rhythm 2012; 9:632–696.e21.
Figure 5
Figure 5
Schematic drawing showing mechanisms of atrial flutter and atrial tachycardia. A: Isthmus-dependent reverse common (clockwise) atrial flutter. B: Isthmus-dependent common (counter clockwise) atrial flutter. C: Focal atrial tachycardia with circumferential spread of activation of the atria (can arise from multiple sites within the left and right atrium). D: Microreentrant atrial tachycardia with circumferential spread of activation of the atria. E: Perimitral atrial flutter. F: Roof-dependent atrial flutter.
Figure 6
Figure 6
Schematic of common lesion sets employed in AF ablation. A: The circumferential ablation lesions that are created in a circumferential fashion around the right and the left PVs. The primary endpoint of this ablation strategy is the electrical isolation of the PV musculature. B: Some of the most common sites of linear ablation lesions. These include a “roof line” connecting the lesions encircling the left and/or right PVs, a “mitral isthmus” line connecting the mitral valve and the lesion encircling the left PVs at the end of the left inferior PV, and an anterior linear lesion connecting either the “roof line” or the left or right circumferential lesion to the mitral annulus anteriorly. A linear lesion created at the cavotricuspid isthmus is also shown. This lesion is generally placed in patients who have experienced cavotricuspid isthmus-dependent atrial flutter clinically or have it induced during EP testing. C: Similar to 6B, but also shows additional linear ablation lesions between the superior and inferior PVs resulting in a figure of eight lesion sets as well as a posterior inferior line allowing for electrical isolation of the posterior left atrial wall. An encircling lesion of the superior vena cava (SVC) directed at electrical isolation of the SVC is also shown. SVC isolation is performed if focal firing from the SVC can be demonstrated. A subset of operators empirically isolates the SVC. D: Representative sites for ablation when targeting rotational activity or CFAEs are targeted. Modified with permission from Calkins et al. Heart Rhythm 2012; 9:632–696.e21.
Figure 7
Figure 7
Indications for catheter ablation of symptomatic atrial fibrillation. Shown in this figure are the indications for catheter ablation of symptomatic paroxysmal, persistent, and long-standing persistent AF. The Class for each indication based on whether ablation is performed after failure of antiar-rhythmic drug therapy or as first-line therapy is shown. Please refer to Table 2B and the text for the indications for catheter ablation of asymptomatic AF.
Figure 8
Figure 8
Indications for surgical ablation of atrial fibrillation. Shown in this figure are the indications for surgical ablation of paroxysmal, persistent, and longstanding persistent AF. The Class for each indication based on whether ablation is performed after failure of antiarrhythmic drug therapy or as first-line therapy is shown. The indications for surgical AF ablation are divided into whether the AF ablation procedure is performed concomitantly with an open surgical procedure (such as mitral valve replacement), a closed surgical procedure (such as coronary artery bypass graft surgery), or as a stand-alone surgical AF ablation procedure performed solely for treatment of atrial fibrillation.
Figure 9
Figure 9
Schematic drawing showing catheter ablation of atrial fibrillation using either RF energy or cryoballoon AF ablation. A: Shows a typical wide area lesion set created using RF energy. Ablation lesions are delivered in a figure of eight pattern around the left and right PV veins. Also shown is a linear cavotricuspid isthmus lesion created for ablation of typical atrial flutter in a patient with a prior history of typical atrial flutter or inducible isthmus-dependent typical atrial flutter at the time of ablation. A multielectrode circular mapping catheter is positioned in the left inferior PV. B: Shows an ablation procedure using the cryoballoon system. Ablation lesions have been created surrounding the right PVs, and the cryoballoon ablation catheter is positioned in the left superior PV. A through the lumen multielectrode circular mapping catheter is positioned in the left superior PV. Illustration: Tim Phelps © 2017 Johns Hopkins University, AAM.

References

    1. Calkins H, et al. HRS/EHRA/ECAS expert Consensus Statement on catheter and surgical ablation of atrial fibrillation: recommendations for personnel, policy, procedures and follow-up. A report of the Heart Rhythm Society (HRS) Task Force on catheter and surgical ablation of atrial fibrillation. Heart Rhythm. 2007;4(6):816–861.
    1. Calkins H, et al. 2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design. Heart Rhythm. 2012;9(4):632–696.e21.
    1. Jacobs AK, Anderson JL, Halperin JL. The evolution and future of ACC/AHA clinical practice guidelines: a 30-year journey: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;64(13):1373–1384.
    1. Anderson JL. Evolution of the ACC/AHA clinical practice guidelines in perspective: guiding the guidelines. J Am Coll Cardiol. 2015;65(25):2735–2738.
    1. January CT, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2014;64(21):e1–e76.
    1. Kirchhof P, et al. 2016 ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur J Cardiothorac Surg. 2016;50(5):e1–e88.
    1. Camm AJ, et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC) Europace. 2010;12(10):1360–1420.
    1. Lloyd-Jones DM, et al. Lifetime risk for development of atrial fibrillation: the Framingham Heart Study. Circulation. 2004;110(9):1042–1046.
    1. Benjamin EJ, et al. Independent risk factors for atrial fibrillation in a populationbased cohort: The Framingham Heart Study. JAMA. 1994;271(11):840–844.
    1. Miller JD, et al. Obesity, exercise, obstructive sleep apnea, and modifiable atherosclerotic cardiovascular disease risk factors in atrial fibrillation. J Am Coll Cardiol. 2015;66(25):2899–2906.
    1. EHRA Scientific Committee Task Force, et al. European Heart Rhythm Association (EHRA)/European Association of Cardiovascular Prevention and Rehabilitation (EACPR) position paper on how to prevent atrial fibrillation endorsed by the Heart Rhythm Society (HRS) and Asia Pacific Heart Rhythm Society (APHRS) Europace. 2017;19(2):190–225.
    1. Allan V, et al. Are cardiovascular risk factors also associated with the incidence of atrial fibrillation? A systematic review and field synopsis of 23 factors in 32 population-based cohorts of 20 million participants. Thromb Haemost. 2017;117(5):837–850.
    1. de Vos CB, et al. Progression from paroxysmal to persistent atrial fibrillation clinical correlates and prognosis. J Am Coll Cardiol. 2010;55(8):725–731.
    1. Wijffels MC, et al. Atrial fibrillation begets atrial fibrillation. A study in awake chronically instrumented goats. Circulation. 1995;92(7):1954–1968.
    1. Walters TE, et al. Progression of atrial remodeling in patients with high-burden atrial fibrillation: Implications for early ablative intervention. Heart Rhythm. 2016;13(2):331–339.
    1. Wakili R, et al. Recent advances in the molecular pathophysiology of atrial fibrillation. J Clin Invest. 2011;121(8):2955–2968.
    1. Heijman J, et al. Cellular and molecular electrophysiology of atrial fibrillation initiation, maintenance, and progression. Circ Res. 2014;114(9):1483–1499.
    1. Kopecky SL, et al. The natural history of lone atrial fibrillation. A population-based study over three decades. N Engl J Med. 1987;317(11):669–674.
    1. Kochhauser S, et al. Predictors for progression of atrial fibrillation in patients awaiting atrial fibrillation ablation. Can J Cardiol. 2016;32(11):1348–1354.
    1. Sugihara C, et al. The development of AF over time in patients with permanent pacemakers: objective assessment with pacemaker diagnostics demonstrates distinct patterns of AF. Europace. 2015;17(6):864–870.
    1. Fox CS, et al. Parental atrial fibrillation as a risk factor for atrial fibrillation in offspring. JAMA. 2004;291(23):2851–2855.
    1. Arnar DO, et al. Familial aggregation of atrial fibrillation in Iceland. Eur Heart J. 2006;27(6):708–712.
    1. Lubitz SA, et al. Association between familial atrial fibrillation and risk of newonset atrial fibrillation. JAMA. 2010;304(20):2263–2269.
    1. Christophersen IE, Ellinor PT. Genetics of atrial fibrillation: from families to genomes. J Hum Genet. 2016;61(1):61–70.
    1. Gudbjartsson DF, et al. Variants conferring risk of atrial fibrillation on chromosome 4q25. Nature. 2007;448(7151):353–357.
    1. Benjamin EJ, et al. Variants in ZFHX3 are associated with atrial fibrillation in individuals of European ancestry. Nat Genet. 2009;41(8):879–881.
    1. Gudbjartsson DF, et al. A sequence variant in ZFHX3 on 16q22 associates with atrial fibrillation and ischemic stroke. Nat Genet. 2009;41(8):876–878.
    1. Ellinor PT, et al. Common variants in KCNN3 are associated with lone atrial fibrillation. Nat Genet. 2010;42(3):240–244.
    1. Ellinor PT, et al. Meta-analysis identifies six new susceptibility loci for atrial fibrillation. Nat Genet. 2012;44(6):670–675.
    1. Sinner MF, et al. Integrating genetic, transcriptional, and functional analyses to identify 5 novel genes for atrial fibrillation. Circulation. 2014;130(15):1225–1235.
    1. Lubitz SA, et al. Novel genetic markers associate with atrial fibrillation risk in Europeans and Japanese. J Am Coll Cardiol. 2014;63(12):1200–1210.
    1. Tada H, et al. Twelve-single nucleotide polymorphism genetic risk score identifies individuals at increased risk for future atrial fibrillation and stroke. Stroke. 2014;45(10):2856–2862.
    1. Everett BM, et al. Novel genetic markers improve measures of atrial fibrillation risk prediction. Eur Heart J. 2013;34(29):2243–2251.
    1. Lubitz SA, et al. Genetic risk prediction of atrial fibrillation. Circulation. 2017;135(14):1311–1320.
    1. Hucker WJ, et al. Atrial fibrillation genetics: is there a practical clinical value now or in the future? Can J Cardiol. 2016;32(11):1300–1305.
    1. Shoemaker MB, et al. Common genetic variants and response to atrial fibrillation ablation. Circ Arrhythm Electrophysiol. 2015;8(2):296–302.
    1. Choi EK, et al. Korean Atrial Fibrillation (AF) Network: genetic variants for AF do not predict ablation success. J Am Heart Assoc. 2015;4(8):e002046.
    1. Chugh SS, et al. Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study. Circulation. 2014;129(8):837–847.
    1. Colilla S, et al. Estimates of current and future incidence and prevalence of atrial fibrillation in the U.S. adult population. Am J Cardiol. 2013;112(8):1142–1147.
    1. Kannel WB, et al. Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol. 1998;82(8A):2N–9N.
    1. Miller PS, Andersson FL, Kalra L. Are cost benefits of anticoagulation for stroke prevention in atrial fibrillation underestimated? Stroke. 2005;36(2):360–366.
    1. Miyasaka Y, et al. Mortality trends in patients diagnosed with first atrial fibrillation: a 21-year community-based study. J Am Coll Cardiol. 2007;49(9):986–992.
    1. Chen LY, Benditt DG, Alonso A. Atrial fibrillation and its association with sudden cardiac death. Circ J. 2014;78(11):2588–2593.
    1. Lubitz SA, et al. Atrial fibrillation patterns and risks of subsequent stroke, HF, or death in the community. J Am Heart Assoc. 2013;2(5):e000126.
    1. Wang TJ, et al. Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality: the Framingham Heart Study. Circulation. 2003;107(23):2920–2925.
    1. Jacobs V, et al. Atrial fibrillation and dementia. Trends Cardiovasc Med. 2015;25(1):44–51.
    1. Dorian P, et al. The impairment of health-related quality of life in patients with intermittent atrial fibrillation: implications for the assessment of investigational therapy. J Am Coll Cardiol. 2000;36(4):1303–1309.
    1. Boriani G, et al. Asymptomatic atrial fibrillation: clinical correlates, management, and outcomes in the EORP-AF Pilot General Registry. Am J Med. 2015;128(5):509–518.e2.
    1. Kim MH, et al. Estimation of total incremental health care costs in patients with atrial fibrillation in the United States. Circ Cardiovasc Qual Outcomes. 2011;4(3):313–320.
    1. Go AS, et al. Executive summary: heart disease and stroke statistics–2014 update: a report from the American Heart Association. Circulation. 2014;129(3):399–410.
    1. Ganesan AN, et al. The impact of atrial fibrillation type on the risk of thromboembolism, mortality, and bleeding: a systematic review and meta-analysis. Eur Heart J. 2016;37(20):1591–1602.
    1. Van Gelder IC, et al. A comparison of rate control and rhythm control in patients with recurrent persistent atrial fibrillation. N Engl J Med. 2002;347(23):1834–1840.
    1. Wyse DG, et al. A comparison of rate control and rhythm control in patients with atrial fibrillation. N Engl J Med. 2002;347(23):1825–1833.
    1. Carlsson J, et al. Randomized trial of rate-control versus rhythm-control in persistent atrial fibrillation: the Strategies of Treatment of Atrial Fibrillation (STAF) study. J Am Coll Cardiol. 2003;41(10):1690–1696.
    1. Roy D, et al. Rhythm control versus rate control for atrial fibrillation and HF. N Engl J Med. 2008;358(25):2667–2677.
    1. Hindricks G, et al. Perception of atrial fibrillation before and after radiofrequency catheter ablation: relevance of asymptomatic arrhythmia recurrence. Circulation. 2005;112(3):307–313.
    1. Vasamreddy CR, et al. Symptomatic and asymptomatic atrial fibrillation in patients undergoing radiofrequency catheter ablation. J Cardiovasc Electrophysiol. 2006;17(2):134–139.
    1. Verma A, et al. Discerning the incidence of symptomatic and asymptomatic episodes of atrial fibrillation before and after catheter ablation (DISCERN AF): a prospective, multicenter study. JAMA Intern Med. 2013;173(2):149–156.
    1. Rienstra M, et al. Asymptomatic persistent atrial fibrillation and outcome: results of the RACE study. Heart Rhythm. 2014;11(6):939–945.
    1. Siontis KC, et al. Typical, atypical, and asymptomatic presentations of new-onset atrial fibrillation in the community: Characteristics and prognostic implications. Heart Rhythm. 2016;13(7):1418–1424.
    1. Reynolds MR, et al. Influence of age, sex, and atrial fibrillation recurrence on quality of life outcomes in a population of patients with new-onset atrial fibrillation: the Fibrillation Registry Assessing Costs, Therapies, Adverse events and Lifestyle (FRACTAL) study. Am Heart J. 2006;152(6):1097–1103.
    1. Pedrote A, et al. Paroxysmal atrial fibrillation burden before and after pulmonary veins isolation: an observational study through a subcutaneous leadless cardiac monitor. J Cardiovasc Electrophysiol. 2013;24(10):1075–1082.
    1. Wokhlu A, et al. Long-term quality of life after ablation of atrial fibrillation the impact of recurrence, symptom relief, and placebo effect. J Am Coll Cardiol. 2010;55(21):2308–2316.
    1. Ho SY, et al. Anatomy of the LA: implications for radiofrequency ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 1999;10(11):1525–1533.
    1. Ho SY, McCarthy KP. Anatomy of the left atrium for interventional electrophysiologists. Pacing Clin Electrophysiol. 2010;33(5):620–627.
    1. Ho SY, Cabrera JA, Sanchez-Quintana D. Left atrial anatomy revisited. Circ Arrhythm Electrophysiol. 2012;5(1):220–228.
    1. Kato R, et al. Pulmonary vein anatomy in patients undergoing catheter ablation of atrial fibrillation: lessons learned by use of magnetic resonance imaging. Circulation. 2003;107(15):2004–2010.
    1. Jongbloed MR, et al. Noninvasive visualization of the cardiac venous system using multislice computed tomography. J Am Coll Cardiol. 2005;45(5):749–753.
    1. Mlcochova H, et al. Magnetic resonance angiography of pulmonary veins: implications for catheter ablation of atrial fibrillation. Pacing Clin Electrophysiol. 2005;28(10):1073–1080.
    1. Nathan H, Eliakim M. The junction between the left atrium and the pulmonary veins. An anatomic study of human hearts. Circulation. 1966;34(3):412–422.
    1. Weiss C, et al. Impact of the distribution and structure of myocardium in the pulmonary veins for radiofrequency ablation of atrial fibrillation. Pacing Clin Electrophysiol. 2002;25(9):1352–1356.
    1. Wang K, et al. Architecture of atrial musculature in humans. Br Heart J. 1995;73(6):559–565.
    1. Anne W, et al. Matrix metalloproteinases and atrial remodeling in patients with mitral valve disease and atrial fibrillation. Cardiovasc Res. 2005;67(4):655–666.
    1. Goette A, Rocken C. Atrial amyloidosis and atrial fibrillation: a gender-dependent “arrhythmogenic substrate”? Eur Heart J. 2004;25(14):1185–1186.
    1. Pashakhanloo F, et al. Myofiber Architecture of the Human Atria as Revealed by Submillimeter Diffusion Tensor Imaging. Circ Arrhythm Electrophysiol. 2016;9(4):e004133.
    1. Hansen BJ, et al. Atrial fibrillation driven by micro-anatomic intramural re-entry revealed by simultaneous sub-epicardial and sub-endocardial optical mapping in explanted human hearts. Eur Heart J. 2015;36(35):2390–2401.
    1. Haissaguerre M, et al. Intermittent drivers anchoring to structural heterogeneities as a major pathophysiological mechanism of human persistent atrial fibrillation. J Physiol. 2016;594(9):2387–2398.
    1. Kim DT, et al. The ligament of Marshall: a structural analysis in human hearts with implications for atrial arrhythmias. J Am Coll Cardiol. 2000;36(4):1324–1327.
    1. Han S, et al. Electrophysiological characteristics of the Marshall bundle in humans. Heart Rhythm. 2010;7(6):786–793.
    1. Cabrera JA, et al. The architecture of the left lateral atrial wall: a particular anatomic region with implications for ablation of atrial fibrillation. Eur Heart J. 2008;29(3):356–362.
    1. Gittenberger-de Groot AC, et al. The role of neural crest and epicardium-derived cells in conduction system formation. Novartis Found Symp. 2003;250:125–134. discussion 134-41, 276-9.
    1. Jongbloed MR, et al. Embryonic conduction tissue: a spatial correlation with adult arrhythmogenic areas. J Cardiovasc Electrophysiol. 2004;15(3):349–355.
    1. Perez-Lugones A, et al. Evidence of specialized conduction cells in human pulmonary veins of patients with atrial fibrillation. J Cardiovasc Electrophysiol. 2003;14(8):803–809.
    1. Ehrlich JR, et al. Cellular electrophysiology of canine pulmonary vein cardiomyocytes: action potential and ionic current properties. J Physiol. 2003;551(Pt 3):801–813.
    1. Chen YC, et al. Heterogeneous expression of potassium currents and pacemaker currents potentially regulates arrhythmogenesis of pulmonary vein cardiomyocytes. J Cardiovasc Electrophysiol. 2009;20(9):1039–1045.
    1. Verheule S, et al. Tissue structure and connexin expression of canine pulmonary veins. Cardiovasc Res. 2002;55(4):727–738.
    1. Honjo H, et al. Pacing-induced spontaneous activity inmyocardial sleeves of pulmonary veins after treatment with ryanodine. Circulation. 2003;107(14):1937–1943.
    1. Levin MD, et al. Melanocyte-like cells in the heart and pulmonary veins contribute to atrial arrhythmia triggers. J Clin Invest. 2009;119(11):3420–3436.
    1. Wongcharoen W, et al. Effects of a Na+/Ca2+ exchanger inhibitor on pulmonary vein electrical activity and ouabain-induced arrhythmogenicity. Cardiovasc Res. 2006;70(3):497–508.
    1. Weerasooriya R, et al. Dissociated pulmonary vein arrhythmia: incidence and characteristics. J Cardiovasc Electrophysiol. 2003;14(11):1173–1179.
    1. Hocini M, et al. Electrical conduction in canine pulmonary veins: electrophysiological and anatomic correlation. Circulation. 2002;105(20):2442–2448.
    1. Arora R, et al. Arrhythmogenic substrate of the pulmonary veins assessed by high-resolution optical mapping. Circulation. 2003;107(13):1816–1821.
    1. Ozgen N, et al. Early electrical remodeling in rabbit pulmonary vein results from trafficking of intracellular SK2 channels to membrane sites. Cardiovasc Res. 2007;75(4):758–769.
    1. Kalifa J, et al. Intra-atrial pressure increases rate and organization of waves emanating from the superior pulmonary veins during atrial fibrillation. Circulation. 2003;108(6):668–671.
    1. Jais P, et al. Distinctive electrophysiological properties of pulmonary veins in patients with atrial fibrillation. Circulation. 2002;106(19):2479–2485.
    1. Chen SA, Tai CT. Catheter ablation of atrial fibrillation originating from the non-pulmonary vein foci. J Cardiovasc Electrophysiol. 2005;16(2):229–232.
    1. Kumagai K, et al. Electrophysiologic properties of pulmonary veins assessed using a multielectrode basket catheter. J Am Coll Cardiol. 2004;43(12):2281–2289.
    1. Sanders P, et al. Spectral analysis identifies sites of high-frequency activity maintaining atrial fibrillation in humans. Circulation. 2005;112(6):789–797.
    1. Atienza F, et al. Activation of inward rectifier potassium channels accelerates atrial fibrillation in humans: evidence for a reentrant mechanism. Circulation. 2006;114(23):2434–2442.
    1. Hou Y, Zhou Q, Po SS. Neuromodulation for cardiac arrhythmia. Heart Rhythm. 2016;13(2):584–592.
    1. Chiou CW, Eble JN, Zipes DP. Efferent vagal innervation of the canine atria and sinus and atrioventricular nodes. The third fat pad. Circulation. 1997;95(11):2573–2584.
    1. Kawashima T. The autonomic nervous system of the human heart with special reference to its origin, course, and peripheral distribution. Anat Embryol (Berl) 2005;209(6):425–438.
    1. Armour JA, et al. Gross and microscopic anatomy of the human intrinsic cardiac nervous system. Anat Rec. 1997;247(2):289–298.
    1. Pauza DH, Skripka V, Pauziene N. Morphology of the intrinsic cardiac nervous system in the dog: a whole-mount study employing histochemical staining with acetylcholinesterase. Cells Tissues Organs. 2002;172(4):297–320.
    1. Po SS, Nakagawa H, Jackman WM. Localization of left atrial ganglionated plexi in patients with atrial fibrillation. J Cardiovasc Electrophysiol. 2009;20(10):1186–1189.
    1. Hou Y, et al. Ganglionated plexi modulate extrinsic cardiac autonomic nerve input: effects on sinus rate, atrioventricular conduction, refractoriness, and inducibility of atrial fibrillation. J Am Coll Cardiol. 2007;50(1):61–68.
    1. Chevalier P, et al. Quantitative study of nerves of the human LA. Heart Rhythm. 2005;2(5):518–522.
    1. Tan AY, et al. Autonomic innervation and segmental muscular disconnections at the human pulmonary vein-atrial junction: implications for catheter ablation of atrial-pulmonary vein junction. J Am Coll Cardiol. 2006;48(1):132–143.
    1. Chen PS, et al. Role of the autonomic nervous system in atrial fibrillation: pathophysiology and therapy. Circ Res. 2014;114(9):1500–1515.
    1. Scherlag BJ, et al. Autonomically induced conversion of pulmonary vein focal firing into atrial fibrillation. J Am Coll Cardiol. 2005;45(11):1878–1886.
    1. Po SS, et al. Experimental model for paroxysmal atrial fibrillation arising at the pulmonary vein-atrial junctions. Heart Rhythm. 2006;3(2):201–208.
    1. Jayachandran JV, et al. Atrial fibrillation produced by prolonged rapid atrial pacing is associated with heterogeneous changes in atrial sympathetic innervation. Circulation. 2000;101(10):1185–1191.
    1. Lu Z, et al. Atrial fibrillation begets atrial fibrillation: autonomic mechanism for atrial electrical remodeling induced by short-term rapid atrial pacing. Circ Arrhythm Electrophysiol. 2008;1(3):184–192.
    1. Patterson E, et al. Triggered firing in pulmonary veins initiated by in vitro autonomic nerve stimulation. Heart Rhythm. 2005;2(6):624–631.
    1. Zhou J, et al. Gradients of atrial refractoriness and inducibility of atrial fibrillation due to stimulation of ganglionated plexi. J Cardiovasc Electrophysiol. 2007;18(1):83–90.
    1. Choi EK, et al. Intrinsic cardiac nerve activity and paroxysmal atrial tachyarrhythmia in ambulatory dogs. Circulation. 2010;121(24):2615–2623.
    1. Lemery R, et al. Feasibility study of endocardial mapping of ganglionated plexuses during catheter ablation of atrial fibrillation. Heart Rhythm. 2006;3(4):387–396.
    1. Scanavacca M, et al. Selective atrial vagal denervation guided by evoked vagal reflex to treat patients with paroxysmal atrial fibrillation. Circulation. 2006;114(9):876–885.
    1. Katritsis D, et al. Anatomic approach for ganglionic plexi ablation in patients with paroxysmal atrial fibrillation. Am J Cardiol. 2008;102(3):330–334.
    1. Pokushalov E, et al. Selective ganglionated plexi ablation for paroxysmal atrial fibrillation. Heart Rhythm. 2009;6(9):1257–1264.
    1. Katritsis DG, et al. Rapid pulmonary vein isolation combined with autonomic ganglia modification: a randomized study. Heart Rhythm. 2011;8(5):672–678.
    1. Katritsis DG, et al. Autonomic denervation added to pulmonary vein isolation for paroxysmal atrial fibrillation: a randomized clinical trial. J Am Coll Cardiol. 2013;62(24):2318–2325.
    1. Driessen AH, et al. Ganglion Plexus Ablation in Advanced Atrial Fibrillation: The AFACT Study. J Am Coll Cardiol. 2016;68(11):1155–1165.
    1. Nakagawa H, et al. Pathophysiologic basis of autonomic ganglionated plexus ablation in patients with atrial fibrillation. Heart Rhythm. 2009;6(12 Suppl):S26–S34.
    1. Chen J, Wasmund SL, Hamdan MH. Back to the future: the role of the autonomic nervous system in atrial fibrillation. Pacing Clin Electrophysiol. 2006;29(4):413–421.
    1. Bauer A, et al. Effects of circumferential or segmental pulmonary vein ablation for paroxysmal atrial fibrillation on cardiac autonomic function. Heart Rhythm. 2006;3(12):1428–1435.
    1. Pokushalov E, et al. A randomized comparison of pulmonary vein isolation with versus without concomitant renal artery denervation in patients with refractory symptomatic atrial fibrillation and resistant hypertension. J Am Coll Cardiol. 2012;60(13):1163–1170.
    1. Pokushalov E, et al. Long-term suppression of atrial fibrillation by botulinum toxin injection into epicardial fat pads in patients undergoing cardiac surgery: one-year follow-up of a randomized pilot study. Circ Arrhythm Electrophysiol. 2015;8(6):1334–1341.
    1. Tsai WC, et al. Effects of renal sympathetic denervation on the stellate ganglion and brain stem in dogs. Heart Rhythm. 2017;14(2):255–262.
    1. Mahnkopf C, et al. Evaluation of the left atrial substrate in patients with lone atrial fibrillation using delayed-enhanced MRI: implications for disease progression and response to catheter ablation. Heart Rhythm. 2010;7(10):1475–1481.
    1. Kottkamp H. Fibrotic atrial cardiomyopathy: a specific disease/syndrome supplying substrates for atrial fibrillation, atrial tachycardia, sinus node disease, AV node disease, and thromboembolic complications. J Cardiovasc Electrophysiol. 2012;23(7):797–799.
    1. Kottkamp H. Human atrial fibrillation substrate: towards a specific fibrotic atrial cardiomyopathy. Eur Heart J. 2013;34(35):2731–2738.
    1. Cochet H, et al. Age, atrial fibrillation, and structural heart disease are the main determinants of left atrial fibrosis detected by delayed-enhanced magnetic resonance imaging in a general cardiology population. J Cardiovasc Electrophysiol. 2015;26(5):484–492.
    1. Chrispin J, et al. Clinical predictors of cardiac magnetic resonance late gadolinium enhancement in patients with atrial fibrillation. Europace. 2017;19(3):371–377.
    1. Konrad T, et al. Primary persistent atrial fibrillation: a distinct arrhythmia subentity of an ablation population. J Cardiovasc Electrophysiol. 2015;26(12):1289–1294.
    1. Boldt A, et al. Fibrosis in left atrial tissue of patients with atrial fibrillation with and without underlying mitral valve disease. Heart. 2004;90(4):400–405.
    1. de Oliveira IM, et al. Fibrosis, myocardial crossings, disconnections, abrupt turns, and epicardial reflections: do they play an actual role in human permanent atrial fibrillation? A controlled necropsy study. Cardiovasc Pathol. 2013;22(1):65–69.
    1. Smorodinova N, et al. Bioptic study of left and right atrial interstitium in cardiac patients with and without atrial fibrillation: interatrial but not rhythm-based differences. PLoS One. 2015;10(6):e0129124.
    1. Platonov PG, et al. Structural abnormalities in atrial walls are associated with presence and persistency of atrial fibrillation but not with age. J Am Coll Cardiol. 2011;58(21):2225–2232.
    1. Kottkamp H, et al. Box Isolation of Fibrotic Areas (BIFA): a patient-tailored substrate modification approach for ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2016;27(1):22–30.
    1. Andrade J, et al. The clinical profile and pathophysiology of atrial fibrillation: relationships among clinical features, epidemiology, and mechanisms. Circ Res. 2014;114(9):1453–1468.
    1. Andrade JG, et al. Incidence and significance of early recurrences of atrial fibrillation after cryoballoon ablation: insights from the multicenter Sustained Treatment of Paroxysmal Atrial Fibrillation (STOP AF) Trial. Circ Arrhythm Electrophysiol. 2014;7(1):69–75.
    1. Andrade J, et al. The time course of exit and entrance block during cryoballoon pulmonary vein isolation. Europace. 2014;16(4):500–504.
    1. Swartz MF, et al. Elevated pre-operative serum peptides for collagen I and III synthesis result in post-surgical atrial fibrillation. J Am Coll Cardiol. 2012;60(18):1799–1806.
    1. Akoum N, et al. Atrial fibrosis quantified using late gadolinium enhancement MRI is associated with sinus node dysfunction requiring pacemaker implant. J Cardiovasc Electrophysiol. 2012;23(1):44–50.
    1. Kottkamp H, Schreiber D. The Substrate in “Early Persistent” Atrial Fibrillation: Arrhythmia Induced, Risk Factor Induced, or From a Specific Fibrotic Atrial Cardiomyopathy? JACC: Clinical Electrophysiology. 2016;2(2):140–142.
    1. Jalife J, et al. Mechanisms of atrial fibrillation: mother rotors or multiple daughter wavelets, or both? J Cardiovasc Electrophysiol. 1998;9(8 Suppl):S2–S12.
    1. Goette A, et al. EHRA/HRS/APHRS/SOLAECE expert consensus on atrial cardiomyopathies: definition, characterization, and clinical implication. Europace. 2016;18(10):1455–1490.
    1. Nattel S, et al. Mechanisms of atrial fibrillation: lessons from animal models. Prog Cardiovasc Dis. 2005;48(1):9–28.
    1. Potpara TS, et al. A 12-year follow-up study of patients with newly diagnosed lone atrial fibrillation: implications of arrhythmia progression on prognosis: the Belgrade Atrial Fibrillation study. Chest. 2012;141(2):339–347.
    1. Holmqvist F, et al. Heart rate is associated with progression of atrial fibrillation, independent of rhythm. Heart. 2015;101(11):894–899.
    1. Veasey RA, et al. The natural history of atrial fibrillation in patients with permanent pacemakers: is atrial fibrillation a progressive disease? J Interv Card Electrophysiol. 2015;44(1):23–30.
    1. Allessie M, Ausma J, Schotten U. Electrical, contractile and structural remodeling during atrial fibrillation. Cardiovasc Res. 2002;54(2):230–246.
    1. Nattel S, Burstein B, Dobrev D. Atrial remodeling and atrial fibrillation: mechanisms and implications. Circ Arrhythm Electrophysiol. 2008;1(1):62–73.
    1. Filgueiras-Rama D, et al. Long-term frequency gradients during persistent atrial fibrillation in sheep are associated with stable sources in the LA. Circ Arrhythm Electrophysiol. 2012;5(6):1160–1167.
    1. Pandit SV, Jalife J. Rotors and the dynamics of cardiac fibrillation. Circ Res. 2013;112(5):849–862.
    1. Nattel S. Paroxysmal atrial fibrillation and pulmonary veins: relationships between clinical forms and automatic versus re-entrant mechanisms. Can J Cardiol. 2013;29(10):1147–1149.
    1. Martins RP, et al. Dominant frequency increase rate predicts transition from paroxysmal to long-term persistent atrial fibrillation. Circulation. 2014;129(14):1472–1482.
    1. Wei SK, et al. Muscarinic modulation of the sodium-calcium exchanger in HF. Circulation. 2007;115(10):1225–1233.
    1. Nattel S, Dobrev D. The multidimensional role of calcium in atrial fibrillation pathophysiology: mechanistic insights and therapeutic opportunities. Eur Heart J. 2012;33(15):1870–1877.
    1. Corradi D. Atrial fibrillation from the pathologist’s perspective. Cardiovasc Pathol. 2014;23(2):71–84.
    1. Pinho-Gomes AC, et al. Targeting inflammation and oxidative stress in atrial fibrillation: role of 3-hydroxy-3-methylglutaryl-coenzyme a reductase inhibition with statins. Antioxid Redox Signal. 2014;20(8):1268–1285.
    1. Deshmukh A, et al. Left atrial transcriptional changes associated with atrial fibrillation susceptibility and persistence. Circ Arrhythm Electrophysiol. 2015;8(1):32–41.
    1. Schiller M, Javelaud D, Mauviel A. TGF-beta-induced SMAD signaling and gene regulation: consequences for extracellular matrix remodeling and wound healing. J Dermatol Sci. 2004;35(2):83–92.
    1. He X, et al. Atrial fibrillation induces myocardial fibrosis through angiotensin II type 1 receptor-specific Arkadia-mediated downregulation of Smad7. Circ Res. 2011;108(2):164–175.
    1. Nattel S, Harada M. Atrial remodeling and atrial fibrillation: recent advances and translational perspectives. J Am Coll Cardiol. 2014;63(22):2335–2345.
    1. Ben Amar M, Bianca C. Towards a unified approach in the modeling of fibrosis: A review with research perspectives. Phys Life Rev. 2016;17:61–85.
    1. Jalife J. Mechanisms of persistent atrial fibrillation. Curr Opin Cardiol. 2014;29(1):20–27.
    1. Jalife J, Kaur K. Atrial remodeling, fibrosis, and atrial fibrillation. Trends Cardiovasc Med. 2015;25(6):475–484.
    1. de Bakker JM, et al. Slow conduction in the infarcted human heart ‘Zigzag’ course of activation. Circulation. 1993;88(3):915–926.
    1. Bian W, Tung L. Structure-related initiation of reentry by rapid pacing in monolayers of cardiac cells. Circ Res. 2006;98(4):e29–e38.
    1. Spach MS, Boineau JP. Microfibrosis produces electrical load variations due to loss of side-to-side cell connections: a major mechanism of structural heart disease arrhythmias. Pacing Clin Electrophysiol. 1997;20(2 Pt 2):397–413.
    1. de Bakker JM, Stein M, van Rijen HV. Three-dimensional anatomic structure as substrate for ventricular tachycardia/ventricular fibrillation. Heart Rhythm. 2005;2(7):777–779.
    1. Valderrabano M, et al. Obstacle-induced transition from ventricular fibrillation to tachycardia in isolated swine right ventricles: insights into the transition dynamics and implications for the critical mass. J Am Coll Cardiol. 2000;36(6):2000–2008.
    1. Basso C, Thiene G. Adipositas cordis, fatty infiltration of the right ventricle, and arrhythmogenic right ventricular cardiomyopathy. Just a matter of fat? Cardiovasc Pathol. 2005;14(1):37–41.
    1. Roberts-Thomson KC, Sanders P, Kalman JM. Sinus node disease: an idiopathic right atrial myopathy. Trends Cardiovasc Med. 2007;17(6):211–214.
    1. Haemers P, et al. Atrial fibrillation is associated with the fibrotic remodelling of adipose tissue in the subepicardium of human and sheep atria. Eur Heart J. 2017;38(1):53–61.
    1. Pathak RK, et al. The implications of obesity for cardiac arrhythmia mechanisms and management. Can J Cardiol. 2015;31(2):203–210.
    1. Nalliah CJ, et al. The role of obesity in atrial fibrillation. Eur Heart J. 2016;37(20):1565–1572.
    1. Mahajan R, et al. Electrophysiological, electroanatomical, and structural remodeling of the atria as consequences of sustained obesity. J Am Coll Cardiol. 2015;66(1):1–11.
    1. Rocken C, et al. Atrial amyloidosis: an arrhythmogenic substrate for persistent atrial fibrillation. Circulation. 2002;106(16):2091–2097.
    1. Podduturi V, et al. Isolated atrial amyloidosis and the importance of molecular classification. Proc (Bayl Univ Med Cent) 2013;26(4):387–389.
    1. Hove-Madsen L, et al. Atrial fibrillation is associated with increased spontaneous calcium release from the sarcoplasmic reticulum in human atrial myocytes. Circulation. 2004;110(11):1358–1363.
    1. Wang L, et al. Optical mapping of sarcoplasmic reticulum Ca2+ in the intact heart: ryanodine receptor refractoriness during alternans and fibrillation. Circ Res. 2014;114(9):1410–1421.
    1. Greiser M, Schotten U. Dynamic remodeling of intracellular Ca(2)(+) signaling during atrial fibrillation. J Mol Cell Cardiol. 2013;58:134–142.
    1. Voigt N, et al. Enhanced sarcoplasmic reticulum Ca2+ leak and increased Na+-Ca2+ exchanger function underlie delayed afterdepolarizations in patients with chronic atrial fibrillation. Circulation. 2012;125(17):2059–2070.
    1. Chiang DY, et al. Loss of microRNA-106b-25 cluster promotes atrial fibrillation by enhancing ryanodine receptor type-2 expression and calcium release. Circ Arrhythm Electrophysiol. 2014;7(6):1214–1222.
    1. Li N, et al. Ryanodine receptor-mediated calcium leak drives progressive development of an atrial fibrillation substrate in a transgenic mouse model. Circulation. 2014;129(12):1276–1285.
    1. Dong LW, et al. Impairment of the ryanodine-sensitive calcium release channels in the cardiac sarcoplasmic reticulum and its underlying mechanism during the hypodynamic phase of sepsis. Shock. 2001;16(1):33–39.
    1. Caballero R, et al. In humans, chronic atrial fibrillation decreases the transient outward current and ultrarapid component of the delayed rectifier current differentially on each atria and increases the slow component of the delayed rectifier current in both. J Am Coll Cardiol. 2010;55(21):2346–2354.
    1. Van Wagoner DR, et al. Atrial L-type Ca2+ currents and human atrial fibrillation. Circ Res. 1999;85(5):428–436.
    1. Voigt N, et al. Left-to-right atrial inward rectifier potassium current gradients in patients with paroxysmal versus chronic atrial fibrillation. Circ Arrhythm Electrophysiol. 2010;3(5):472–480.
    1. Nattel S. Changes in the atrial transcriptome and atrial fibrillation: susceptibility, persistence, causes, and consequences. Circ Arrhythm Electrophysiol. 2015;8(1):5–7.
    1. Jalife J, Berenfeld O, Mansour M. Mother rotors and fibrillatory conduction: a mechanism of atrial fibrillation. Cardiovasc Res. 2002;54(2):204–216.
    1. Nattel S. New ideas about atrial fibrillation 50 years on. Nature. 2002;415(6868):219–226.
    1. Schotten U, et al. Pathophysiological mechanisms of atrial fibrillation: a translational appraisal. Physiol Rev. 2011;91(1):265–325.
    1. Haissaguerre M, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med. 1998;339(10):659–666.
    1. Engelman TW. Ueber den Einfluss der Systole auf die motorische Leitung in der Herzkammer, mit Bemerkungen zur Theorie allorhythmischer Herzstörungen. Archiv für die gesamte Physiologie des Menschen und der Tiere. 1896;62(12):543–566.
    1. Moe GK, Rheinboldt WC, Abildskov JA. A computer model of atrial fibrillation. Am Heart J. 1964;67:200–220.
    1. Garrey WE. The nature of fibrillary contraction of the heart. Its relation to tissue mass and form. Annals of Noninvasive Electrocardiology. 1998;3(2):163–180.
    1. Jalife J. Deja vu in the theories of atrial fibrillation dynamics. Cardiovasc Res. 2011;89(4):766–775.
    1. Lewis T. Oliver-Sharpey Lectures on the nature of flutter and fibrillation of the auricle. Br Med J. 1921;1(3146):551–555.
    1. de Boer RA, et al. Galectin-3: a novel mediator of heart failure development and progression. Eur J Heart Fail. 2009;11(9):811–817.
    1. Chen YJ, et al. Effects of rapid atrial pacing on the arrhythmogenic activity of single cardiomyocytes from pulmonary veins: implication in initiation of atrial fibrillation. Circulation. 2001;104(23):2849–2854.
    1. Voigt N, et al. Cellular and molecular mechanisms of atrial arrhythmogenesis in patients with paroxysmal atrial fibrillation. Circulation. 2014;129(2):145–156.
    1. Christ T, et al. Arrhythmias, elicited by catecholamines and serotonin, vanish in human chronic atrial fibrillation. Proc Natl Acad Sci U S A. 2014;111(30):11193–11198.
    1. Greiser M, et al. Tachycardia-induced silencing of subcellular Ca2+ signaling in atrial myocytes. J Clin Invest. 2014;124(11):4759–4772.
    1. Lee SH, et al. Predictors of non-pulmonary vein ectopic beats initiating paroxysmal atrial fibrillation: implication for catheter ablation. J Am Coll Cardiol. 2005;46(6):1054–1059.
    1. Allessie MA, Bonke FI, Schopman FJ. Circus movement in rabbit atrial muscle as a mechanism of trachycardia. Circ Res. 1973;33(1):54–62.
    1. Mines GR. On circulating excitations in heart muscles and their possible relation to tachycardia and fibrillation. 1914
    1. Wiener N, Rosenblueth A. The mathematical formulation of the problem of conduction of impulses in a network of connected excitable elements, specifically in cardiac muscle. Arch Inst Cardiol Mex. 1946;16(3):205–265.
    1. Allessie MA, Bonke FI, Schopman FJ. Circus movement in rabbit atrial muscle as a mechanism of tachycardia. III. The “leading circle” concept: a new model of circus movement in cardiac tissue without the involvement of an anatomical obstacle. Circ Res. 1977;41(1):9–18.
    1. Winfree AT. Varieties of spiral wave behavior: An experimentalist’s approach to the theory of excitable media. Chaos. 1991;1(3):303–334.
    1. Rensma PL, et al. Length of excitation wave and susceptibility to reentrant atrial arrhythmias in normal conscious dogs. Circ Res. 1988;62(2):395–410.
    1. Winfree AT. Vortex action potentials in normal ventricular muscle. Ann N Y Acad Sci. 1990;591:190–207.
    1. Davidenko JM, et al. Sustained vortex-like waves in normal isolated ventricular muscle. Proc Natl Acad Sci U S A. 1990;87(22):8785–8789.
    1. Jalife J, D M, Anumonwo J, Berenfeld O, Kalifa J. Basic Cardiac Electrophysiology for the Clinician. Armonk, NY: Futura Pub; 1999.
    1. Fast VG, Kleber AG. Role of wavefront curvature in propagation of cardiac impulse. Cardiovasc Res. 1997;33(2):258–271.
    1. Zhao J, et al. Integration of High-Resolution Optical Mapping and 3-Dimensional Micro-Computed Tomographic Imaging to Resolve the Structural Basis of Atrial Conduction in the Human Heart. Circ Arrhythm Electrophysiol. 2015;8(6):1514–1517.
    1. Kneller J, et al. Mechanisms of atrial fibrillation termination by pure sodium channel blockade in an ionically-realistic mathematical model. Circ Res. 2005;96(5):e35–e47.
    1. Cuculich PS, et al. Noninvasive characterization of epicardial activation in humans with diverse atrial fibrillation patterns. Circulation. 2010;122(14):1364–1372.
    1. Haissaguerre M, et al. Driver domains in persistent atrial fibrillation. Circulation. 2014;130(7):530–538.
    1. Narayan SM, et al. Ablation of rotor and focal sources reduces late recurrence of atrial fibrillation compared with trigger ablation alone: extended follow-up of the CONFIRM trial (Conventional Ablation for Atrial Fibrillation With or Without Focal Impulse and Rotor Modulation) J Am Coll Cardiol. 2014;63(17):1761–1768.
    1. Lin YJ, et al. Prevalence, characteristics, mapping, and catheter ablation of potential rotors in nonparoxysmal atrial fibrillation. Circ Arrhythm Electrophysiol. 2013;6(5):851–858.
    1. Lin Y-J, et al. Benefits of atrial substrate modification guided by electrogram similarity and phase mapping techniques to eliminate rotors and focal sources versus conventional defragmentation in persistent atrial fibrillation. JACC: Clinical Electrophysiology. 2016;2(6):667–678.
    1. Miller JM, et al. Initial independent outcomes from focal impulse and rotor modulation ablation for atrial fibrillation: multicenter FIRM registry. J Cardiovasc Electrophysiol. 2014;25(9):921–929.
    1. Lee S, et al. Simultaneous biatrial high-density (510-512 electrodes) epicardial mapping of persistent and long-standing persistent atrial fibrillation in patients: new insights into the mechanism of its maintenance. Circulation. 2015;132(22):2108–2117.
    1. van der Does LJ, et al. Dynamics of endo- and epicardial focal fibrillation waves at the right atrium in a patient with advanced atrial remodelling. Can J Cardiol. 2016;32(10):1260.e19–1260.e21.
    1. de Groot N, et al. Direct proof of endo-epicardial asynchrony of the atrial wall during atrial fibrillation in humans. Circ Arrhythm Electrophysiol. 2016;9(5)
    1. Perez FJ, et al. Long-term outcomes after catheter ablation of cavo-tricuspid isthmus dependent atrial flutter: a meta-analysis. Circ Arrhythm Electrophysiol. 2009;2(4):393–401.
    1. Pappone C, et al. Mortality, morbidity, and quality of life after circumferential pulmonary vein ablation for atrial fibrillation: outcomes from a controlled nonrandomized long-term study. J Am Coll Cardiol. 2003;42(2):185–197.
    1. Hsu LF, et al. Atrial fibrillation originating from persistent left superior vena cava. Circulation. 2004;109(7):828–832.
    1. Chen MS, et al. Pulmonary vein isolation for the treatment of atrial fibrillation in patients with impaired systolic function. J Am Coll Cardiol. 2004;43(6):1004–1009.
    1. Gentlesk PJ, et al. Reversal of left ventricular dysfunction following ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2007;18(1):9–14.
    1. Khan MN, et al. Pulmonary-vein isolation for atrial fibrillation in patients with HF. N Engl J Med. 2008;359(17):1778–1785.
    1. MacDonald MR, et al. Radiofrequency ablation for persistent atrial fibrillation in patients with advanced heart failure and severe left ventricular systolic dysfunction: a randomised controlled trial. Heart. 2011;97(9):740–747.
    1. Hunter RJ, et al. A randomized controlled trial of catheter ablation versus medical treatment of atrial fibrillation in heart failure (the CAMTAF trial) Circ Arrhythm Electrophysiol. 2014;7(1):31–38.
    1. Themistoclakis S, et al. The risk of thromboembolism and need for oral anticoagulation after successful atrial fibrillation ablation. J Am Coll Cardiol. 2010;55(8):735–743.
    1. Bunch TJ, et al. Patients treated with catheter ablation for atrial fibrillation have long-term rates of death, stroke, and dementia similar to patients without atrial fibrillation. J Cardiovasc Electrophysiol. 2011;22(8):839–845.
    1. Dagres N, et al. Catheter ablation for atrial fibrillation in patients with left ventricular systolic dysfunction. A systematic review and meta-analysis. J Card Fail. 2011;17(11):964–970.
    1. Lin YJ, et al. Successful catheter ablation reduces the risk of cardiovascular events in atrial fibrillation patients with CHA2DS2-VASc risk score of 1 and higher. Europace. 2013;15(5):676–684.
    1. Ghanbari H, et al. Mortality and cerebrovascular events after radiofrequency catheter ablation of atrial fibrillation. Heart Rhythm. 2014;11(9):1503–1511.
    1. Yaksh A, et al. Atrial fibrillation: to map or not to map? Neth Heart J. 2014;22(6):259–266.
    1. Pappone C, et al. Circumferential radiofrequency ablation of pulmonary vein ostia: A new anatomic approach for curing atrial fibrillation. Circulation. 2000;102(21):2619–2628.
    1. Verma A, et al. Approaches to catheter ablation for persistent atrial fibrillation. N Engl J Med. 2015;372(19):1812–1822.
    1. Kottkamp H, et al. Time courses and quantitative analysis of atrial fibrillation episode number and duration after circular plus linear left atrial lesions: trigger elimination or substrate modification: early or delayed cure? J Am Coll Cardiol. 2004;44(4):869–877.
    1. Pappone C, et al. Pulmonary vein denervation enhances long-term benefit after circumferential ablation for paroxysmal atrial fibrillation. Circulation. 2004;109(3):327–334.
    1. Byrd GD, et al. Importance of geometry and refractory period in sustaining atrial fibrillation: testing the critical mass hypothesis. Circulation. 2005;112(9 Suppl):I7–I13.
    1. Tan AY, et al. Electrical connections between left superior pulmonary vein, LA, and ligament of Marshall: implications for mechanisms of atrial fibrillation. Am J Physiol Heart Circ Physiol. 2006;290(1):H312–H322.
    1. Narayan SM, et al. Direct or coincidental elimination of stable rotors or focal sources may explain successful atrial fibrillation ablation: on-treatment analysis of the CONFIRM trial (Conventional ablation for AF with or without focal impulse and rotor modulation) J Am Coll Cardiol. 2013;62(2):138–147.
    1. Gaita F, et al. Very long-term results of surgical and transcatheter ablation of long-standing persistent atrial fibrillation. Ann Thorac Surg. 2013;96(4):1273–1278.
    1. Ganesan AN, et al. Long-term outcomes of catheter ablation of atrial fibrillation: a systematic review and meta-analysis. J Am Heart Assoc. 2013;2(2):e004549.
    1. Oral H, et al. Clinical significance of early recurrences of atrial fibrillation after pulmonary vein isolation. J Am Coll Cardiol. 2002;40(1):100–104.
    1. Joshi S, et al. Prevalence, predictors, and prognosis of atrial fibrillation early after pulmonary vein isolation: findings from 3 months of continuous automatic ECG loop recordings. J Cardiovasc Electrophysiol. 2009;20(10):1089–1094.
    1. Andrade JG, et al. Incidence and significance of early recurrences associated with different ablation strategies for AF: a STAR-AF substudy. J Cardiovasc Electrophysiol. 2012;23(12):1295–1301.
    1. Grubman E, et al. Histopathologic effects of radiofrequency catheter ablation in previously infarcted human myocardium. J Cardiovasc Electrophysiol. 1999;10(3):336–342.
    1. Hsieh MH, et al. Alterations of heart rate variability after radiofrequency catheter ablation of focal atrial fibrillation originating from pulmonary veins. Circulation. 1999;100(22):2237–2243.
    1. Fenelon G, Brugada P. Delayed effects of radiofrequency energy: mechanisms and clinical implications. Pacing Clin Electrophysiol. 1996;19(4 Pt 1):484–489.
    1. Lodzinski P, et al. Does a blanking period after pulmonary vein isolation impact long-term results? Results after 55 months of follow-up. Cardiol J. 2014;21(4):384–391.
    1. Liang JJ, et al. Early recurrence of atrial arrhythmias following pulmonary vein antral isolation: Timing and frequency of early recurrences predicts long-term ablation success. Heart Rhythm. 2015;12(12):2461–2468.
    1. Jais P, et al. Catheter ablation versus antiarrhythmic drugs for atrial fibrillation: the A4 study. Circulation. 2008;118(24):2498–2505.
    1. Calkins H, et al. Treatment of atrial fibrillation with antiarrhythmic drugs or radiofrequency ablation: two systematic literature reviews and meta-analyses. Circ Arrhythm Electrophysiol. 2009;2(4):349–361.
    1. Verma A, et al. Response of atrial fibrillation to pulmonary vein antrum isolation is directly related to resumption and delay of pulmonary vein conduction. Circulation. 2005;112(5):627–635.
    1. Eitel C, et al. Circumferential pulmonary vein isolation and linear left atrial ablation as a single-catheter technique to achieve bidirectional conduction block: the pace-and-ablate approach. Heart Rhythm. 2010;7(2):157–164.
    1. Macle L, et al. Adenosine-guided pulmonary vein isolation for the treatment of paroxysmal atrial fibrillation: an international, multicentre, randomised superiority trial. Lancet. 2015;386(9994):672–679.
    1. Ouyang F, et al. Long-term results of catheter ablation in paroxysmal atrial fibrillation: lessons from a 5-year follow-up. Circulation. 2010;122(23):2368–2377.
    1. Weerasooriya R, et al. Catheter ablation for atrial fibrillation: are results maintained at 5 years of follow-up? J Am Coll Cardiol. 2011;57(2):160–166.
    1. Wokhlu A, et al. Long-term outcome of atrial fibrillation ablation: impact and predictors of very late recurrence. J Cardiovasc Electrophysiol. 2010;21(10):1071–1078.
    1. Hsieh MH, et al. The different mechanisms between late and very late recurrences of atrial fibrillation in patients undergoing a repeated catheter ablation. J Cardiovasc Electrophysiol. 2006;17(3):231–235.
    1. Sotomi Y, et al. Cause of very late recurrence of atrial fibrillation or flutter after catheter ablation for atrial fibrillation. Am J Cardiol. 2013;111(4):552–556.
    1. Mainigi SK, et al. Incidence and predictors of very late recurrence of atrial fibrillation after ablation. J Cardiovasc Electrophysiol. 2007;18(1):69–74.
    1. Gaztanaga L, et al. Time to recurrence of atrial fibrillation influences outcome following catheter ablation. Heart Rhythm. 2012;10(1):2–9.
    1. January CT, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2014;64(21):e1–e76.
    1. January CT, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. Circulation. 2014;130(23):2071–2104.
    1. EHRA Scientific Committee Task Force, et al. European Heart Rhythm Association (EHRA)/European Association of Cardiovascular Prevention and Rehabilitation (EACPR) position paper on how to prevent atrial fibrillation. Endorsed by the Heart Rhythm Society (HRS) and Asia Pacific Heart Rhythm Society (APHRS) Europace. 2016 Epub ahead of print.
    1. Dublin S, et al. Risk of new-onset atrial fibrillation in relation to body mass index. Arch Intern Med. 2006;166(21):2322–2328.
    1. Gami AS, et al. Obstructive sleep apnea, obesity, and the risk of incident atrial fibrillation. J Am Coll Cardiol. 2007;49(5):565–571.
    1. Tedrow UB, et al. The long- and short-term impact of elevated body mass index on the risk of new atrial fibrillation the WHS (Women’s Health Study) J Am Coll Cardiol. 2010;55(21):2319–2327.
    1. Huxley RR, et al. Absolute and attributable risks of atrial fibrillation in relation to optimal and borderline risk factors: the Atherosclerosis Risk in Communities (ARIC) study. Circulation. 2011;123(14):1501–1508.
    1. Munger TM, et al. Electrophysiological and hemodynamic characteristics associated with obesity in patients with atrial fibrillation. J Am Coll Cardiol. 2012;60(9):851–860.
    1. Abed HS, et al. Obesity results in progressive atrial structural and electrical remodeling: implications for atrial fibrillation. Heart Rhythm. 2013;10(1):90–100.
    1. Richter B, et al. Is inducibility of atrial fibrillation after radio frequency ablation really a relevant prognostic factor? Eur Heart J. 2006;27(21):2553–2559.
    1. Jongnarangsin K, et al. Body mass index, obstructive sleep apnea, and outcomes of catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2008;19(7):668–672.
    1. Shah AN, et al. Long-term outcome following successful pulmonary vein isolation: pattern and prediction of very late recurrence. J Cardiovasc Electrophysiol. 2008;19(7):661–667.
    1. Chang SL, et al. Comparison of outcome in catheter ablation of atrial fibrillation in patients with versus without the metabolic syndrome. Am J Cardiol. 2009;103(1):67–72.
    1. Letsas KP, et al. Pre-ablative predictors of atrial fibrillation recurrence following pulmonary vein isolation: the potential role of inflammation. Europace. 2009;11(2):158–163.
    1. Tang RB, et al. Metabolic syndrome and risk of recurrence of atrial fibrillation after catheter ablation. Circ J. 2009;73(3):438–443.
    1. Jin Hwang H, et al. Atrial electroanatomical remodeling as a determinant of different outcomes between two current ablation strategies: circumferential pulmonary vein isolation vs pulmonary vein isolation. Clin Cardiol. 2010;33(3):E69–E74.
    1. Patel D, et al. Outcomes and complications of catheter ablation for atrial fibrillation in females. Heart Rhythm. 2010;7(2):167–172.
    1. Patel D, et al. Safety and efficacy of pulmonary vein antral isolation in patients with obstructive sleep apnea: the impact of continuous positive airway pressure. Circ Arrhythm Electrophysiol. 2010;3(5):445–451.
    1. Patel D, et al. The impact of statins and renin-angiotensin-aldosterone system blockers on pulmonary vein antrum isolation outcomes in post-menopausal females. Europace. 2010;12(3):322–330.
    1. Chao TF, et al. Associations between renal function, atrial substrate properties and outcome of catheter ablation in patients with paroxysmal atrial fibrillation. Circ J. 2011;75(10):2326–2332.
    1. Winkle RA, et al. Relation of early termination of persistent atrial fibrillation by cardioversion or drugs to ablation outcomes. Am J Cardiol. 2011;108(3):374–379.
    1. Wong CX, et al. Pericardial fat is associated with atrial fibrillation severity and ablation outcome. J Am Coll Cardiol. 2011;57(17):1745–1751.
    1. Kang JH, et al. Prediction of long-term outcomes of catheter ablation of persistent atrial fibrillation by parameters of preablation DC cardioversion. J Cardiovasc Electrophysiol. 2012;23(11):1165–1170.
    1. Mohanty S, et al. Impact of metabolic syndrome on procedural outcomes in patients with atrial fibrillation undergoing catheter ablation. J Am Coll Cardiol. 2012;59(14):1295–1301.
    1. Ejima K, et al. Impact of diastolic dysfunction on the outcome of catheter ablation in patients with atrial fibrillation. Int J Cardiol. 2013;164(1):88–93.
    1. Letsas KP, et al. The impact of body mass index on the efficacy and safety of catheter ablation of atrial fibrillation. Int J Cardiol. 2013;164(1):94–98.
    1. Wong CX, et al. Obesity and the risk of incident, post-operative, and postablation atrial fibrillation: a meta-analysis of 626,603 individuals in 51 studies. JACC: Clinical Electrophysiology. 2015;1(3):139–152.
    1. Alonso A, et al. Effect of an intensive lifestyle intervention on atrial fibrillation risk in individuals with type 2 diabetes: the Look AHEAD randomized trial. Am Heart J. 2015;170(4):770–777.e5.
    1. Pathak RK, et al. Aggressive risk factor reduction study for atrial fibrillation and implications for the outcome of ablation: the ARREST-AF cohort study. J Am Coll Cardiol. 2014;64(21):2222–2231.
    1. Bitter T, et al. Sleep-disordered breathing and cardiac arrhythmias. Can J Cardiol. 2015;31(7):928–934.
    1. Fletcher EC. Effect of episodic hypoxia on sympathetic activity and blood pressure. Respir Physiol. 2000;119(2-3):189–197.
    1. Kraiczi H, et al. Increased vasoconstrictor sensitivity in obstructive sleep apnea. J Appl Physiol (1985) 2000;89(2):493–498.
    1. Ghias M, et al. The role of ganglionated plexi in apnea-related atrial fibrillation. J Am Coll Cardiol. 2009;54(22):2075–2083.
    1. Linz D, et al. Negative tracheal pressure during obstructive respiratory events promotes atrial fibrillation by vagal activation. Heart Rhythm. 2011;8(9):1436–1443.
    1. Linz D, et al. Renal sympathetic denervation suppresses postapneic blood pressure rises and atrial fibrillation in a model for sleep apnea. Hypertension. 2012;60(1):172–178.
    1. Linz D, et al. Effect of renal denervation on neurohumoral activation triggering atrial fibrillation in obstructive sleep apnea. Hypertension. 2013;62(4):767–774.
    1. Iwasaki YK, et al. Determinants of atrial fibrillation in an animal model of obesity and acute obstructive sleep apnea. Heart Rhythm. 2012;9(9):1409–1416.e1.
    1. Iwasaki YK, et al. Atrial fibrillation promotion with long-term repetitive obstructive sleep apnea in a rat model. J Am Coll Cardiol. 2014;64(19):2013–2023.
    1. Dimitri H, et al. Atrial remodeling in obstructive sleep apnea: implications for atrial fibrillation. Heart Rhythm. 2012;9(3):321–327.
    1. Stevenson IH, et al. Atrial electrophysiology is altered by acute hypercapnia but not hypoxemia: implications for promotion of atrial fibrillation in pulmonary disease and sleep apnea. Heart Rhythm. 2010;7(9):1263–1270.
    1. Holmqvist F, et al. Impact of obstructive sleep apnea and continuous positive airway pressure therapy on outcomes in patients with atrial fibrillation-Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) Am Heart J. 2015;169(5):647–654.e2.
    1. Kwon Y, et al. Association of sleep characteristics with atrial fibrillation: the Multi-Ethnic Study of Atherosclerosis. Thorax. 2015;70(9):873–879.
    1. Kanagala R, et al. Obstructive sleep apnea and the recurrence of atrial fibrillation. Circulation. 2003;107(20):2589–2594.
    1. Fein AS, et al. Treatment of obstructive sleep apnea reduces the risk of atrial fibrillation recurrence after catheter ablation. J Am Coll Cardiol. 2013;62(4):300–305.
    1. Matiello M, et al. Low efficacy of atrial fibrillation ablation in severe obstructive sleep apnoea patients. Europace. 2010;12(8):1084–1089.
    1. Naruse Y, et al. Concomitant obstructive sleep apnea increases the recurrence of atrial fibrillation following radiofrequency catheter ablation of atrial fibrillation: clinical impact of continuous positive airway pressure therapy. Heart Rhythm. 2013;10(3):331–337.
    1. Neilan TG, et al. Effect of sleep apnea and continuous positive airway pressure on cardiac structure and recurrence of atrial fibrillation. J Am Heart Assoc. 2013;2(6):e000421.
    1. Li L, et al. Efficacy of catheter ablation of atrial fibrillation in patients with obstructive sleep apnoea with and without continuous positive airway pressure treatment: a meta-analysis of observational studies. Europace. 2014;16(9):1309–1314.
    1. Kannel WB, et al. Epidemiologic features of chronic atrial fibrillation: the Framingham study. N Engl J Med. 1982;306(17):1018–1022.
    1. Krahn AD, et al. The natural history of atrial fibrillation: incidence, risk factors, and prognosis in the Manitoba Follow-Up Study. Am J Med. 1995;98(5):476–484.
    1. Thomas MC, et al. Blood pressure control and risk of incident atrial fibrillation. Am J Hypertens. 2008;21(10):1111–1116.
    1. Tremblay-Gravel M, et al. Blood Pressure and Atrial Fibrillation: A Combined AF-CHF and AFFIRM Analysis. J Cardiovasc Electrophysiol. 2015;26(5):509–514.
    1. Grundvold I, et al. Upper normal blood pressures predict incident atrial fibrillation in healthy middle-aged men: a 35-year follow-up study. Hypertension. 2012;59(2):198–204.
    1. Conen D, et al. Influence of systolic and diastolic blood pressure on the risk of incident atrial fibrillation in women. Circulation. 2009;119(16):2146–2152.
    1. Kistler PM, et al. Atrial electrical and structural abnormalities in an ovine model of chronic blood pressure elevation after prenatal corticosteroid exposure: implications for development of atrial fibrillation. Eur Heart J. 2006;27(24):3045–3056.
    1. Berruezo A, et al. Pre-procedural predictors of atrial fibrillation recurrence after circumferential pulmonary vein ablation. Eur Heart J. 2007;28(7):836–841.
    1. Arya A, et al. Long-term results and the predictors of outcome of catheter ablation of atrial fibrillation using steerable sheath catheter navigation after single procedure in 674 patients. Europace. 2010;12(2):173–180.
    1. Santoro F, et al. Impact of Uncontrolled Hypertension on Atrial Fibrillation Ablation Outcome. JACC: Clinical Electrophysiology. 2015;1(3):164–173.
    1. Pokushalov E, et al. Renal denervation for improving outcomes of catheter ablation in patients with atrial fibrillation and hypertension: early experience. Heart Rhythm. 2014;11(7):1131–1138.
    1. Healey JS, et al. Prevention of atrial fibrillation with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: a meta-analysis. J Am Coll Cardiol. 2005;45(11):1832–1839.
    1. Al Chekakie MO, et al. The effects of statins and renin-angiotensin system blockers on atrial fibrillation recurrence following antral pulmonary vein isolation. J Cardiovasc Electrophysiol. 2007;18(9):942–946.
    1. Tayebjee MH, et al. Impact of angiotensin-converting enzyme-inhibitors and angiotensin receptor blockers on long-term outcome of catheter ablation for atrial fibrillation. Europace. 2010;12(11):1537–1542.
    1. Kato T, et al. What are arrhythmogenic substrates in diabetic rat atria? J Cardiovasc Electrophysiol. 2006;17(8):890–894.
    1. Huxley RR, et al. Meta-analysis of cohort and case-control studies of type 2 diabetes mellitus and risk of atrial fibrillation. Am J Cardiol. 2011;108(1):56–62.
    1. Huxley RR, et al. Type 2 diabetes, glucose homeostasis and incident atrial fibrillation: the Atherosclerosis Risk in Communities study. Heart. 2012;98(2):133–138.
    1. Lin KJ, et al. Impact of metabolic syndrome on the risk of atrial fibrillation recurrence after catheter ablation: systematic review and meta-analysis. J Interv Card Electrophysiol. 2014;39(3):211–223.
    1. Ettinger PO, et al. Arrhythmias and the “Holiday Heart”: alcohol-associated cardiac rhythm disorders. Am Heart J. 1978;95(5):555–562.
    1. Patel N, et al. Does alcohol use increase the risk of atrial fibrillation recurrence after radiofrequency ablation? J Am Coll Cardiol. 2013;61(10_S)
    1. Mohanty S, et al. Impact of alcohol intake on thromboembolic events following catheter ablation for atrial fibrillation. J Am Coll Cardiol. 2014;63(12_S)
    1. Qiao Y, et al. Impact of alcohol consumption on substrate remodeling and ablation outcome of paroxysmal atrial fibrillation. J Am Heart Assoc. 2015;4(11)
    1. Wilber DJ. Fibroblasts, focal triggers, and persistent atrial fibrillation: is there a connection? Circ Arrhythm Electrophysiol. 2012;5(2):249–251.
    1. Rohr S. Arrhythmogenic implications of fibroblast-myocyte interactions. Circ Arrhythm Electrophysiol. 2012;5(2):442–452.
    1. Qureshi WT, et al. Cardiorespiratory fitness and risk of incident atrial fibrillation: results from the Henry Ford Exercise Testing (FIT) project. Circulation. 2015;131(21):1827–1834.
    1. Malmo V, et al. Aerobic interval training reduces the burden of atrial fibrillation in the short term: a randomized trial. Circulation. 2016;133(5):466–473.
    1. Abdulla J, Nielsen JR. Is the risk of atrial fibrillation higher in athletes than in the general population? A systematic review and meta-analysis. Europace. 2009;11(9):1156–1159.
    1. Aizer A, et al. Relation of vigorous exercise to risk of atrial fibrillation. Am J Cardiol. 2009;103(11):1572–1577.
    1. Mont L, Elosua R, Brugada J. Endurance sport practice as a risk factor for atrial fibrillation and atrial flutter. Europace. 2009;11(1):11–17.
    1. Hoogsteen J, et al. Paroxysmal atrial fibrillation in male endurance athletes. A 9-year follow up. Europace. 2004;6(3):222–228.
    1. Pelliccia A, et al. Prevalence and clinical significance of left atrial remodeling in competitive athletes. J Am Coll Cardiol. 2005;46(4):690–696.
    1. Swanson DR. Atrial fibrillation in athletes: implicit literature-based connections suggest that overtraining and subsequent inflammation may be a contributory mechanism. Med Hypotheses. 2006;66(6):1085–1092.
    1. Heidbuchel H, et al. Endurance sports is a risk factor for atrial fibrillation after ablation for atrial flutter. Int J Cardiol. 2006;107(1):67–72.
    1. Andersen K, et al. Risk of arrhythmias in 52 755 long-distance cross-country skiers: a cohort study. Eur Heart J. 2013;34(47):3624–3631.
    1. Bettoni M, Zimmermann M. Autonomic tone variations before the onset of paroxysmal atrial fibrillation. Circulation. 2002;105(23):2753–2759.
    1. Pelliccia A, et al. Physiologic left ventricular cavity dilatation in elite athletes. Ann Intern Med. 1999;130(1):23–31.
    1. Eijsvogels TM, Fernandez AB, Thompson PD. Are There Deleterious Cardiac Effects of Acute and Chronic Endurance Exercise? Physiol Rev. 2016;96(1):99–125.
    1. Allison MA, et al. Sedentary behavior and adiposity-associated inflammation: the Multi-Ethnic Study of Atherosclerosis. Am J Prev Med. 2012;42(1):8–13.
    1. Kasapis C, Thompson PD. The effects of physical activity on serum C-reactive protein and inflammatory markers: a systematic review. J Am Coll Cardiol. 2005;45(10):1563–1569.
    1. Engelmann MD, Svendsen JH. Inflammation in the genesis and perpetuation of atrial fibrillation. Eur Heart J. 2005;26(20):2083–2092.
    1. Chung MK, et al. C-reactive protein elevation in patients with atrial arrhythmias: inflammatory mechanisms and persistence of atrial fibrillation. Circulation. 2001;104(24):2886–2891.
    1. Korantzopoulos P, et al. Atrial fibrillation and electrical remodeling: the potential role of inflammation and oxidative stress. Med Sci Monit. 2003;9(9):RA225–RA229.
    1. Psychari SN, et al. Relation of elevated C-reactive protein and interleukin-6 levels to left atrial size and duration of episodes in patients with atrial fibrillation. Am J Cardiol. 2005;95(6):764–767.
    1. Mohlenkamp S, et al. Running: the risk of coronary events: Prevalence and prognostic relevance of coronary atherosclerosis in marathon runners. Eur Heart J. 2008;29(15):1903–1910.
    1. Marrouche NF, et al. Association of atrial tissue fibrosis identified by delayed enhancement MRI and atrial fibrillation catheter ablation: the DECAAF study. JAMA. 2014;311(5):498–506.
    1. Benito B, et al. Cardiac arrhythmogenic remodeling in a rat model of long-term intensive exercise training. Circulation. 2011;123(1):13–22.
    1. Lindsay MM, Dunn FG. Biochemical evidence of myocardial fibrosis in veteran endurance athletes. Br J Sports Med. 2007;41(7):447–452.
    1. Gay-Jordi G, et al. Losartan prevents heart fibrosis induced by long-term intensive exercise in an animal model. PLoS One. 2013;8(2):e55427.
    1. Sorokin AV, et al. Atrial fibrillation in endurance-trained athletes. Br J Sports Med. 2011;45(3):185–188.
    1. Calvo N, et al. Efficacy of circumferential pulmonary vein ablation of atrial fibrillation in endurance athletes. Europace. 2010;12(1):30–36.
    1. Koopman P, et al. Efficacy of radiofrequency catheter ablation in athletes with atrial fibrillation. Europace. 2011;13(10):1386–1393.
    1. Furlanello F, et al. Radiofrequency catheter ablation of atrial fibrillation in athletes referred for disabling symptoms preventing usual training schedule and sport competition. J Cardiovasc Electrophysiol. 2008;19(5):457–462.
    1. Pathak RK, et al. Impact of CARDIOrespiratory FITness on Arrhythmia Recurrence in Obese Individuals With Atrial Fibrillation: The CARDIO-FIT Study. J Am Coll Cardiol. 2015;66(9):985–996.
    1. Fjeldsoe B, et al. Systematic review of maintenance of behavior change following physical activity and dietary interventions. Health Psychol. 2011;30(1):99–109.
    1. European Heart Rhythm, A, et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC) Europace. 2010;12(10):1360–1420.
    1. Camm AJ, et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association. Eur Heart J. 2012;33(21):2719–2747.
    1. Wazni OM, et al. Radiofrequency ablation vs antiarrhythmic drugs as first-line treatment of symptomatic atrial fibrillation: a randomized trial. JAMA. 2005;293(21):2634–2640.
    1. Cosedis Nielsen J, et al. Radiofrequency ablation as initial therapy in paroxysmal atrial fibrillation. N Engl J Med. 2012;367(17):1587–1595.
    1. Morillo CA, et al. Radiofrequency ablation vs antiarrhythmic drugs as first-line treatment of paroxysmal atrial fibrillation (RAAFT-2): a randomized trial. JAMA. 2014;311(7):692–700.
    1. Hakalahti A, et al. Radiofrequency ablation vs antiarrhythmic drug therapy as first line treatment of symptomatic atrial fibrillation: systematic review and meta-analysis. Europace. 2015;17(3):370–378.
    1. Hocini M, et al. Reverse remodeling of sinus node function after catheter ablation of atrial fibrillation in patients with prolonged sinus pauses. Circulation. 2003;108(10):1172–1175.
    1. Chen YW, et al. Pacing or ablation: which is better for paroxysmal atrial fibrillation-related tachycardia-bradycardia syndrome? Pacing Clin Electrophysiol. 2014;37(4):403–411.
    1. Inada K, et al. The role of successful catheter ablation in patients with paroxysmal atrial fibrillation and prolonged sinus pauses: outcome during a 5-year follow-up. Europace. 2014;16(2):208–213.
    1. Tondo C, et al. Pulmonary vein vestibule ablation for the control of atrial fibrillation in patients with impaired left ventricular function. Pacing Clin Electrophysiol. 2006;29(9):962–970.
    1. Bunch TJ, et al. Substrate and procedural predictors of outcomes after catheter ablation for atrial fibrillation in patients with hypertrophic cardiomyopathy. J Cardiovasc Electrophysiol. 2008;19(10):1009–1014.
    1. Lutomsky BA, et al. Catheter ablation of paroxysmal atrial fibrillation improves cardiac function: a prospective study on the impact of atrial fibrillation ablation on left ventricular function assessed by magnetic resonance imaging. Europace. 2008;10(5):593–599.
    1. Choi AD, et al. Ablation vs medical therapy in the setting of symptomatic atrial fibrillation and left ventricular dysfunction. Congest Heart Fail. 2010;16(1):10–14.
    1. De Potter T, et al. Left ventricular systolic dysfunction by itself does not influence outcome of atrial fibrillation ablation. Europace. 2010;12(1):24–29.
    1. Cha YM, et al. Success of ablation for atrial fibrillation in isolated left ventricular diastolic dysfunction: a comparison to systolic dysfunction and normal ventricular function. Circ Arrhythm Electrophysiol. 2011;4(5):724–732.
    1. Jones DG, et al. A randomized trial to assess catheter ablation versus rate control in the management of persistent atrial fibrillation in HF. J Am Coll Cardiol. 2013;61(18):1894–1903.
    1. Machino-Ohtsuka T, et al. Efficacy, safety, and outcomes of catheter ablation of atrial fibrillation in patients with heart failure with preserved ejection fraction. J Am Coll Cardiol. 2013;62(20):1857–1865.
    1. Al Halabi S, et al. Catheter ablation for atrial fibrillation in heart failure patients: a meta-analysis of randomized controlled trials. JACC Clin Electrophysiol. 2015;1(3):200–209.
    1. Bunch TJ, et al. Five-year outcomes of catheter ablation in patients with atrial fibrillation and left ventricular systolic dysfunction. J Cardiovasc Electrophysiol. 2015;26(4):363–370.
    1. Lobo TJ, et al. Atrial fibrillation ablation in systolic dysfunction: clinical and echocardiographic outcomes. Arq Bras Cardiol. 2015;104(1):45–52.
    1. Ling LH, et al. Sinus rhythm restores ventricular function in patients with cardiomyopathy and no late gadolinium enhancement on cardiac magnetic resonance imaging who undergo catheter ablation for atrial fibrillation. Heart Rhythm. 2013;10(9):1334–1339.
    1. Spragg DD, et al. Complications of catheter ablation for atrial fibrillation: incidence and predictors. J Cardiovasc Electrophysiol. 2008;19(6):627–631.
    1. Kusumoto F, et al. Radiofrequency catheter ablation of atrial fibrillation in older patients: outcomes and complications. J Interv Card Electrophysiol. 2009;25(1):31–35.
    1. Bunch TJ, et al. Long-term clinical efficacy and risk of catheter ablation for atrial fibrillation in octogenarians. Pacing Clin Electrophysiol. 2010;33(2):146–152.
    1. Santangeli P, et al. Ablation for atrial fibrillation: termination of atrial fibrillation is not the end point. Card Electrophysiol Clin. 2012;4(3):343–352.
    1. Santangeli P, et al. Ablation of atrial fibrillation under therapeutic warfarin reduces periprocedural complications: evidence from a meta-analysis. Circ Arrhythm Electrophysiol. 2012;5(2):302–311.
    1. Santangeli P, et al. Catheter ablation of atrial fibrillation in octogenarians: safety and outcomes. J Cardiovasc Electrophysiol. 2012;23(7):687–693.
    1. Nademanee K, et al. Benefits and risks of catheter ablation in elderly patients with atrial fibrillation. Heart Rhythm. 2015;12(1):44–51.
    1. Bunch TJ, et al. The impact of age on 5-year outcomes after atrial fibrillation catheter ablation. J Cardiovasc Electrophysiol. 2016;27(2):141–146.
    1. Metzner I, et al. Ablation of atrial fibrillation in patients >/=75 years: long-term clinical outcome and safety. Europace. 2016;18(4):543–549.
    1. Leong-Sit P, et al. Efficacy and risk of atrial fibrillation ablation before 45 years of age. Circ Arrhythm Electrophysiol. 2010;3(5):452–457.
    1. Oral H, et al. Risk of thromboembolic events after percutaneous left atrial radiofrequency ablation of atrial fibrillation. Circulation. 2006;114(8):759–765.
    1. Hussein AA, et al. Natural history and long-term outcomes of ablated atrial fibrillation. Circ Arrhythm Electrophysiol. 2011;4(3):271–278.
    1. Hunter RJ, et al. Maintenance of sinus rhythm with an ablation strategy in patients with atrial fibrillation is associated with a lower risk of stroke and death. Heart. 2012;98(1):48–53.
    1. Winkle RA, et al. Discontinuing anticoagulation following successful atrial fibrillation ablation in patients with prior strokes. J Interv Card Electrophysiol. 2013;38(3):147–153.
    1. Karasoy D, et al. Oral anticoagulation therapy after radiofrequency ablation of atrial fibrillation and the risk of thromboembolism and serious bleeding: longterm follow-up in nationwide cohort of Denmark. Eur Heart J. 2015;36(5):307–314a.
    1. Schlingloff F, et al. Oral anticoagulation after successful atrial fibrillation ablation operations: is it necessary? Ann Thorac Surg. 2016;101(4):1471–1476.
    1. Nuhrich JM, et al. Oral anticoagulation is frequently discontinued after ablation of paroxysmal atrial fibrillation despite previous stroke: data from the German Ablation Registry. Clin Res Cardiol. 2015;104(6):463–470.
    1. Oral H, et al. Prevalence of asymptomatic recurrences of atrial fibrillation after successful radiofrequency catheter ablation. J Cardiovasc Electrophysiol. 2004;15(8):920–924.
    1. Tondo C, et al. Rhythm-symptom correlation in patients on continuous monitoring after catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2014;25(2):154–160.
    1. Kirchhof P, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016;37(38):2893–2962.
    1. Forleo GB, et al. Clinical impact of catheter ablation in patients with asymptomatic atrial fibrillation: the IRON-AF (Italian registry on NavX atrial fibrillation ablation procedures) study. Int J Cardiol. 2013;168(4):3968–3970.
    1. Mohanty S, et al. Catheter ablation of asymptomatic longstanding persistent atrial fibrillation: impact on quality of life, exercise performance, arrhythmia perception, and arrhythmia-free survival. J Cardiovasc Electrophysiol. 2014;25(10):1057–1064.
    1. Wu L, et al. Comparison of radiofrequency catheter ablation between asymptomatic and symptomatic persistent atrial fibrillation: a propensity score matched analysis. J Cardiovasc Electrophysiol. 2016;27(5):531–535.
    1. Cox JL, et al. The surgical treatment of atrial fibrillation. II. Intraoperative electrophysiologic mapping and description of the electrophysiologic basis of atrial flutter and atrial fibrillation. J Thorac Cardiovasc Surg. 1991;101(3):406–426.
    1. Sundt TM, 3rd, Camillo CJ, Cox JL. The maze procedure for cure of atrial fibrillation. Cardiol Clin. 1997;15(4):739–748.
    1. Melo J, et al. Surgery for atrial fibrillation using radiofrequency catheter ablation: assessment of results at one year. Eur J Cardiothorac Surg. 1999;15(6):851–854. discussion 855.
    1. Sueda T, et al. Efficacy of pulmonary vein isolation for the elimination of chronic atrial fibrillation in cardiac valvular surgery. Ann Thorac Surg. 2001;71(4):1189–1193.
    1. Swartz JF, P G, Silvers J, Pattern L, Cervantez D. A catheter-based curative approach to atrial fibrillation in humans. [abstract] Circulation. 1994;90(Suppl I):I–335.
    1. Haissaguerre M, et al. Right and left atrial radiofrequency catheter therapy of paroxysmal atrial fibrillation. J Cardiovasc Electrophysiol. 1996;7(12):1132–1144.
    1. Gaita F, et al. Atrial mapping and radiofrequency catheter ablation in patients with idiopathic atrial fibrillation. Electrophysiological findings and ablation results. Circulation. 1998;97(21):2136–2145.
    1. Jais P, et al. Long-term follow-up after right atrial radiofrequency catheter treatment of paroxysmal atrial fibrillation. Pacing Clin Electrophysiol. 1998;21(11 Pt 2):2533–2538.
    1. Calkins H, et al. A new system for catheter ablation of atrial fibrillation. Am J Cardiol. 1999;83(5B):227D–236D.
    1. Natale A, et al. Catheter ablation approach on the right side only for paroxysmal atrial fibrillation therapy: long-term results. Pacing Clin Electrophysiol. 2000;23(2):224–233.
    1. Kocheril AG, et al. Hybrid therapy with right atrial catheter ablation and previously ineffective antiarrhythmic drugs for the management of atrial fibrillation. J Interv Card Electrophysiol. 2005;12(3):189–197.
    1. Haissaguerre M, et al. Radiofrequency catheter ablation in unusual mechanisms of atrial fibrillation: report of three cases. J Cardiovasc Electrophysiol. 1994;5(9):743–751.
    1. Jais P, et al. A focal source of atrial fibrillation treated by discrete radiofrequency ablation. Circulation. 1997;95(3):572–576.
    1. Pappone C, et al. Catheter ablation of paroxysmal atrial fibrillation using a 3D mapping system. Circulation. 1999;100(11):1203–1208.
    1. Haissaguerre M, et al. Electrophysiological end point for catheter ablation of atrial fibrillation initiated from multiple pulmonary venous foci. Circulation. 2000;101(12):1409–1417.
    1. Robbins IM, et al. Pulmonary vein stenosis after catheter ablation of atrial fibrillation. Circulation. 1998;98(17):1769–1775.
    1. Marrouche NF, et al. Phased-array intracardiac echocardiography monitoring during pulmonary vein isolation in patients with atrial fibrillation: impact on outcome and complications. Circulation. 2003;107(21):2710–2716.
    1. Oral H, et al. Segmental ostial ablation to isolate the pulmonary veins during atrial fibrillation: feasibility and mechanistic insights. Circulation. 2002;106(10):1256–1262.
    1. Pappone C, et al. Atrial electroanatomic remodeling after circumferential radiofrequency pulmonary vein ablation: efficacy of an anatomic approach in a large cohort of patients with atrial fibrillation. Circulation. 2001;104(21):2539–2544.
    1. Ouyang F, et al. Complete isolation of left atrium surrounding the pulmonary veins: new insights from the double-Lasso technique in paroxysmal atrial fibrillation. Circulation. 2004;110(15):2090–2096.
    1. Takahashi A, et al. Electrical connections between pulmonary veins: implication for ostial ablation of pulmonary veins in patients with paroxysmal atrial fibrillation. Circulation. 2002;105(25):2998–3003.
    1. Callans DJ, et al. Efficacy of repeat pulmonary vein isolation procedures in patients with recurrent atrial fibrillation. J Cardiovasc Electrophysiol. 2004;15(9):1050–1055.
    1. Oral H, et al. Catheter ablation for paroxysmal atrial fibrillation: segmental pulmonary vein ostial ablation versus left atrial ablation. Circulation. 2003;108(19):2355–2360.
    1. Karch MR, et al. Freedom from atrial tachyarrhythmias after catheter ablation of atrial fibrillation: a randomized comparison between 2 current ablation strategies. Circulation. 2005;111(22):2875–2880.
    1. Arentz T, et al. Small or large isolation areas around the pulmonary veins for the treatment of atrial fibrillation? Results from a prospective randomized study. Circulation. 2007;115(24):3057–3063.
    1. Yamada T, et al. Electrophysiological pulmonary vein antrum isolation with a multielectrode basket catheter is feasible and effective for curing paroxysmal atrial fibrillation: efficacy of minimally extensive pulmonary vein isolation. Heart Rhythm. 2006;3(4):377–384.
    1. Gerstenfeld EP, et al. Utility of exit block for identifying electrical isolation of the pulmonary veins. J Cardiovasc Electrophysiol. 2002;13(10):971–979.
    1. Nanthakumar K, et al. Resumption of electrical conduction in previously isolated pulmonary veins: rationale for a different strategy? Circulation. 2004;109(10):1226–1229.
    1. Ouyang F, et al. Recovered pulmonary vein conduction as a dominant factor for recurrent atrial tachyarrhythmias after complete circular isolation of the pulmonary veins: lessons from double Lasso technique. Circulation. 2005;111(2):127–135.
    1. Cheema A, et al. Incidence and time course of early recovery of pulmonary vein conduction after catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2007;18(4):387–391.
    1. Pratola C, et al. Radiofrequency ablation of atrial fibrillation: is the persistence of all intraprocedural targets necessary for long-term maintenance of sinus rhythm? Circulation. 2008;117(2):136–143.
    1. Rajappan K, et al. Acute and chronic pulmonary vein reconnection after atrial fibrillation ablation: a prospective characterization of anatomical sites. Pacing Clin Electrophysiol. 2008;31(12):1598–1605.
    1. Bansch D, et al. Circumferential pulmonary vein isolation: wait or stop early after initial successful pulmonary vein isolation? Europace. 2013;15(2):183–188.
    1. Nakamura K, et al. Optimal observation time after completion of circumferential pulmonary vein isolation for atrial fibrillation to prevent chronic pulmonary vein reconnections. Int J Cardiol. 2013;168(6):5300–5310.
    1. Neuzil P, et al. Electrical reconnection after pulmonary vein isolation is contingent on contact force during initial treatment: results from the EFFICAS I study. Circ Arrhythm Electrophysiol. 2013;6(2):327–333.
    1. Jiang RH, et al. Incidence of pulmonary vein conduction recovery in patients without clinical recurrence after ablation of paroxysmal atrial fibrillation: mechanistic implications. Heart Rhythm. 2014;11(6):969–976.
    1. Kim TH, et al. Pulmonary vein reconnection predicts good clinical outcome after second catheter ablation for atrial fibrillation. Europace. 2016 Epub ahead of print.
    1. Kuck KH, et al. Impact of complete versus incomplete circumferential lines around the pulmonary veins during catheter ablation of paroxysmal atrial fibrillation: results from the Gap-Atrial Fibrillation-German Atrial Fibrillation Competence Network 1 Trial. Circ Arrhythm Electrophysiol. 2016;9(1):e003337.
    1. Wang XH, et al. Early identification and treatment of PV re-connections: role of observation time and impact on clinical results of atrial fibrillation ablation. Europace. 2007;9(7):481–486.
    1. Sauer WH, et al. Atrioventricular nodal reentrant tachycardia in patients referred for atrial fibrillation ablation: response to ablation that incorporates slowpathway modification. Circulation. 2006;114(3):191–195.
    1. Ninomiya Y, et al. Usefulness of the adenosine triphosphate with a sufficient observation period for detecting reconduction after pulmonary vein isolation. Pacing Clin Electrophysiol. 2009;32(10):1307–1312.
    1. Yamane T, et al. Repeated provocation of time- and ATP-induced early pulmonary vein reconnections after pulmonary vein isolation: eliminating paroxysmal atrial fibrillation in a single procedure. Circ Arrhythm Electrophysiol. 2011;4(5):601–608.
    1. Kobori A, et al. Adenosine triphosphate-guided pulmonary vein isolation for atrial fibrillation: the UNmasking Dormant Electrical Reconduction by Adenosine TriPhosphate (UNDER-ATP) trial. Eur Heart J. 2015;36(46):3276–3287.
    1. Packer DL, et al. Cryoballoon ablation of pulmonary veins for paroxysmal atrial fibrillation: first results of the North American Arctic Front (STOP AF) pivotal trial. J Am Coll Cardiol. 2013;61(16):1713–1723.
    1. Arentz T, et al. “Dormant” pulmonary vein conduction revealed by adenosine after ostial radiofrequency catheter ablation. J Cardiovasc Electrophysiol. 2004;15(9):1041–1047.
    1. Tritto M, et al. Adenosine restores atrio-venous conduction after apparently successful ostial isolation of the pulmonary veins. Eur Heart J. 2004;25(23):2155–2163.
    1. Datino T, et al. Mechanisms by which adenosine restores conduction in dormant canine pulmonary veins. Circulation. 2010;121(8):963–972.
    1. Dallaglio PD, et al. The role of adenosine in pulmonary vein isolation: a critical review. Cardiol Res Pract. 2016;2016:8632509.
    1. Kapa S, et al. Dose-dependent pulmonary vein reconnection in response to adenosine: relevance of atrioventricular block during infusion. J Interv Card Electrophysiol. 2016;47(1):117–123.
    1. Andrade JG, et al. Pulmonary vein isolation using “contact force” ablation: the effect on dormant conduction and long-term freedom from recurrent atrial fibrillation– a prospective study. Heart Rhythm. 2014;11(11):1919–1924.
    1. Miyazaki S, et al. Impact of adenosine-provoked acute dormant pulmonary vein conduction on recurrence of atrial fibrillation. J Cardiovasc Electrophysiol. 2012;23(3):256–260.
    1. Zhang J, et al. Origin and ablation of the adenosine triphosphate induced atrial fibrillation after circumferential pulmonary vein isolation: effects on procedural success rate. J Cardiovasc Electrophysiol. 2014;25(4):364–370.
    1. Datino T, et al. Differential effectiveness of pharmacological strategies to reveal dormant pulmonary vein conduction: a clinical-experimental correlation. Heart Rhythm. 2011;8(9):1426–1433.
    1. Steven D, et al. Loss of pace capture on the ablation line: a new marker for complete radiofrequency lesions to achieve pulmonary vein isolation. Heart Rhythm. 2010;7(3):323–330.
    1. Andrade JG, et al. Pulmonary vein isolation using a pace-capture-guided versus an adenosine-guided approach: effect on dormant conduction and long-term freedom from recurrent atrial fibrillation–a prospective study. Circ Arrhythm Electrophysiol. 2013;6(6):1103–1108.
    1. Steven D, et al. Benefit of pulmonary vein isolation guided by loss of pace capture on the ablation line: results from a prospective 2-center randomized trial. J Am Coll Cardiol. 2013;62(1):44–50.
    1. Schaeffer B, et al. Loss of pace capture on the ablation line during pulmonary vein isolation versus “dormant conduction”: is adenosine expendable? J Cardiovasc Electrophysiol. 2015;26(10):1075–1080.
    1. Weerasooriya R, et al. Cost analysis of catheter ablation for paroxysmal atrial fibrillation. Pacing Clin Electrophysiol. 2003;26(1 Pt 2):292–294.
    1. Vijayaraman P, et al. Assessment of exit block following pulmonary vein isolation: far-field capture masquerading as entrance without exit block. Heart Rhythm. 2012;9(10):1653–1659.
    1. Ip JE, et al. Method for differentiating left superior pulmonary vein exit conduction from pseudo-exit conduction. Pacing Clin Electrophysiol. 2013;36(3):299–308.
    1. Spector P. Principles of cardiac electric propagation and their implications for reentrant arrhythmias. Circ Arrhythm Electrophysiol. 2013;6(3):655–661.
    1. Chen S, et al. Blocking the pulmonary vein to left atrium conduction in addition to the entrance block enhances clinical efficacy in atrial fibrillation ablation. Pacing Clin Electrophysiol. 2012;35(5):524–531.
    1. Kim JY, et al. Achievement of successful pulmonary vein isolation: methods of adenosine testing and incremental benefit of exit block. J Interv Card Electrophysiol. 2016;46(3):315–324.
    1. Andrade JG, et al. Efficacy and safety of cryoballoon ablation for atrial fibrillation: a systematic review of published studies. Heart Rhythm. 2011;8(9):1444–1451.
    1. Furnkranz A, et al. Characterization of conduction recovery after pulmonary vein isolation using the “single big cryoballoon” technique. Heart Rhythm. 2010;7(2):184–190.
    1. Furnkranz A, et al. Improved procedural efficacy of pulmonary vein isolation using the novel second-generation cryoballoon. J Cardiovasc Electrophysiol. 2013;24(5):492–497.
    1. Ciconte G, et al. Spontaneous and adenosine-induced pulmonary vein reconnection after cryoballoon ablation with the second-generation device. J Cardiovasc Electrophysiol. 2014;25(8):845–851.
    1. Metzner A, et al. One-year clinical outcome after pulmonary vein isolation using the second-generation 28-mm cryoballoon. Circ Arrhythm Electrophysiol. 2014;7(2):288–292.
    1. Bordignon S, et al. High rate of durable pulmonary vein isolation after secondgeneration cryoballoon ablation: analysis of repeat procedures. Europace. 2015;17(5):725–731.
    1. Heeger CH, et al. Bonus-freeze: benefit or risk? Two-year outcome and procedural comparison of a “bonus-freeze” and “no bonus-freeze” protocol using the second-generation cryoballoon for pulmonary vein isolation. Clin Res Cardiol. 2016;105(9):774–782.
    1. Kuck KH, et al. Cryoballoon or radiofrequency ablation for paroxysmal atrial fibrillation. N Engl J Med. 2016;374(23):2235–2245.
    1. Kuck KH, et al. Cryoballoon or radiofrequency ablation for symptomatic paroxysmal atrial fibrillation: reintervention, rehospitalization, and quality-of-life outcomes in the FIRE AND ICE trial. Eur Heart J. 2016;37(38):2858–2865.
    1. Miyazaki S, et al. Durability of cryothermal pulmonary vein isolation—Creating contiguous lesions is necessary for persistent isolation. Int J Cardiol. 2016;220:395–399.
    1. Straube F, et al. First-line catheter ablation of paroxysmal atrial fibrillation: outcome of radiofrequency vs. cryoballoon pulmonary vein isolation. Europace. 2016;18(3):368–375.
    1. Straube F, et al. Outcome of paroxysmal atrial fibrillation ablation with the cryoballoon using two different application times: the 4- versus 3-min protocol. J Interv Card Electrophysiol. 2016;45(2):169–177.
    1. Raatikainen MJ, et al. Radiofrequency catheter ablation maintains its efficacy better than antiarrhythmic medication in patients with paroxysmal atrial fibrillation: On-treatment analysis of the randomized controlled MANTRA-PAF trial. Int J Cardiol. 2015;198:108–114.
    1. Kumar N, et al. Adenosine testing after second-generation cryoballoon ablation (ATSCA) study improves clinical success rate for atrial fibrillation. Europace. 2015;17(6):871–876.
    1. Schmidt B, et al. Feasibility of circumferential pulmonary vein isolation using a novel endoscopic ablation system. Circ Arrhythm Electrophysiol. 2010;3(5):481–488.
    1. Dukkipati SR, et al. The durability of pulmonary vein isolation using the visually guided laser balloon catheter: multicenter results of pulmonary vein remapping studies. Heart Rhythm. 2012;9(6):919–925.
    1. Dukkipati SR, et al. Pulmonary vein isolation using a visually guided laser balloon catheter: the first 200-patient multicenter clinical experience. Circ Arrhythm Electrophysiol. 2013;6(3):467–472.
    1. Metzner A, et al. Acute and long-term clinical outcome after endoscopic pulmonary vein isolation: results from the first prospective, multicenter study. J Cardiovasc Electrophysiol. 2013;24(1):7–13.
    1. Metzner A, et al. The influence of varying energy settings on efficacy and safety of endoscopic pulmonary vein isolation. Heart Rhythm. 2012;9(9):1380–1385.
    1. Bordignon S, et al. Comparison of balloon catheter ablation technologies for pulmonary vein isolation: the laser versus cryo study. J Cardiovasc Electrophysiol. 2013;24(9):987–994.
    1. Bordignon S, et al. Energy titration strategies with the endoscopic ablation system: lessons from the high-dose vs. low-dose laser ablation study. Europace. 2013;15(5):685–689.
    1. Dukkipati SR, et al. Pulmonary vein isolation using the visually guided laser balloon: a prospective, multicenter, and randomized comparison to standard radiofrequency ablation. J Am Coll Cardiol. 2015;66(12):1350–1360.
    1. Patel NJ, et al. Contemporary utilization and safety outcomes of catheter ablation of atrial flutter in the United States: Analysis of 89,638 procedures. Heart Rhythm. 2016;13(6):1317–1325.
    1. Ernst S, et al. Total pulmonary vein occlusion as a consequence of catheter ablation for atrial fibrillation mimicking primary lung disease. J Cardiovasc Electrophysiol. 2003;14(4):366–370.
    1. Pappone C, et al. Prevention of iatrogenic atrial tachycardia after ablation of atrial fibrillation: a prospective randomized study comparing circumferential pulmonary vein ablation with a modified approach. Circulation. 2004;110(19):3036–3042.
    1. Sawhney N, et al. Circumferential pulmonary vein ablation with additional linear ablation results in an increased incidence of left atrial flutter compared with segmental pulmonary vein isolation as an initial approach to ablation of paroxysmal atrial fibrillation. Circ Arrhythm Electrophysiol. 2010;3(3):243–248.
    1. Chae S, et al. Atrial tachycardia after circumferential pulmonary vein ablation of atrial fibrillation: mechanistic insights, results of catheter ablation, and risk factors for recurrence. J Am Coll Cardiol. 2007;50(18):1781–1787.
    1. Vogler J, et al. Pulmonary vein isolation versus defragmentation: the CHASEAF clinical trial. J Am Coll Cardiol. 2015;66(24):2743–2752.
    1. Ouyang F, et al. Characterization of reentrant circuits in left atrial macroreentrant tachycardia: critical isthmus block can prevent atrial tachycardia recurrence. Circulation. 2002;105(16):1934–1942.
    1. Wazni O, et al. Randomized study comparing combined pulmonary vein-left atrial junction disconnection and cavotricuspid isthmus ablation versus pulmonary vein-left atrial junction disconnection alone in patients presenting with typical atrial flutter and atrial fibrillation. Circulation. 2003;108(20):2479–2483.
    1. Matsuo S, et al. Peri-mitral atrial flutter in patients with atrial fibrillation ablation. Heart Rhythm. 2010;7(1):2–8.
    1. Tzeis S, et al. The modified anterior line: an alternative linear lesion in perimitral flutter. J Cardiovasc Electrophysiol. 2010;21(6):665–670.
    1. Haissaguerre M, et al. Catheter ablation of long-lasting persistent atrial fibrillation: clinical outcome and mechanisms of subsequent arrhythmias. J Cardiovasc Electrophysiol. 2005;16(11):1138–1147.
    1. Scherr D, et al. Five-year outcome of catheter ablation of persistent atrial fibrillation using termination of atrial fibrillation as a procedural endpoint. Circ Arrhythm Electrophysiol. 2015;8(1):18–24.
    1. Nademanee K, et al. A new approach for catheter ablation of atrial fibrillation: mapping of the electrophysiologic substrate. J Am Coll Cardiol. 2004;43(11):2044–2053.
    1. O’Neill MD, et al. Long-term follow-up of persistent atrial fibrillation ablation using termination as a procedural endpoint. Eur Heart J. 2009;30(9):1105–1112.
    1. Lo LW, et al. Predicting factors for atrial fibrillation acute termination during catheter ablation procedures: implications for catheter ablation strategy and long-term outcome. Heart Rhythm. 2009;6(3):311–318.
    1. Zhang Z, et al. Linear ablation following pulmonary vein isolation in patients with atrial fibrillation: a meta-analysis. Pacing Clin Electrophysiol. 2016;39(6):623–630.
    1. Kim TH, et al. Linear ablation in addition to circumferential pulmonary vein isolation (Dallas lesion set) does not improve clinical outcome in patients with paroxysmal atrial fibrillation: a prospective randomized study. Europace. 2015;17(3):388–395.
    1. Wynn GJ, et al. Biatrial linear ablation in sustained nonpermanent AF: results of the substrate modification with ablation and antiarrhythmic drugs in nonpermanent atrial fibrillation (SMAN-PAF) trial. Heart Rhythm. 2016;13(2):399–406.
    1. Kumagai K, et al. A new approach for complete isolation of the posterior left atrium including pulmonary veins for atrial fibrillation. J Cardiovasc Electrophysiol. 2007;18(10):1047–1052.
    1. Yamaguchi Y, et al. Long-term effects of box isolation on sympathovagal balance in atrial fibrillation. Circ J. 2010;74(6):1096–1103.
    1. Kumagai K. Catheter ablation of atrial fibrillation. State of the Art Circ J. 2011;75(10):2305–2311.
    1. Kim JS, et al. Does isolation of the left atrial posterior wall improve clinical outcomes after radiofrequency catheter ablation for persistent atrial fibrillation? A prospective randomized clinical trial. Int J Cardiol. 2015;181:277–283.
    1. He X, et al. Left atrial posterior wall isolation reduces the recurrence of atrial fibrillation: a meta-analysis. J Interv Card Electrophysiol. 2016;46(3):267–274.
    1. Tamborero D, et al. Left atrial posterior wall isolation does not improve the outcome of circumferential pulmonary vein ablation for atrial fibrillation: a prospective randomized study. Circ Arrhythm Electrophysiol. 2009;2(1):35–40.
    1. Di Biase L, et al. Left atrial appendage isolation in patients with long-standing persistent AF undergoing catheter ablation: BELIEF trial. J Am Coll Cardiol. 2016;68(18):1929–1940.
    1. Di Biase L, et al. Ablation versus amiodarone for treatment of persistent atrial fibrillation in patients with congestive heart failure and an implanted device: results from the AATAC multicenter randomized trial. Circulation. 2016;133(17):1637–1644.
    1. Shah D, et al. Nonpulmonary vein foci: do they exist? Pacing Clin Electrophysiol. 2003;26(7 Pt 2):1631–1635.
    1. Lin D, et al. Provocability of atrial fibrillation triggers during pulmonary vein isolation in patients with infrequent AF [abstract] Heart Rhythm. 2004;1(Suppl):S231.
    1. Di Biase L, et al. Periprocedural stroke and management of major bleeding complications in patients undergoing catheter ablation of atrial fibrillation: the impact of periprocedural therapeutic international normalized ratio. Circulation. 2010;121(23):2550–2556.
    1. Di Biase L, et al. Left atrial appendage: an underrecognized trigger site of atrial fibrillation. Circulation. 2010;122(2):109–118.
    1. Santangeli P, et al. Prevalence and distribution of focal triggers in persistent and long-standing persistent atrial fibrillation. Heart Rhythm. 2016;13(2):374–382.
    1. Lin WS, et al. Catheter ablation of paroxysmal atrial fibrillation initiated by nonpulmonary vein ectopy. Circulation. 2003;107(25):3176–3183.
    1. Lakkireddy D, et al. Effect of atrial fibrillation ablation on gastric motility: the atrial fibrillation gut study. Circ Arrhythm Electrophysiol. 2015;8(3):531–536.
    1. Lee RJ, et al. Percutaneous alternative to the Maze procedure for the treatment of persistent or long-standing persistent atrial fibrillation (aMAZE trial): Rationale and design. Am Heart J. 2015;170(6):1184–1194.
    1. Zhao Y, et al. Importance of non-pulmonary vein triggers ablation to achieve long-term freedom from paroxysmal atrial fibrillation in patients with low ejection fraction. Heart Rhythm. 2016;13(1):141–149.
    1. Dixit S, et al. Randomized ablation strategies for the treatment of persistent atrial fibrillation: RASTA study. Circ Arrhythm Electrophysiol. 2012;5(2):287–294.
    1. Dagres N, et al. Current ablation techniques for persistent atrial fibrillation: results of the European Heart Rhythm Association Survey. Europace. 2015;17(10):1596–1600.
    1. Hocini M, et al. Localized reentry within the left atrial appendage: arrhythmogenic role in patients undergoing ablation of persistent atrial fibrillation. Heart Rhythm. 2011;8(12):1853–1861.
    1. Panikker S, et al. Left atrial appendage electrical isolation and concomitant device occlusion: A safety and feasibility study with histologic characterization. Heart Rhythm. 2015;12(1):202–210.
    1. Panikker S, et al. Left atrial appendage electrical isolation and concomitant device occlusion to treat persistent atrial fibrillation: a first-in-human safety, feasibility, and efficacy study. Circ Arrhythm Electrophysiol. 2016;9(7)
    1. Rillig A, et al. Unexpectedly high incidence of stroke and left atrial appendage thrombus formation after electrical isolation of the left atrial appendage for the treatment of atrial tachyarrhythmias. Circ Arrhythm Electrophysiol. 2016;9(5):e003461.
    1. Nademanee K, et al. Clinical outcomes of catheter substrate ablation for highrisk patients with atrial fibrillation. J Am Coll Cardiol. 2008;51(8):843–849.
    1. Haissaguerre M, et al. Localized sources maintaining atrial fibrillation organized by prior ablation. Circulation. 2006;113(5):616–625.
    1. Haissaguerre M, et al. Catheter ablation of long-lasting persistent atrial fibrillation: critical structures for termination. J Cardiovasc Electrophysiol. 2005;16(11):1125–1137.
    1. Takahashi Y, et al. Characterization of electrograms associated with termination of chronic atrial fibrillation by catheter ablation. J Am Coll Cardiol. 2008;51(10):1003–1010.
    1. Singh SM, et al. Intraprocedural use of ibutilide to organize and guide ablation of complex fractionated atrial electrograms: preliminary assessment of a modified step-wise approach to ablation of persistent atrial fibrillation. J Cardiovasc Electrophysiol. 2010;21(6):608–616.
    1. Narayan SM, et al. Classifying fractionated electrograms in human atrial fibrillation using monophasic action potentials and activation mapping: evidence for localized drivers, rate acceleration, and nonlocal signal etiologies. Heart Rhythm. 2011;8(2):244–253.
    1. Verma A, et al. Selective CFAE targeting for atrial fibrillation study (SELECT AF): clinical rationale, design, and implementation. J Cardiovasc Electrophysiol. 2011;22(5):541–547.
    1. Quintanilla JG, et al. Mechanistic approaches to detect, target, and ablate the drivers of atrial fibrillation. Circ Arrhythm Electrophysiol. 2016;9(1):e002481.
    1. Kottkamp H, Bender R, Berg J. Catheter ablation of atrial fibrillation: how to modify the substrate? J Am Coll Cardiol. 2015;65(2):196–206.
    1. Rolf S, et al. Tailored atrial substrate modification based on low-voltage areas in catheter ablation of atrial fibrillation. Circ Arrhythm Electrophysiol. 2014;7(5):825–833.
    1. Bai R, et al. Proven isolation of the pulmonary vein antrum with or without left atrial posterior wall isolation in patients with persistent atrial fibrillation. Heart Rhythm. 2016;13(1):132–140.
    1. Cutler MJ, et al. Impact of voltage mapping to guide whether to perform ablation of the posterior wall in patients with persistent atrial fibrillation. J Cardiovasc Electrophysiol. 2016;27(1):13–21.
    1. Yang G, et al. Catheter ablation of nonparoxysmal atrial fibrillation using electrophysiologically guided substrate modification during sinus rhythm after pulmonary vein isolation. Circ Arrhythm Electrophysiol. 2016;9(2):e003382.
    1. Verma A, et al. Pre-existent left atrial scarring in patients undergoing pulmonary vein antrum isolation: an independent predictor of procedural failure. J Am Coll Cardiol. 2005;45(2):285–292.
    1. Kapa S, et al. Contact electroanatomic mapping derived voltage criteria for characterizing left atrial scar in patients undergoing ablation for atrial fibrillation. J Cardiovasc Electrophysiol. 2014;25(10):1044–1052.
    1. Oakes RS, et al. Detection and quantification of left atrial structural remodeling with delayed-enhancement magnetic resonance imaging in patients with atrial fibrillation. Circulation. 2009;119(13):1758–1767.
    1. McGann C, et al. Atrial fibrillation ablation outcome is predicted by left atrial remodeling on MRI. Circ Arrhythm Electrophysiol. 2014;7(1):23–30.
    1. Lin YJ, et al. Electrophysiological characteristics and catheter ablation in patients with paroxysmal right atrial fibrillation. Circulation. 2005;112(12):1692–1700.
    1. Narayan SM, et al. Treatment of atrial fibrillation by the ablation of localized sources: CONFIRM (Conventional Ablation for Atrial Fibrillation With or Without Focal Impulse and Rotor Modulation) trial. J Am Coll Cardiol. 2012;60(7):628–636.
    1. Rappel WJ, Narayan SM. Theoretical considerations for mapping activation in human cardiac fibrillation. Chaos. 2013;23(2):023113.
    1. Gianni C, et al. Acute and early outcomes of focal impulse and rotor modulation (FIRM)-guided rotors-only ablation in patients with nonparoxysmal atrial fibrillation. Heart Rhythm. 2016;13(4):830–835.
    1. Narayan SM, Zaman JA. Mechanistically based mapping of human cardiac fibrillation. J Physiol. 2016;594(9):2399–2415.
    1. Sommer P, et al. Successful repeat catheter ablation of recurrent long-standing persistent atrial fibrillation with rotor elimination as the procedural endpoint: a case series. J Cardiovasc Electrophysiol. 2016;27(3):274–280.
    1. Buch E, et al. Long-term clinical outcomes of focal impulse and rotor modulation for treatment of atrial fibrillation: A multicenter experience. Heart Rhythm. 2016;13(3):636–641.
    1. Benharash P, et al. Quantitative analysis of localized sources identified by focal impulse and rotor modulation mapping in atrial fibrillation. Circ Arrhythm Electrophysiol. 2015;8(3):554–561.
    1. Ramanathan C, et al. Noninvasive electrocardiographic imaging for cardiac electrophysiology and arrhythmia. Nat Med. 2004;10(4):422–428.
    1. Lim HS, et al. Noninvasive mapping to guide atrial fibrillation ablation. Card Electrophysiol Clin. 2015;7(1):89–98.
    1. Yamashita S, et al. Body surface mapping to guide atrial fibrillation ablation. Arrhythm Electrophysiol Rev. 2015;4(3):172–176.
    1. Guillem MS, et al. Noninvasive mapping of human atrial fibrillation. J Cardiovasc Electrophysiol. 2009;20(5):507–513.
    1. Guillem MS, et al. Noninvasive localization of maximal frequency sites of atrial fibrillation by body surface potential mapping. Circ Arrhythm Electrophysiol. 2013;6(2):294–301.
    1. Rodrigo M, et al. Body surface localization of left and right atrial high-frequency rotors in atrial fibrillation patients: a clinical-computational study. Heart Rhythm. 2014;11(9):1584–1591.
    1. Pauza DH, et al. Morphology, distribution, and variability of the epicardiac neural ganglionated subplexuses in the human heart. Anat Rec. 2000;259(4):353–382.
    1. Scherlag BJ, et al. Electrical stimulation to identify neural elements on the heart: their role in atrial fibrillation. J Interv Card Electrophysiol. 2005;13(Suppl 1):37–42.
    1. Patterson E, et al. Sodium-calcium exchange initiated by the Ca2+ transient: an arrhythmia trigger within pulmonary veins. J Am Coll Cardiol. 2006;47(6):1196–1206.
    1. Lemola K, et al. Pulmonary vein region ablation in experimental vagal atrial fibrillation: role of pulmonary veins versus autonomic ganglia. Circulation. 2008;117(4):470–477.
    1. Nishida K, et al. The role of pulmonary veins vs. autonomic ganglia in different experimental substrates of canine atrial fibrillation. Cardiovasc Res. 2011;89(4):825–833.
    1. Nishida K, et al. Atrial fibrillation ablation: translating basic mechanistic insights to the patient. J Am Coll Cardiol. 2014;64(8):823–831.
    1. Stavrakis S, et al. The role of the autonomic ganglia in atrial fibrillation. JACC Clin Electrophysiol. 2015;1(1-2):1–13.
    1. Pokushalov E, et al. Left atrial ablation at the anatomic areas of ganglionated plexi for paroxysmal atrial fibrillation. Pacing Clin Electrophysiol. 2010;33(10):1231–1238.
    1. Pokushalov E, et al. Ganglionated plexi ablation for long-standing persistent atrial fibrillation. Europace. 2010;12(3):342–346.
    1. Pokushalov E, et al. Catheter versus surgical ablation of atrial fibrillation after a failed initial pulmonary vein isolation procedure: a randomized controlled trial. J Cardiovasc Electrophysiol. 2013;24(12):1338–1343.
    1. Pokushalov E, et al. Ganglionated plexus ablation vs linear ablation in patients undergoing pulmonary vein isolation for persistent/long-standing persistent atrial fibrillation: a randomized comparison. Heart Rhythm. 2013;10(9):1280–1286.
    1. Morillo CA, et al. Chronic rapid atrial pacing. Structural, functional, and electrophysiological characteristics of a new model of sustained atrial fibrillation. Circulation. 1995;91(5):1588–1595.
    1. Harada A, et al. Atrial activation during chronic atrial fibrillation in patients with isolated mitral valve disease. Ann Thorac Surg. 1996;61(1):104–111. discussion 111-2.
    1. Gray RA, Pertsov AM, Jalife J. Spatial and temporal organization during cardiac fibrillation. Nature. 1998;392(6671):75–78.
    1. Berenfeld O, et al. Spatially distributed dominant excitation frequencies reveal hidden organization in atrial fibrillation in the Langendorff-perfused sheep heart. J Cardiovasc Electrophysiol. 2000;11(8):869–879.
    1. Mansour M, et al. Left-to-right gradient of atrial frequencies during acute atrial fibrillation in the isolated sheep heart. Circulation. 2001;103(21):2631–2636.
    1. Lazar S, et al. Presence of left-to-right atrial frequency gradient in paroxysmal but not persistent atrial fibrillation in humans. Circulation. 2004;110(20):3181–3186.
    1. Atienza F, et al. Real-time dominant frequency mapping and ablation of dominant frequency sites in atrial fibrillation with left-to-right frequency gradients predicts long-term maintenance of sinus rhythm. Heart Rhythm. 2009;6(1):33–40.
    1. Atienza F, et al. Comparison of radiofrequency catheter ablation of drivers and circumferential pulmonary vein isolation in atrial fibrillation: a noninferiority randomized multicenter RADAR-AF trial. J Am Coll Cardiol. 2014;64(23):2455–2467.
    1. Zhao Q, et al. Effect of renal sympathetic denervation on the inducibility of atrial fibrillation during rapid atrial pacing. J Interv Card Electrophysiol. 2012;35(2):119–125.
    1. Wang X, et al. Effect of renal sympathetic denervation on the progression of paroxysmal atrial fibrillation in canines with long-term intermittent atrial pacing. Europace. 2015;17(4):647–654.
    1. Zhou Q, et al. Renal sympathetic denervation suppresses atrial fibrillation induced by acute atrial ischemia/infarction through inhibition of cardiac sympathetic activity. Int J Cardiol. 2016;203:187–195.
    1. Vollmann D, et al. Renal artery ablation instead of pulmonary vein ablation in a hypertensive patient with symptomatic, drug-resistant, persistent atrial fibrillation. Clin Res Cardiol. 2013;102(4):315–318.
    1. Schlaich MP, et al. Sympathetic activation in chronic renal failure. J Am Soc Nephrol. 2009;20(5):933–939.
    1. Bakris GL, et al. 12-month blood pressure results of catheter-based renal artery denervation for resistant hypertension: the SYMPLICITY HTN-3 trial. J Am Coll Cardiol. 2015;65(13):1314–1321.
    1. Boersma LV, et al. Atrial fibrillation catheter ablation versus surgical ablation treatment (FAST): a 2-center randomized clinical trial. Circulation. 2012;125(1):23–30.
    1. Wang S, Liu L, Zou C. Comparative study of video-assisted thoracoscopic surgery ablation and radiofrequency catheter ablation on treating paroxysmal atrial fibrillation: a randomized, controlled short-term trial. Chin Med J (Engl) 2014;127(14):2567–2570.
    1. Phan K, et al. Thoracoscopic surgical ablation versus catheter ablation for atrial fibrillation. Eur J Cardiothorac Surg. 2016;49(4):1044–1051.
    1. Krul SP, et al. Epicardial and endocardial electrophysiological guided thoracoscopic surgery for atrial fibrillation: a multidisciplinary approach of atrial fibrillation ablation in challenging patients. Int J Cardiol. 2014;173(2):229–235.
    1. Probst J, et al. Thoracoscopic epicardial left atrial ablation in symptomatic patients with atrial fibrillation. Europace. 2016;18(10):1538–1544.
    1. Mahapatra S, et al. Initial experience of sequential surgical epicardial-catheter endocardial ablation for persistent and long-standing persistent atrial fibrillation with long-term follow-up. Ann Thorac Surg. 2011;91(6):1890–1898.
    1. Gersak B, et al. Low rate of atrial fibrillation recurrence verified by implantable loop recorder monitoring following a convergent epicardial and endocardial ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2012;23(10):1059–1066.
    1. Pison L, et al. Hybrid thoracoscopic surgical and transvenous catheter ablation of atrial fibrillation. J Am Coll Cardiol. 2012;60(1):54–61.
    1. Zembala M, et al. Minimally invasive hybrid ablation procedure for the treatment of persistent atrial fibrillation: one year results. Kardiol Pol. 2012;70(8):819–828.
    1. Bisleri G, et al. Hybrid approach for the treatment of long-standing persistent atrial fibrillation: electrophysiological findings and clinical results. Eur J Cardiothorac Surg. 2013;44(5):919–923.
    1. Gehi AK, et al. Hybrid epicardial-endocardial ablation using a pericardioscopic technique for the treatment of atrial fibrillation. Heart Rhythm. 2013;10(1):22–28.
    1. La Meir M, et al. Minimally invasive surgical treatment of lone atrial fibrillation: early results of hybrid versus standard minimally invasive approach employing radiofrequency sources. Int J Cardiol. 2013;167(4):1469–1475.
    1. Gersak B, et al. European experience of the convergent atrial fibrillation procedure: multicenter outcomes in consecutive patients. J Thorac Cardiovasc Surg. 2014;147(4):1411–1416.
    1. Kurfirst V, et al. Two-staged hybrid treatment of persistent atrial fibrillation: short-term single-centre results. Interact Cardiovasc Thorac Surg. 2014;18(4):451–456.
    1. Pison L, et al. Effectiveness and safety of simultaneous hybrid thoracoscopic and endocardial catheter ablation of lone atrial fibrillation. Ann Cardiothorac Surg. 2014;3(1):38–44.
    1. Bulava A, et al. Sequential hybrid procedure for persistent atrial fibrillation. J Am Heart Assoc. 2015;4(3):e001754.
    1. Raitt MH, et al. Reversal of electrical remodeling after cardioversion of persistent atrial fibrillation. J Cardiovasc Electrophysiol. 2004;15(5):507–512.
    1. Chalfoun N, et al. Reverse electrical remodeling of the atria post cardioversion in patients who remain in sinus rhythm assessed by signal averaging of the P-wave. Pacing Clin Electrophysiol. 2007;30(4):502–509.
    1. Igarashi M, et al. Effect of restoration of sinus rhythm by extensive antiarrhythmic drugs in predicting results of catheter ablation of persistent atrial fibrillation. Am J Cardiol. 2010;106(1):62–68.
    1. Rivard L, et al. Improved outcome following restoration of sinus rhythm prior to catheter ablation of persistent atrial fibrillation: a comparative multicenter study. Heart Rhythm. 2012;9(7):1025–1030.
    1. Mohanty S, et al. Effect of periprocedural amiodarone on procedure outcome in patients with long-standing persistent atrial fibrillation undergoing extended pulmonary vein antrum isolation: results from a randomized study (SPECULATE) Heart Rhythm. 2015;12(3):477–483.
    1. Gerstenfeld EP, et al. Mechanisms of organized left atrial tachycardias occurring after pulmonary vein isolation. Circulation. 2004;110(11):1351–1357.
    1. Chugh A, et al. Catheter ablation of atypical atrial flutter and atrial tachycardia within the coronary sinus after left atrial ablation for atrial fibrillation. J Am Coll Cardiol. 2005;46(1):83–91.
    1. Chugh A, et al. Prevalence, mechanisms, and clinical significance of macroreentrant atrial tachycardia during and following left atrial ablation for atrial fibrillation. Heart Rhythm. 2005;2(5):464–471.
    1. Deisenhofer I, et al. Left atrial tachycardia after circumferential pulmonary vein ablation for atrial fibrillation: incidence, electrophysiological characteristics, and results of radiofrequency ablation. Europace. 2006;8(8):573–582.
    1. Mesas CE, et al. Left atrial tachycardia after circumferential pulmonary vein ablation for atrial fibrillation: electroanatomic characterization and treatment. J Am Coll Cardiol. 2004;44(5):1071–1079.
    1. Anter E, et al. Evaluation of a novel high-resolution mapping technology for ablation of recurrent scar-related atrial tachycardias. Heart Rhythm. 2016;13(10):2048–2055.
    1. Shah D, et al. Narrow, slow-conducting isthmus dependent left atrial reentry developing after ablation for atrial fibrillation: ECG characterization and elimination by focal RF ablation. J Cardiovasc Electrophysiol. 2006;17(5):508–515.
    1. Chugh A, et al. Characteristics of cavotricuspid isthmus-dependent atrial flutter after left atrial ablation of atrial fibrillation. Circulation. 2006;113(5):609–615.
    1. Gerstenfeld EP, et al. Surface electrocardiogram characteristics of atrial tachycardias occurring after pulmonary vein isolation. Heart Rhythm. 2007;4(9):1136–1143.
    1. Steven D, et al. Mapping of atrial tachycardias after catheter ablation for atrial fibrillation: use of bi-atrial activation patterns to facilitate recognition of origin. Heart Rhythm. 2010;7(5):664–672.
    1. Anter E, et al. Pulmonary vein isolation using the Rhythmia mapping system: Verification of intracardiac signals using the Orion mini-basket catheter. Heart Rhythm. 2015;12(9):1927–1934.
    1. Di Biase L, et al. General anesthesia reduces the prevalence of pulmonary vein reconnection during repeat ablation when compared with conscious sedation: results from a randomized study. Heart Rhythm. 2011;8(3):368–372.
    1. Hutchinson MD, et al. Efforts to enhance catheter stability improve atrial fibrillation ablation outcome. Heart Rhythm. 2013;10(3):347–353.
    1. Nair KK, et al. The prevalence and risk factors for atrioesophageal fistula after percutaneous radiofrequency catheter ablation for atrial fibrillation: the Canadian experience. J Interv Card Electrophysiol. 2014;39(2):139–144.
    1. Di Biase L, et al. Relationship between catheter forces, lesion characteristics, “popping,” and char formation: experience with robotic navigation system. J Cardiovasc Electrophysiol. 2009;20(4):436–440.
    1. Di Biase L, et al. Esophageal capsule endoscopy after radiofrequency catheter ablation for atrial fibrillation: documented higher risk of luminal esophageal damage with general anesthesia as compared with conscious sedation. Circ Arrhythm Electrophysiol. 2009;2(2):108–112.
    1. Martinek M, et al. Esophageal damage during radiofrequency ablation of atrial fibrillation: impact of energy settings, lesion sets, and esophageal visualization. J Cardiovasc Electrophysiol. 2009;20(7):726–733.
    1. Martinek M, et al. Acute development of gastroesophageal reflux after radiofrequency catheter ablation of atrial fibrillation. Heart Rhythm. 2009;6(10):1457–1462.
    1. Sadek MM, et al. Recurrent atrial arrhythmias in the setting of chronic pulmonary vein isolation. Heart Rhythm. 2016;13(11):2174–2180.
    1. Elayi CS, et al. Atrial fibrillation termination as a procedural endpoint during ablation in long-standing persistent atrial fibrillation. Heart Rhythm. 2010;7(9):1216–1223.
    1. Lim HS, et al. Is ablation to termination the best strategy for ablation of persistent atrial fibrillation? Persistent atrial fibrillation is best ablated by a strategy that terminates the arrhythmia: procedural termination is associated with improved long-term outcomes. Circ Arrhythm Electrophysiol. 2015;8(4):963–971.
    1. Kochhauser S, et al. Impact of acute atrial fibrillation termination and prolongation of atrial fibrillation cycle length on the outcome of ablation of persistent atrial fibrillation: a substudy of the STAR AF II trial. Heart Rhythm. 2017;14(4):476–483.
    1. Scott PA, Silberbauer J, Murgatroyd FD. The impact of adjunctive complex fractionated atrial electrogram ablation and linear lesions on outcomes in persistent atrial fibrillation: a meta-analysis. Europace. 2016;18(3):359–367.
    1. Zaman JA, Peters NS, Narayan SM. Rotor mapping and ablation to treat atrial fibrillation. Curr Opin Cardiol. 2015;30(1):24–32.
    1. Bai R, et al. Ablation of perimitral flutter following catheter ablation of atrial fibrillation: impact on outcomes from a randomized study (PROPOSE) J Cardiovasc Electrophysiol. 2012;23(2):137–144.
    1. Bai R, et al. Worldwide experience with the robotic navigation system in catheter ablation of atrial fibrillation: methodology, efficacy and safety. J Cardiovasc Electrophysiol. 2012;23(8):820–826.
    1. Kobza R, et al. Late recurrent arrhythmias after ablation of atrial fibrillation: incidence, mechanisms, and treatment. Heart Rhythm. 2004;1(6):676–683.
    1. Ouyang F, et al. Electrophysiological findings during ablation of persistent atrial fibrillation with electroanatomic mapping and double Lasso catheter technique. Circulation. 2005;112(20):3038–3048.
    1. Boersma LV, et al. Pulmonary vein isolation by duty-cycled bipolar and unipolar radiofrequency energy with a multielectrode ablation catheter. Heart Rhythm. 2008;5(12):1635–1642.
    1. Jais P, et al. Successful irrigated-tip catheter ablation of atrial flutter resistant to conventional radiofrequency ablation. Circulation. 1998;98(9):835–838.
    1. Haines DE. The biophysics and pathophysiology of lesion formation during radiofrequency catheter ablation. In: Zipes D, J J, editors. Cardiac Electrophysiology: From Cell to Bedside. 4. New York: WB Saunders; 2006. pp. 1018–1027.
    1. Haines DE, et al. The biophysics of passive convective cooling during catheter ablation with gold versus platinum electrodes and multielectrode phased radiofrequency energy delivery. J Cardiovasc Electrophysiol. 2015 Epub ahead of print.
    1. Nakagawa H, et al. Comparison of in vivo tissue temperature profile and lesion geometry for radiofrequency ablation with a saline-irrigated electrode versus temperature control in a canine thigh muscle preparation. Circulation. 1995;91(8):2264–2273.
    1. Reddy VY, et al. Randomized, controlled trial of the safety and effectiveness of a contact force-sensing irrigated catheter for ablation of paroxysmal atrial fibrillation: results of the TactiCath Contact Force Ablation Catheter Study for Atrial Fibrillation (TOCCASTAR) study. Circulation. 2015;132(10):907–915.
    1. Finta B, Haines DE. Catheter ablation therapy for atrial fibrillation. Cardiol Clin. 2004;22(1):127–145, ix.
    1. Thomas SP, et al. A comparison of open irrigated and non-irrigated tip catheter ablation for pulmonary vein isolation. Europace. 2004;6(4):330–335.
    1. Bruce GK, et al. Discrepancies between catheter tip and tissue temperature in cooled-tip ablation: relevance to guiding left atrial ablation. Circulation. 2005;112(7):954–960.
    1. Oh S, et al. Avoiding microbubbles formation during radiofrequency left atrial ablation versus continuous microbubbles formation and standard radiofrequency ablation protocols: comparison of energy profiles and chronic lesion characteristics. J Cardiovasc Electrophysiol. 2006;17(1):72–77.
    1. Tanno K, et al. Histopathology of canine hearts subjected to catheter ablation using radiofrequency energy. Jpn Circ J. 1994;58(2):123–135.
    1. Nath S, et al. Cellular electrophysiological effects of hyperthermia on isolated guinea pig papillary muscle. Implications for catheter ablation. Circulation. 1993;88(4 Pt 1):1826–1831.
    1. Everett THt, et al. Role of calcium in acute hyperthermic myocardial injury. J Cardiovasc Electrophysiol. 2001;12(5):563–569.
    1. Saad EB, et al. Pulmonary vein stenosis after radiofrequency ablation of atrial fibrillation: functional characterization, evolution, and influence of the ablation strategy. Circulation. 2003;108(25):3102–3107.
    1. Bunch TJ, et al. Analysis of catheter-tip (8-mm) and actual tissue temperatures achieved during radiofrequency ablation at the orifice of the pulmonary vein. Circulation. 2004;110(19):2988–2995.
    1. Haines DE. Determinants of lesion size during radiofrequency catheter ablation: the role of electrode-tissue contact pressure and duration of energy delivery. Journal of Cardiovascular Electrophysiology. 1991;2(6):509–515.
    1. Strickberger SA, et al. Relation between impedance and endocardial contact during radiofrequency catheter ablation. Am Heart J. 1994;128(2):226–229.
    1. Avitall B, et al. The effects of electrode-tissue contact on radiofrequency lesion generation. Pacing Clin Electrophysiol. 1997;20(12 Pt 1):2899–2910.
    1. Yokoyama K, et al. Novel contact force sensor incorporated in irrigated radiofrequency ablation catheter predicts lesion size and incidence of steam pop and thrombus. Circ Arrhythm Electrophysiol. 2008;1(5):354–362.
    1. Kuck KH, et al. A novel radiofrequency ablation catheter using contact force sensing: Toccata study. Heart Rhythm. 2012;9(1):18–23.
    1. Ikeda A, et al. Relationship between catheter contact force and radiofrequency lesion size and incidence of steam pop in the beating canine heart: electrogram amplitude, impedance, and electrode temperature are poor predictors of electrode-tissue contact force and lesion size. Circ Arrhythm Electrophysiol. 2014;7(6):1174–1180.
    1. Nakagawa H, et al. Locations of high contact force during left atrial mapping in atrial fibrillation patients: electrogram amplitude and impedance are poor predictors of electrode-tissue contact force for ablation of atrial fibrillation. Circ Arrhythm Electrophysiol. 2013;6(4):746–753.
    1. Nakagawa H, et al. Prospective study to test the ability to create RF lesions at predicted depth and diameter using a new formula incorporating contact force, radiofrequency power and application time (force-power-time index) in the beating heart [abstract] Heart Rhythm. 2014;11(Suppl):S548.
    1. Natale A, et al. Paroxysmal AF catheter ablation with a contact force sensing catheter: results of the prospective, multicenter SMART-AF trial. J AmColl Cardiol. 2014;64(7):647–656.
    1. Kumar S, et al. Predictive value of impedance changes for real-time contact force measurements during catheter ablation of atrial arrhythmias in humans. Heart Rhythm. 2013;10(7):962–969.
    1. Kumar S, et al. Prospective characterization of catheter-tissue contact force at different anatomic sites during antral pulmonary vein isolation. Circ Arrhythm Electrophysiol. 2012;5(6):1124–1129.
    1. Reddy VY, et al. The relationship between contact force and clinical outcome during radiofrequency catheter ablation of atrial fibrillation in the TOCCATA study. Heart Rhythm. 2012;9(11):1789–1795.
    1. Haldar S, et al. Contact force sensing technology identifies sites of inadequate contact and reduces acute pulmonary vein reconnection: a prospective case control study. Int J Cardiol. 2013;168(2):1160–1166.
    1. Perna F, et al. Assessment of catheter tip contact force resulting in cardiac perforation in swine atria using force sensing technology. Circ Arrhythm Electrophysiol. 2011;4(2):218–224.
    1. Kimura M, et al. Comparison of lesion formation between contact force-guided and non-guided circumferential pulmonary vein isolation: a prospective, randomized study. Heart Rhythm. 2014;11(6):984–991.
    1. Sohns C, et al. Quantitative magnetic resonance imaging analysis of the relationship between contact force and left atrial scar formation after catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2014;25(2):138–145.
    1. Martinek M, et al. Clinical impact of an open-irrigated radiofrequency catheter with direct force measurement on atrial fibrillation ablation. Pacing Clin Electrophysiol. 2012;35(11):1312–1318.
    1. Marijon E, et al. Real-time contact force sensing for pulmonary vein isolation in the setting of paroxysmal atrial fibrillation: procedural and 1-year results. J Cardiovasc Electrophysiol. 2014;25(2):130–137.
    1. Sigmund E, et al. Optimizing radiofrequency ablation of paroxysmal and persistent atrial fibrillation by direct catheter force measurement-a case-matched comparison in 198 patients. Pacing Clin Electrophysiol. 2015;38(2):201–208.
    1. Wilber DJ, et al. Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation: a randomized controlled trial. JAMA. 2010;303(4):333–340.
    1. Ullah W, et al. Randomized trial comparing pulmonary vein isolation using the SmartTouch catheter with or without real-time contact force data. Heart Rhythm. 2016;13(9):1761–1767.
    1. Wakili R, et al. Impact of real-time contact force and impedance measurement in pulmonary vein isolation procedures for treatment of atrial fibrillation. Clin Res Cardiol. 2014;103(2):97–106.
    1. Van Belle Y, et al. Pulmonary vein isolation using an occluding cryoballoon for circumferential ablation: feasibility, complications, and short-term outcome. Eur Heart J. 2007;28(18):2231–2237.
    1. Neumann T, et al. Circumferential pulmonary vein isolation with the cryoballoon technique results from a prospective 3-center study. J Am Coll Cardiol. 2008;52(4):273–278.
    1. Reddy VY, et al. Durability of pulmonary vein isolation with cryoballoon ablation: results fromthe Sustained PV Isolation with Arctic Front Advance (SUPIR) study. J Cardiovasc Electrophysiol. 2015;26(5):493–500.
    1. Coulombe N, Paulin J, Su W. Improved in vivo performance of second-generation cryoballoon for pulmonary vein isolation. J Cardiovasc Electrophysiol. 2013;24(8):919–925.
    1. Straube F, et al. Comparison of the first and second cryoballoon: high-volume single-center safety and efficacy analysis. Circ Arrhythm Electrophysiol. 2014;7(2):293–299.
    1. Straube F, et al. Differences of two cryoballoon generations: insights from the prospective multicentre, multinational FREEZE Cohort Substudy. Europace. 2014;16(10):1434–1442.
    1. Schmidt M, et al. Cryoballoon versus RF ablation in paroxysmal atrial fibrillation: results from the German Ablation Registry. J Cardiovasc Electrophysiol. 2014;25(1):1–7.
    1. Linhart M, et al. Comparison of cryoballoon and radiofrequency ablation of pulmonary veins in 40 patients with paroxysmal atrial fibrillation: a case-control study. J Cardiovasc Electrophysiol. 2009;20(12):1343–1348.
    1. Aryana A, et al. Acute and long-term outcomes of catheter ablation of atrial fibrillation using the second-generation cryoballoon versus open-irrigated radiofrequency: a multicenter experience. J Cardiovasc Electrophysiol. 2015;26(8):832–839.
    1. Hunter RJ, et al. Point-by-point radiofrequency ablation versus the cryoballoon or a novel combined approach: a randomized trial comparing 3 methods of pulmonary vein isolation for paroxysmal atrial fibrillation (The Cryo Versus RF Trial) J Cardiovasc Electrophysiol. 2015;26(12):1307–1314.
    1. Furnkranz A, et al. Rationale and Design of FIRE AND ICE: A multicenter randomized trial comparing efficacy and safety of pulmonary vein isolation using a cryoballoon versus radiofrequency ablation with 3D-reconstruction. J Cardiovasc Electrophysiol. 2014;25(12):1314–1320.
    1. Namdar M, et al. Isolating the pulmonary veins as first-line therapy in patients with lone paroxysmal atrial fibrillation using the cryoballoon. Europace. 2012;14(2):197–203.
    1. Dukkipati SR, et al. Visual balloon-guided point-by-point ablation: reliable, reproducible, and persistent pulmonary vein isolation. Circ Arrhythm Electrophysiol. 2010;3(3):266–273.
    1. Metzner A, et al. Esophageal temperature change and esophageal thermal lesions after pulmonary vein isolation using the novel endoscopic ablation system. Heart Rhythm. 2011;8(6):815–820.
    1. Metzner A, et al. One-year clinical outcome after pulmonary vein isolation using the novel endoscopic ablation system in patients with paroxysmal atrial fibrillation. Heart Rhythm. 2011;8(7):988–993.
    1. Koruth JS, et al. Pre-clinical investigation of a low-intensity collimated ultrasound system for pulmonary vein isolation in a porcine model. JACC: Clinical Electrophysiology. 2015;1(4):306–314.
    1. Meininger GR, et al. Initial experience with a novel focused ultrasound ablation system for ring ablation outside the pulmonary vein. J Interv Card Electrophysiol. 2003;8(2):141–148.
    1. Metzner A, et al. Long-term clinical outcome following pulmonary vein isolation with high-intensity focused ultrasound balloon catheters in patients with paroxysmal atrial fibrillation. Europace. 2010;12(2):188–193.
    1. Neven K, et al. Fatal end of a safety algorithm for pulmonary vein isolation with use of high-intensity focused ultrasound. Circ Arrhythm Electrophysiol. 2010;3(3):260–265.
    1. Sohara H, et al. Feasibility of the radiofrequency hot balloon catheter for isolation of the posterior left atrium and pulmonary veins for the treatment of atrial fibrillation. Circ Arrhythm Electrophysiol. 2009;2(3):225–232.
    1. Evonich RF, Nori DM, Haines DE. Efficacy of pulmonary vein isolation with a novel hot balloon ablation catheter. J Interv Card Electrophysiol. 2012;34(1):29–36.
    1. Yamaguchi Y, et al. Long-term results of radiofrequency hot balloon ablation in patients with paroxysmal atrial fibrillation: safety and rhythm outcomes. J Cardiovasc Electrophysiol. 2015;26(12):1298–1306.
    1. Sohara H, et al. HotBalloon ablation of the pulmonary veins for paroxysmal AF: a multicenter randomized trial in Japan. J Am Coll Cardiol. 2016;68(25):2747–2757.
    1. Mansour M, et al. Initial experience with the Mesh catheter for pulmonary vein isolation in patients with paroxysmal atrial fibrillation. Heart Rhythm. 2008;5(11):1510–1516.
    1. Steinwender C, et al. Acute results of pulmonary vein isolation in patients with paroxysmal atrial fibrillation using a single mesh catheter. J Cardiovasc Electrophysiol. 2009;20(2):147–152.
    1. Hofmann R, et al. Pulmonary vein isolation with Mesh Ablator versus cryoballoon catheters: 6-month outcomes. J Interv Card Electrophysiol. 2010;29(3):179–185.
    1. Steinwender C, et al. One-year follow-up after pulmonary vein isolation using a single mesh catheter in patients with paroxysmal atrial fibrillation. Heart Rhythm. 2010;7(3):333–339.
    1. Koch L, et al. Mesh ablator vs. cryoballoon pulmonary vein ablation of symptomatic paroxysmal atrial fibrillation: results of the MACPAF study. Europace. 2012;14(10):1441–1449.
    1. Shin DI, et al. Initial results of using a novel irrigated multielectrode mapping and ablation catheter for pulmonary vein isolation. Heart Rhythm. 2014;11(3):375–383.
    1. Zellerhoff S, et al. Pulmonary vein isolation using a circular, open irrigated mapping and ablation catheter (nMARQ): a report on feasibility and efficacy. Europace. 2014;16(9):1296–1303.
    1. Rodriguez-Entem F, et al. Initial experience and treatment of atrial fibrillation using a novel irrigated multielectrode catheter: Results from a prospective two-center study. J Arrhythm. 2016;32(2):95–101.
    1. Stabile G, et al. Safety and efficacy of pulmonary vein isolation using a circular, open-irrigated mapping and ablation catheter: A multicenter registry. Heart Rhythm. 2015;12(8):1782–1788.
    1. Deneke T, et al. Acute safety and efficacy of a novel multipolar irrigated radiofrequency ablation catheter for pulmonary vein isolation. J Cardiovasc Electrophysiol. 2014;25(4):339–345.
    1. Vurma M, et al. Safety and efficacy of the nMARQ catheter for paroxysmal and persistent atrial fibrillation. Europace. 2016;18(8):1164–1169.
    1. Rosso R, et al. Radiofrequency ablation of paroxysmal atrial fibrillation with the newirrigated multipolar nMARQablation catheter: verification of intracardiac signals with a second circular mapping catheter. Heart Rhythm. 2014;11(4):559–565.
    1. Kiss A, et al. Cerebral microembolization during atrial fibrillation ablation: comparison of different single-shot ablation techniques. Int J Cardiol. 2014;174(2):276–281.
    1. Gaita F, et al. Incidence of silent cerebral thromboembolic lesions after atrial fibrillation ablation may change according to technology used: comparison of irrigated radiofrequency, multipolar nonirrigated catheter and cryoballoon. J Cardiovasc Electrophysiol. 2011;22(9):961–968.
    1. Herrera Siklody C, et al. Incidence of asymptomatic intracranial embolic events after pulmonary vein isolation: comparison of different atrial fibrillation ablation technologies in a multicenter study. J Am Coll Cardiol. 2011;58(7):681–688.
    1. De Greef Y, et al. Duty-cycled multi-electrode radiofrequency vs. conventional irrigated point-by-point radiofrequency ablation for recurrent atrial fibrillation: comparative 3-year data. Europace. 2014;16(6):820–825.
    1. McCready J, et al. Safety and efficacy of multipolar pulmonary vein ablation catheter vs. irrigated radiofrequency ablation for paroxysmal atrial fibrillation: a randomized multicentre trial. Europace. 2014;16(8):1145–1153.
    1. Wasmer K, et al. Safety profile of multielectrode-phased radiofrequency pulmonary vein ablation catheter and irrigated radiofrequency catheter. Europace. 2016;18(1):78–84.
    1. Verma A, et al. Evaluation and reduction of asymptomatic cerebral embolism in ablation of atrial fibrillation, but high prevalence of chronic silent infarction: results of the evaluation of reduction of asymptomatic cerebral embolism trial. Circ Arrhythm Electrophysiol. 2013;6(5):835–842.
    1. Nagy-Balo E, et al. Predictors of cerebral microembolization during phased radiofrequency ablation of atrial fibrillation: analysis of biophysical parameters from the ablation generator. Heart Rhythm. 2014;11(6):977–983.
    1. Zellerhoff S, et al. Modified phased radiofrequency ablation of atrial fibrillation reduces the number of cerebral microembolic signals. Europace. 2014;16(3):341–346.
    1. De Greef Y, et al. Low rate of asymptomatic cerebral embolism and improved procedural efficiency with the novel pulmonary vein ablation catheter GOLD: results of the PRECISION GOLD trial. Europace. 2016;18(5):687–695.
    1. Leitz P, et al. Data on procedural handling and complications of pulmonary vein isolation using the pulmonary vein ablation catheter GOLD(R) Europace. 2016;18(5):696–701.
    1. Hummel J, et al. Phased RF ablation in persistent atrial fibrillation. Heart Rhythm. 2014;11(2):202–209.
    1. Boersma LV, et al. Multielectrode pulmonary vein isolation versus single tip wide area catheter ablation for paroxysmal atrial fibrillation: a multinational multicenter randomized clinical trial. Circ Arrhythm Electrophysiol. 2016;9(4):e003151.
    1. Bourier F, et al. Sensor-Based Electromagnetic Navigation (Mediguide(R)): How Accurate Is It? A Phantom Model Study. J Cardiovasc Electrophysiol. 2015;26(10):1140–1145.
    1. Nakagawa H, et al. Rapid high resolution electroanatomical mapping: evaluation of a new system in a canine atrial linear lesion model. Circ Arrhythm Electrophysiol. 2012;5(2):417–424.
    1. Dong J, et al. Integrated electroanatomic mapping with three-dimensional computed tomographic images for real-time guided ablations. Circulation. 2006;113(2):186–194.
    1. Kistler PM, et al. The impact of CT image integration into an electroanatomic mapping system on clinical outcomes of catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2006;17(10):1093–1101.
    1. Ector J, et al. Biplane three-dimensional augmented fluoroscopy as single navigation tool for ablation of atrial fibrillation: accuracy and clinical value. Heart Rhythm. 2008;5(7):957–964.
    1. Sporton SC, et al. Electroanatomic versus fluoroscopic mapping for catheter ablation procedures: a prospective randomized study. J Cardiovasc Electrophysiol. 2004;15(3):310–315.
    1. Estner HL, et al. Electrical isolation of pulmonary veins in patients with atrial fibrillation: reduction of fluoroscopy exposure and procedure duration by the use of a non-fluoroscopic navigation system (NavX) Europace. 2006;8(8):583–587.
    1. Scaglione M, et al. Visualization of multiple catheters with electroanatomical mapping reduces X-ray exposure during atrial fibrillation ablation. Europace. 2011;13(7):955–962.
    1. Martinek M, et al. Impact of integration of multislice computed tomography imaging into three-dimensional electroanatomic mapping on clinical outcomes, safety, and efficacy using radiofrequency ablation for atrial fibrillation. Pacing Clin Electrophysiol. 2007;30(10):1215–1223.
    1. Kistler PM, et al. The impact of image integration on catheter ablation of atrial fibrillation using electroanatomic mapping: a prospective randomized study. Eur Heart J. 2008;29(24):3029–3036.
    1. Bertaglia E, et al. Image integration increases efficacy of paroxysmal atrial fibrillation catheter ablation: results from the CartoMerge Italian Registry. Europace. 2009;11(8):1004–1010.
    1. Della Bella P, et al. Image integration-guided catheter ablation of atrial fibrillation: a prospective randomized study. J Cardiovasc Electrophysiol. 2009;20(3):258–265.
    1. Caponi D, et al. Ablation of atrial fibrillation: does the addition of threedimensional magnetic resonance imaging of the left atrium to electroanatomic mapping improve the clinical outcome? A randomized comparison of Carto-Merge vs. Carto-XP three-dimensional mapping ablation in patients with paroxysmal and persistent atrial fibrillation. Europace. 2010;12(8):1098–1104.
    1. Filgueiras-Rama D, et al. Remote magnetic navigation for accurate, real-time catheter positioning and ablation in cardiac electrophysiology procedures. J Vis Exp. 2013(74)
    1. Proietti R, et al. Remote magnetic with open-irrigated catheter vs. manual navigation for ablation of atrial fibrillation: a systematic review and meta-analysis. Europace. 2013;15(9):1241–1248.
    1. Wutzler A, et al. Robotic ablation of atrial fibrillation with a new remote catheter system. J Interv Card Electrophysiol. 2014;40(3):215–219.
    1. Dello Russo A, et al. Analysis of catheter contact force during atrial fibrillation ablation using the robotic navigation system: results from a randomized study. J Interv Card Electrophysiol. 2016;46(2):97–103.
    1. Faddis MN, et al. Novel, magnetically guided catheter for endocardial mapping and radiofrequency catheter ablation. Circulation. 2002;106(23):2980–2985.
    1. Greenberg S, et al. Remote controlled magnetically guided pulmonary vein isolation in canines. Heart Rhythm. 2006;3(1):71–76.
    1. Pappone C, et al. Robotic magnetic navigation for atrial fibrillation ablation. J Am Coll Cardiol. 2006;47(7):1390–1400.
    1. Saliba W, et al. Atrial fibrillation ablation using a robotic catheter remote control system: initial human experience and long-term follow-up results. J Am Coll Cardiol. 2008;51(25):2407–2411.
    1. Wazni OM, et al. Experience with the hansen robotic system for atrial fibrillation ablation–lessons learned and techniques modified: Hansen in the real world. J Cardiovasc Electrophysiol. 2009;20(11):1193–1196.
    1. Bradfield J, et al. Catheter ablation utilizing remote magnetic navigation: a review of applications and outcomes. Pacing Clin Electrophysiol. 2012;35(8):1021–1034.
    1. Hlivak P, et al. Robotic navigation in catheter ablation for paroxysmal atrial fibrillation: midterm efficacy and predictors of postablation arrhythmia recurrences. J Cardiovasc Electrophysiol. 2011;22(5):534–540.
    1. Willems S, et al. Persistence of pulmonary vein isolation after robotic remotenavigated ablation for atrial fibrillation and its relation to clinical outcome. J Cardiovasc Electrophysiol. 2010;21(10):1079–1084.
    1. Troianos CA, et al. Guidelines for performing ultrasound guided vascular cannulation: recommendations of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. J Am Soc Echocardiogr. 2011;24(12):1291–1318.
    1. Wynn GJ, et al. Improving safety in catheter ablation for atrial fibrillation: a prospective study of the use of ultrasound to guide vascular access. J Cardiovasc Electrophysiol. 2014;25(7):680–685.
    1. Saliba W, Thomas J. Intracardiac echocardiography during catheter ablation of atrial fibrillation. Europace. 2008;10(Suppl 3):iii42–47.
    1. Ferguson JD, et al. Catheter ablation of atrial fibrillation without fluoroscopy using intracardiac echocardiography and electroanatomic mapping. Circ Arrhythm Electrophysiol. 2009;2(6):611–619.
    1. Kim SS, et al. The use of intracardiac echocardiography and other intracardiac imaging tools to guide noncoronary cardiac interventions. J Am Coll Cardiol. 2009;53(23):2117–2128.
    1. Schmidt M, et al. Intracardiac echocardiography improves procedural efficiency during cryoballoon ablation for atrial fibrillation: a pilot study. J Cardiovasc Electrophysiol. 2010;21(11):1202–1207.
    1. Packer DL, et al. New generation of electro-anatomic mapping: full intracardiac ultrasound image integration. Europace. 2008;10(Suppl 3):iii35–iii41.
    1. Rostock T, et al. Atrial fibrillation begets atrial fibrillation in the pulmonary veins on the impact of atrial fibrillation on the electrophysiological properties of the pulmonary veins in humans. J Am Coll Cardiol. 2008;51(22):2153–2160.
    1. Ren JF, Marchlinski FE, Callans DJ. Left atrial thrombus associated with ablation for atrial fibrillation: identification with intracardiac echocardiography. J Am Coll Cardiol. 2004;43(10):1861–1867.
    1. Vasamreddy CR, et al. Technique and results of pulmonary vein angiography in patients undergoing catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2004;15(1):21–26.
    1. Strohmer B, Schernthaner C, Pichler M. Simultaneous angiographic imaging of ipsilateral pulmonary veins for catheter ablation of atrial fibrillation. Clin Res Cardiol. 2006;95(11):591–599.
    1. Fynn SP, Kalman JM. Pulmonary veins: anatomy, electrophysiology, tachycardia, and fibrillation. Pacing Clin Electrophysiol. 2004;27(11):1547–1559.
    1. Walters TE, Ellims AH, Kalman JM. The role of left atrial imaging in the management of atrial fibrillation. Prog Cardiovasc Dis. 2015;58(2):136–151.
    1. Lin WS, et al. Pulmonary vein morphology in patients with paroxysmal atrial fibrillation initiated by ectopic beats originating from the pulmonary veins: implications for catheter ablation. Circulation. 2000;101(11):1274–1281.
    1. Tsao HM, et al. Role of right middle pulmonary vein in patients with paroxysmal atrial fibrillation. J Cardiovasc Electrophysiol. 2001;12(12):1353–1357.
    1. Perez-Lugones A, et al. Three-dimensional reconstruction of pulmonary veins in patients with atrial fibrillation and controls: morphological characteristics of different veins. Pacing Clin Electrophysiol. 2003;26(1 Pt 1):8–15.
    1. Schwartzman D, Lacomis J, Wigginton WG. Characterization of left atrium and distal pulmonary vein morphology using multidimensional computed tomography. J Am Coll Cardiol. 2003;41(8):1349–1357.
    1. Lickfett L, et al. Characterization of a new pulmonary vein variant using magnetic resonance angiography: incidence, imaging, and interventional implications of the “right top pulmonary vein”. J Cardiovasc Electrophysiol. 2004;15(5):538–543.
    1. Mansour M, et al. Assessment of pulmonary vein anatomic variability by magnetic resonance imaging: implications for catheter ablation techniques for atrial fibrillation. J Cardiovasc Electrophysiol. 2004;15(4):387–393.
    1. Chun KR, et al. The ‘single big cryoballoon’ technique for acute pulmonary vein isolation in patients with paroxysmal atrial fibrillation: a prospective observational single centre study. Eur Heart J. 2009;30(6):699–709.
    1. Donal E, et al. EACVI/EHRA Expert Consensus Document on the role of multimodality imaging for the evaluation of patients with atrial fibrillation. Eur Heart J Cardiovasc Imaging. 2016;17(4):355–383.
    1. Hadid C, et al. Value of intraprocedural radiologic rotational angiography in atrial fibrillation ablation. Comparison with other imaging techniques. Rev Esp Cardiol (Engl Ed) 2012;65(6):574–575.
    1. Lehar F, et al. Comparison of clinical outcomes and safety of catheter ablation for atrial fibrillation supported by data from CT scan or three-dimensional rotational angiogram of left atrium and pulmonary veins. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015;159(4):622–628.
    1. Hauser TH, et al. Prognostic value of pulmonary vein size in prediction of atrial fibrillation recurrence after pulmonary vein isolation: a cardiovascular magnetic resonance study. J Cardiovasc Magn Reson. 2015;17:49.
    1. Dewire J, et al. The association of pre-existing left atrial fibrosis with clinical variables in patients referred for catheter ablation of atrial fibrillation. Clin Med Insights Cardiol. 2014;8(Suppl 1):25–30.
    1. Kim RJ, et al. Relationship ofMRI delayed contrast enhancement to irreversible injury, infarct age, and contractile function. Circulation. 1999;100(19):1992–2002.
    1. Kim RJ, et al. The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction. N Engl J Med. 2000;343(20):1445–1453.
    1. Karim R, et al. Evaluation of current algorithms for segmentation of scar tissue from late gadolinium enhancement cardiovascular magnetic resonance of the LA: an open-access grand challenge. J Cardiovasc Magn Reson. 2013;15:105.
    1. Khurram IM, et al. MRI evaluation of radiofrequency, cryothermal, and laser left atrial lesion formation in patients with atrial fibrillation. Pacing Clin Electrophysiol. 2015;38(11):1317–1324.
    1. Khurram IM, et al. Left atrial LGE and arrhythmia recurrence following pulmonary vein isolation for paroxysmal and persistent AF. JACC Cardiovasc Imaging. 2016;9(2):142–148.
    1. Sramko M, et al. Clinical value of assessment of left atrial late gadolinium enhancement in patients undergoing ablation of atrial fibrillation. Int J Cardiol. 2015;179:351–357.
    1. Spragg DD, et al. Initial experience with magnetic resonance imaging of atrial scar and co-registration with electroanatomic voltage mapping during atrial fibrillation: success and limitations. Heart Rhythm. 2012;9(12):2003–2009.
    1. Grothoff M, et al. MR imaging-guided electrophysiological ablation studies in humans with passive catheter tracking: initial results. Radiology. 2014;271(3):695–702.
    1. Nazarian S, et al. Feasibility of real-time magnetic resonance imaging for catheter guidance in electrophysiology studies. Circulation. 2008;118(3):223–229.
    1. Halperin HR, Kolandaivelu A. MRI-Guided Electrophysiology Intervention. Rambam Maimonides Med J. 2010;1(2):e0015.
    1. Vergara GR, et al. Real-time magnetic resonance imaging-guided radiofrequency atrial ablation and visualization of lesion formation at 3 Tesla. Heart Rhythm. 2011;8(2):295–303.
    1. Scherr D, et al. Incidence and predictors of left atrial thrombus prior to catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2009;20(4):379–384.
    1. Vazquez SR, Johnson SA, Rondina MT. Peri-procedural anticoagulation in patients undergoing ablation for atrial fibrillation. Thromb Res. 2010;126(2):e69–e77.
    1. Liu Y, et al. Incidence and outcomes of cerebrovascular events complicating catheter ablation for atrial fibrillation. Europace. 2016;18(9):1357–1365.
    1. Noseworthy PA, et al. Risk of stroke after catheter ablation versus cardioversion for atrial fibrillation: a propensity-matched study of 24,244 patients. Heart Rhythm. 2015;12(6):1154–1161.
    1. Deneke T, et al. Silent cerebral events/lesions related to atrial fibrillation ablation: a clinical review. J Cardiovasc Electrophysiol. 2015;26(4):455–463.
    1. Dorwarth U, et al. Radiofrequency catheter ablation: different cooled and noncooled electrode systems induce specific lesion geometries and adverse effects profiles. Pacing Clin Electrophysiol. 2003;26(7 Pt 1):1438–1445.
    1. Maleki K, et al. Intracardiac ultrasound detection of thrombus on transseptal sheath: incidence, treatment, and prevention. J Cardiovasc Electrophysiol. 2005;16(6):561–565.
    1. Wazni OM, et al. Embolic events and char formation during pulmonary vein isolation in patients with atrial fibrillation: impact of different anticoagulation regimens and importance of intracardiac echo imaging. J Cardiovasc Electrophysiol. 2005;16(6):576–581.
    1. Shah D. Filamentous thrombi during left-sided sheath-assisted catheter ablations. Europace. 2010;12(12):1657–1658.
    1. Sparks PB, et al. Left atrial “stunning” following radiofrequency catheter ablation of chronic atrial flutter. J Am Coll Cardiol. 1998;32(2):468–475.
    1. Cappato R, et al. Worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation. Circulation. 2005;111(9):1100–1105.
    1. Abhishek F, et al. Effectiveness of a strategy to reduce major vascular complications from catheter ablation of atrial fibrillation. J Interv Card Electrophysiol. 2011;30(3):211–215.
    1. Hoyt H, et al. Complications arising from catheter ablation of atrial fibrillation: temporal trends and predictors. Heart Rhythm. 2011;8(12):1869–1874.
    1. Chilukuri K, et al. Transoesophageal echocardiography predictors of periprocedural cerebrovascular accident in patients undergoing catheter ablation of atrial fibrillation. Europace. 2010;12(11):1543–1549.
    1. Schernthaner C, et al. High incidence of echocardiographic abnormalities of the interatrial septum in patients undergoing ablation for atrial fibrillation. Echocardiography. 2013;30(4):402–406.
    1. Yamamoto M, et al. Complex left atrial appendage morphology and left atrial appendage thrombus formation in patients with atrial fibrillation. Circ Cardiovasc Imaging. 2014;7(2):337–343.
    1. Puwanant S, et al. Role of the CHADS2 score in the evaluation of thromboembolic risk in patients with atrial fibrillation undergoing transesophageal echocardiography before pulmonary vein isolation. J Am Coll Cardiol. 2009;54(22):2032–2039.
    1. McCready JW, et al. Incidence of left atrial thrombus prior to atrial fibrillation ablation: is pre-procedural transoesophageal echocardiography mandatory? Europace. 2010;12(7):927–932.
    1. Gula LJ, et al. Impact of routine transoesophageal echocardiography on safety, outcomes, and cost of pulmonary vein ablation: inferences drawn from a decision analysis model. Europace. 2010;12(11):1550–1557.
    1. Calkins H, et al. Uninterrupted dabigatran versus warfarin for ablation in atrial fibrillation. N Engl J Med. 2017;376(17):1627–1636.
    1. Kapa S, et al. ECG-gated dual-source CT for detection of left atrial appendage thrombus in patients undergoing catheter ablation for atrial fibrillation. J Interv Card Electrophysiol. 2010;29(2):75–81.
    1. Romero J, et al. Detection of left atrial appendage thrombus by cardiac computed tomography in patients with atrial fibrillation: a meta-analysis. Circ Cardiovasc Imaging. 2013;6(2):185–194.
    1. Gottlieb I, et al. Diagnostic accuracy of arterial phase 64-slice multidetector CT angiography for left atrial appendage thrombus in patients undergoing atrial fibrillation ablation. J Cardiovasc Electrophysiol. 2008;19(3):247–251.
    1. Lazoura O, et al. A low-dose, dual-phase cardiovascular CT protocol to assess left atrial appendage anatomy and exclude thrombus prior to left atrial intervention. Int J Cardiovasc Imaging. 2016;32(2):347–354.
    1. Saksena S, et al. A prospective comparison of cardiac imaging using intracardiac echocardiography with transesophageal echocardiography in patients with atrial fibrillation: the intracardiac echocardiography guided cardioversion helps interventional procedures study. Circ Arrhythm Electrophysiol. 2010;3(6):571–577.
    1. Baran J, et al. Intracardiac echocardiography for detection of thrombus in the left atrial appendage: comparison with transesophageal echocardiography in patients undergoing ablation for atrial fibrillation: the Action-Ice I Study. Circ Arrhythm Electrophysiol. 2013;6(6):1074–1081.
    1. Ren JF, et al. Intracardiac echocardiographic diagnosis of thrombus formation in the left atrial appendage: a complementary role to transesophageal echocardiography. Echocardiography. 2013;30(1):72–80.
    1. Anter E, et al. Comparison of intracardiac echocardiography and transesophageal echocardiography for imaging of the right and left atrial appendages. Heart Rhythm. 2014;11(11):1890–1897.
    1. Sriram CS, et al. Detection of left atrial thrombus by intracardiac echocardiography in patients undergoing ablation of atrial fibrillation. J Interv Card Electrophysiol. 2015;43(3):227–236.
    1. Connolly SJ, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361(12):1139–1151.
    1. Granger CB, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365(11):981–992.
    1. Patel MR, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011;365(10):883–891.
    1. Giugliano RP, et al. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2013;369(22):2093–2104.
    1. Wazni OM, et al. Atrial fibrillation ablation in patients with therapeutic international normalized ratio: comparison of strategies of anticoagulation management in the periprocedural period. Circulation. 2007;116(22):2531–2534.
    1. Schmidt M, et al. Atrial fibrillation ablation in patients with therapeutic international normalized ratios. Pacing Clin Electrophysiol. 2009;32(8):995–999.
    1. Kwak JJ, et al. Safety and convenience of continuous warfarin strategy during the periprocedural period in patients who underwent catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2010;21(6):620–625.
    1. Gopinath D, et al. Pulmonary vein antrum isolation for atrial fibrillation on therapeutic coumadin: special considerations. J Cardiovasc Electrophysiol. 2011;22(2):236–239.
    1. Hakalahti A, et al. Catheter ablation of atrial fibrillation in patients with therapeutic oral anticoagulation treatment. Europace. 2011;13(5):640–645.
    1. Di Biase L, et al. Periprocedural stroke and bleeding complications in patients undergoing catheter ablation of atrial fibrillation with different anticoagulation management: results from the Role of Coumadin in Preventing Thromboembolism in Atrial Fibrillation (AF) Patients Undergoing Catheter Ablation (COMPARE) randomized trial. Circulation. 2014;129(25):2638–2644.
    1. Bassiouny M, et al. Use of dabigatran for periprocedural anticoagulation in patients undergoing catheter ablation for atrial fibrillation. Circ Arrhythm Electrophysiol. 2013;6(3):460–466.
    1. Bin Abdulhak AA, et al. Safety and efficacy of interrupted dabigatran for periprocedural anticoagulation in catheter ablation of atrial fibrillation: a systematic review and meta-analysis. Europace. 2013;15(10):1412–1420.
    1. Hohnloser SH, Camm AJ. Safety and efficacy of dabigatran etexilate during catheter ablation of atrial fibrillation: a meta-analysis of the literature. Europace. 2013;15(10):1407–1411.
    1. Providencia R, et al. Rivaroxaban and dabigatran in patients undergoing catheter ablation of atrial fibrillation. Europace. 2014;16(8):1137–1144.
    1. Winkle RA, et al. Peri-procedural interrupted oral anticoagulation for atrial fibrillation ablation: comparison of aspirin, warfarin, dabigatran, and rivaroxaban. Europace. 2014;16(10):1443–1449.
    1. Armbruster HL, et al. Safety of novel oral anticoagulants compared with uninterrupted warfarin for catheter ablation of atrial fibrillation. Ann Pharmacother. 2015;49(3):278–284.
    1. Calkins H, et al. RE-CIRCUIT study-randomized evaluation of Dabigatran etexilate compared to warfarin in pulmonary vein ablation: assessment of an uninterrupted periprocedural anticoagulation strategy. Am J Cardiol. 2015;115(1):154–155.
    1. Cappato R, et al. Uninterrupted rivaroxaban vs. uninterrupted vitamin K antagonists for catheter ablation in non-valvular atrial fibrillation. Eur Heart J. 2015;36(28):1805–1811.
    1. Phan K, et al. Rivaroxaban versus warfarin or dabigatran in patients undergoing catheter ablation for atrial fibrillation: A meta-analysis. Int J Cardiol. 2015;185:209–213.
    1. Pollack CV, Jr, et al. Idarucizumab for Dabigatran Reversal. N Engl J Med. 2015;373(6):511–520.
    1. Siegal DM, et al. Andexanet Alfa for the Reversal of Factor Xa Inhibitor Activity. N Engl J Med. 2015;373(25):2413–2424.
    1. Ren JF, et al. Increased intensity of anticoagulation may reduce risk of thrombus during atrial fibrillation ablation procedures in patients with spontaneous echo contrast. J Cardiovasc Electrophysiol. 2005;16(5):474–477.
    1. Bruce CJ, et al. Early heparinization decreases the incidence of left atrial thrombi detected by intracardiac echocardiography during radiofrequency ablation for atrial fibrillation. J Interv Card Electrophysiol. 2008;22(3):211–219.
    1. Asbach S, et al. Early heparin administration reduces risk for left atrial thrombus formation during atrial fibrillation ablation procedures. Cardiol Res Pract. 2011;2011:615087.
    1. Briceno DF, et al. Clinical impact of heparin kinetics during catheter ablation of atrial fibrillation: meta-analysis and meta-regression. J Cardiovasc Electrophysiol. 2016;27(6):683–693.
    1. Lakshmanadoss U, K R, Kutinsky I, Williamson B, Wong W, Haines DE. Figure-of-eight suture for vascular hemostasis in fully anticoagulated patients after atrial fibrillation catheter ablation [abstract] Europace. 2015;15(Suppl 3):iii136–iii159.
    1. Chilukuri K, et al. Incidence and outcomes of protamine reactions in patients undergoing catheter ablation of atrial fibrillation. J Interv Card Electrophysiol. 2009;25(3):175–181.
    1. Majeed A, et al. Thromboembolic safety and efficacy of prothrombin complex concentrates in the emergency reversal of warfarin coagulopathy. Thromb Res. 2012;129(2):146–151.
    1. Connolly SJ, et al. Apixaban in patients with atrial fibrillation. N Engl J Med. 2011;364(9):806–817.
    1. Mega JL, et al. Rivaroxaban in patients with a recent acute coronary syndrome. N Engl J Med. 2012;366(1):9–19.
    1. Daoud EG, et al. Temporal relationship of atrial tachyarrhythmias, cerebrovascular events, and systemic emboli based on stored device data: a subgroup analysis of TRENDS. Heart Rhythm. 2011;8(9):1416–1423.
    1. Riley MP, et al. Risk of stroke or transient ischemic attack after atrial fibrillation ablation with oral anticoagulant use guided by ECG monitoring and pulse assessment. J Cardiovasc Electrophysiol. 2014;25(6):591–596.
    1. Saad EB, et al. Very low risk of thromboembolic events in patients undergoing successful catheter ablation of atrial fibrillation with a CHADS2 score </=3: a long-term outcome study. Circ Arrhythm Electrophysiol. 2011;4(5):615–621.
    1. Yagishita A, et al. Incidence of late thromboembolic events after catheter ablation of atrial fibrillation. Circ J. 2011;75(10):2343–2349.
    1. Zuern CS, et al. Anticoagulation after catheter ablation of atrial fibrillation guided by implantable cardiac monitors. Pacing Clin Electrophysiol. 2015;38(6):688–693.
    1. Tran VN, et al. Thromboembolic events 7-11 years after catheter ablation of atrial fibrillation. Pacing Clin Electrophysiol. 2015;38(4):499–506.
    1. Piccini JP, et al. Pulmonary vein isolation for the maintenance of sinus rhythm in patients with atrial fibrillation: a meta-analysis of randomized, controlled trials. Circ Arrhythm Electrophysiol. 2009;2(6):626–633.
    1. Noseworthy PA, et al. Patterns of anticoagulation use and cardioembolic risk after catheter ablation for atrial fibrillation. J Am Heart Assoc. 2015;4(11)
    1. Sjalander S, et al. Assessment of use vs discontinuation of oral anticoagulation after pulmonary vein isolation in patients with atrial fibrillation. JAMA Cardiol. 2017;2(2):146–152.
    1. Elkassabany N, et al. Anesthetic management of patients undergoing pulmonary vein isolation for treatment of atrial fibrillation using high-frequency jet ventilation. J Cardiothorac Vasc Anesth. 2012;26(3):433–438.
    1. Santangeli P, Lin D. Catheter Ablation of Paroxysmal Atrial Fibrillation: Have We Achieved Cure with Pulmonary Vein Isolation? Methodist Debakey Cardiovasc J. 2015;11(2):71–75.
    1. Pappone C, et al. Atrio-esophageal fistula as a complication of percutaneous transcatheter ablation of atrial fibrillation. Circulation. 2004;109(22):2724–2726.
    1. Cummings JE, et al. Brief communication: atrial-esophageal fistulas after radiofrequency ablation. Ann Intern Med. 2006;144(8):572–574.
    1. Shah D, et al. Acute pyloric spasm and gastric hypomotility: an extracardiac adverse effect of percutaneous radiofrequency ablation for atrial fibrillation. J Am Coll Cardiol. 2005;46(2):327–330.
    1. Lemola K, et al. Computed tomographic analysis of the anatomy of the left atrium and the esophagus: implications for left atrial catheter ablation. Circulation. 2004;110(24):3655–3660.
    1. Cummings JE, et al. Left atrial flutter following pulmonary vein antrumisolation with radiofrequency energy: linear lesions or repeat isolation. J Cardiovasc Electrophysiol. 2005;16(3):293–297.
    1. Cummings JE, et al. Assessment of temperature, proximity, and course of the esophagus during radiofrequency ablation within the LA. Circulation. 2005;112(4):459–464.
    1. Good E, et al. Movement of the esophagus during left atrial catheter ablation for atrial fibrillation. J Am Coll Cardiol. 2005;46(11):2107–2110.
    1. Kottkamp H, et al. Topographic variability of the esophageal left atrial relation influencing ablation lines in patients with atrial fibrillation. J Cardiovasc Electrophysiol. 2005;16(2):146–150.
    1. Redfearn DP, et al. Esophageal temperature monitoring during radiofrequency ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2005;16(6):589–593.
    1. Ren JF, Marchlinski FE, Callans DJ. Real-time intracardiac echocardiographic imaging of the posterior left atrial wall contiguous to anterior wall of the esophagus. J Am Coll Cardiol. 2006;48(3):594.
    1. Ruby RS, et al. Prevalence of fever in patients undergoing left atrial ablation of atrial fibrillation guided by barium esophagraphy. J Cardiovasc Electrophysiol. 2009;20(8):883–887.
    1. Ripley KL, et al. Time course of esophageal lesions after catheter ablation with cryothermal and radiofrequency ablation: implication for atrio-esophageal fistula formation after catheter ablation for atrial fibrillation. J Cardiovasc Electrophysiol. 2007;18(6):642–646.
    1. Ahmed H, et al. The esophageal effects of cryoenergy during cryoablation for atrial fibrillation. Heart Rhythm. 2009;6(7):962–969.
    1. Kawasaki R, et al. Atrioesophageal fistula complicating cryoballoon pulmonary vein isolation for paroxysmal atrial fibrillation. J Cardiovasc Electrophysiol. 2014;25(7):787–792.
    1. Lim HW, et al. Atrioesophageal fistula during cryoballoon ablation for atrial fibrillation. J Cardiovasc Electrophysiol. 2014;25(2):208–213.
    1. Yokoyama K, et al. Canine model of esophageal injury and atrial-esophageal fistula after applications of forward-firing high-intensity focused ultrasound and side-firing unfocused ultrasound in the left atrium and inside the pulmonary vein. Circ Arrhythm Electrophysiol. 2009;2(1):41–49.
    1. Singh SM, et al. Esophageal injury and temperature monitoring during atrial fibrillation ablation. Circ Arrhythm Electrophysiol. 2008;1(3):162–168.
    1. Kuwahara T, et al. Safe and effective ablation of atrial fibrillation: importance of esophageal temperature monitoring to avoid periesophageal nerve injury as a complication of pulmonary vein isolation. J Cardiovasc Electrophysiol. 2009;20(1):1–6.
    1. Contreras-Valdes FM, et al. Severity of esophageal injury predicts time to healing after radiofrequency catheter ablation for atrial fibrillation. Heart Rhythm. 2011;8(12):1862–1868.
    1. Leite LR, et al. Luminal esophageal temperature monitoring with a deflectable esophageal temperature probe and intracardiac echocardiography may reduce esophageal injury during atrial fibrillation ablation procedures: results of a pilot study. Circ Arrhythm Electrophysiol. 2011;4(2):149–156.
    1. Tschabrunn CM, et al. Comparison between single- and multi-sensor oesophageal temperature probes during atrial fibrillation ablation: thermodynamic characteristics. Europace. 2015;17(6):891–897.
    1. Deneke T, et al. Utility of esophageal temperature monitoring during pulmonary vein isolation for atrial fibrillation using duty-cycled phased radiofrequency ablation. J Cardiovasc Electrophysiol. 2011;22(3):255–261.
    1. Carroll BJ, et al. Multi-sensor esophageal temperature probe used during radiofrequency ablation for atrial fibrillation is associated with increased intraluminal temperature detection and increased risk of esophageal injury compared to single-sensor probe. J Cardiovasc Electrophysiol. 2013;24(9):958–964.
    1. Muller P, et al. Higher incidence of esophageal lesions after ablation of atrial fibrillation related to the use of esophageal temperature probes. Heart Rhythm. 2015;12(7):1464–1469.
    1. Tsuchiya T, et al. Atrial fibrillation ablation with esophageal cooling with a cooled water-irrigated intraesophageal balloon: a pilot study. J Cardiovasc Electrophysiol. 2007;18(2):145–150.
    1. Arruda MS, et al. Feasibility and safety of using an esophageal protective system to eliminate esophageal thermal injury: implications on atrialesophageal fistula following AF ablation. J Cardiovasc Electrophysiol. 2009;20(11):1272–1278.
    1. Kuwahara T, et al. Oesophageal cooling with ice water does not reduce the incidence of oesophageal lesions complicating catheter ablation of atrial fibrillation: randomized controlled study. Europace. 2014;16(6):834–839.
    1. Kuwahara T, et al. Incidences of esophageal injury during esophageal temperature monitoring: a comparative study of a multi-thermocouple temperature probe and a deflectable temperature probe in atrial fibrillation ablation. J Interv Card Electrophysiol. 2014;39(3):251–257.
    1. Chugh A, et al. Mechanical displacement of the esophagus in patients undergoing left atrial ablation of atrial fibrillation. Heart Rhythm. 2009;6(3):319–322.
    1. Koruth JS, et al. Mechanical esophageal displacement during catheter ablation for atrial fibrillation. J Cardiovasc Electrophysiol. 2012;23(2):147–154.
    1. Zellerhoff S, Lenze F, Eckardt L. Prophylactic proton pump inhibition after atrial fibrillation ablation: is there any evidence? Europace. 2011;13(9):1219–1221.
    1. Zellerhoff S, et al. Fatal course of esophageal stenting of an atrioesophageal fistula after atrial fibrillation ablation. Heart Rhythm. 2011;8(4):624–626.
    1. Khan M, et al. Medical treatments in the short term management of reflux oesophagitis. Cochrane Database Syst Rev. 2007(2) CD003244.
    1. Kahrilas PJ. Clinical practice. Gastroesophageal reflux disease. N Engl J Med. 2008;359(16):1700–1707.
    1. Martinek M, et al. Identification of a high-risk population for esophageal injury during radiofrequency catheter ablation of atrial fibrillation: procedural and anatomical considerations. Heart Rhythm. 2010;7(9):1224–1230.
    1. Shaheen NJ, et al. Pantoprazole reduces the size of postbanding ulcers after variceal band ligation: a randomized, controlled trial. Hepatology. 2005;41(3):588–594.
    1. Halm U, et al. Thermal esophageal lesions after radiofrequency catheter ablation of left atrial arrhythmias. Am J Gastroenterol. 2010;105(3):551–556.
    1. Knopp H, et al. Incidental and ablation-induced findings during upper gastrointestinal endoscopy in patients after ablation of atrial fibrillation: a retrospective study of 425 patients. Heart Rhythm. 2014;11(4):574–578.
    1. Dagres N, et al. Rapid detection and successful treatment of esophageal perforation after radiofrequency ablation of atrial fibrillation: lessons from five cases. J Cardiovasc Electrophysiol. 2006;17(11):1213–1215.
    1. Eitel C, et al. Successful nonsurgical treatment of esophagopericardial fistulas after atrial fibrillation catheter ablation: a case series. Circ Arrhythm Electrophysiol. 2013;6(4):675–681.
    1. Singh SM, et al. Clinical outcomes after repair of left atrial esophageal fistulas occurring after atrial fibrillation ablation procedures. Heart Rhythm. 2013;10(11):1591–1597.
    1. Bunch TJ, et al. Temporary esophageal stenting allows healing of esophageal perforations following atrial fibrillation ablation procedures. J Cardiovasc Electrophysiol. 2006;17(4):435–439.
    1. Cappato R, et al. Prevalence and causes of fatal outcome in catheter ablation of atrial fibrillation. J Am Coll Cardiol. 2009;53(19):1798–1803.
    1. Tan C, Coffey A. Atrioesophageal fistula after surgical unipolar radiofrequency atrial ablation for atrial fibrillation. Ann Thorac Surg. 2013;95(3):e61–e62.
    1. Mohanty S. Outcomes of atrio-esophageal fistula following catheter ablation of atrial fibrillation treated with surgical repair versus esophageal stenting. J Cardiovasc Electrophysiol. 2014;25(9):E6.
    1. Mohanty S, et al. Outcomes of atrioesophageal fistula following catheter ablation of atrial fibrillation treated with surgical repair versus esophageal stenting. J Cardiovasc Electrophysiol. 2014;25(6):579–584.
    1. Hazell W, et al. Atrio-oesophageal fistula: an emergent complication of radiofrequency ablation. Emerg Med Australas. 2009;21(4):329–332.
    1. Cazavet A, et al. Successful surgery for atrioesophageal fistula caused by transcatheter ablation of atrial fibrillation. J Thorac Cardiovasc Surg. 2010;140(3):e43–e45.
    1. Podgaetz E, Deschamps C. Esophageal complications of catheter ablation for atrial fibrillation: a case report. J Thorac Cardiovasc Surg. 2013;145(1):e9–13.
    1. Queneherve L, et al. Endoscopic management of an esophagopericardial fistula after radiofrequency ablation for atrial fibrillation. World J Gastroenterol. 2013;19(21):3352–3353.
    1. Gunes MF, et al. Ablating the posterior heart: cardioesophageal fistula complicating radiofrequency ablation in the coronary sinus. J Cardiovasc Electrophysiol. 2015;26(12):1376–1378.
    1. Qadeer MA, et al. Endoscopic clips for closing esophageal perforations: case report and pooled analysis. Gastrointest Endosc. 2007;66(3):605–611.
    1. Ellis CR, et al. Successful treatment of esophageal perforation following atrial fibrillation ablation with a fully covered esophageal stent: prevention of atrialesophageal fistula. Journal of Innovations in Cardiac Rhythm Management. 2012;3:874–878.
    1. Markar SR, et al. Novel multimodality endoscopic closure of postoperative esophageal fistula. Int J Surg Case Rep. 2012;3(11):577–579.
    1. Cappato R, et al. Updated worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation. Circ Arrhythm Electrophysiol. 2010;3(1):32–38.
    1. Deshmukh A, et al. In-hospital complications associated with catheter ablation of atrial fibrillation in the United States between 2000 and 2010: analysis of 93 801 procedures. Circulation. 2013;128(19):2104–2112.
    1. Gupta A, et al. Complications of catheter ablation of atrial fibrillation: a systematic review. Circ Arrhythm Electrophysiol. 2013;6(6):1082–1088.
    1. Takahashi Y, et al. Acute occlusion of the left circumflex coronary artery during mitral isthmus linear ablation. J Cardiovasc Electrophysiol. 2005;16(10):1104–1107.
    1. Chilukuri K, et al. Association of transseptal punctures with isolated migraine aura in patients undergoing catheter ablation of cardiac arrhythmias. J Cardiovasc Electrophysiol. 2009;20(11):1227–1230.
    1. Noheria A, et al. Migraine headaches following catheter ablation for atrial fibrillation. J Interv Card Electrophysiol. 2011;30(3):227–232.
    1. Barbhaiya CR, et al. Global survey of esophageal and gastric injury in atrial fibrillation ablation: incidence, time to presentation, and outcomes. J Am Coll Cardiol. 2015;65(13):1377–1378.
    1. Holmes DR, Jr, Monahan KH, Packer D. Pulmonary vein stenosis complicating ablation for atrial fibrillation: clinical spectrum and interventional considerations. JACC Cardiovasc Interv. 2009;2(4):267–276.
    1. Fender EA, Packer DL, Holmes DR., Jr Pulmonary vein stenosis after atrial fibrillation ablation. EuroIntervention. 2016;12(Suppl X):X31–X34.
    1. Kirchhof P, et al. Comprehensive risk reduction in patients with atrial fibrillation: emerging diagnostic and therapeutic options–a report from the 3rd Atrial Fibrillation Competence NETwork/European Heart Rhythm Association consensus conference. Europace. 2012;14(1):8–27.
    1. Oral H, et al. A tailored approach to catheter ablation of paroxysmal atrial fibrillation. Circulation. 2006;113(15):1824–1831.
    1. Vasamreddy CR, et al. Predictors of recurrence following catheter ablation of atrial fibrillation using an irrigated-tip ablation catheter. J Cardiovasc Electrophysiol. 2004;15(6):692–697.
    1. Bertaglia E, et al. Predictive value of early atrial tachyarrhythmias recurrence after circumferential anatomical pulmonary vein ablation. Pacing Clin Electrophysiol. 2005;28(5):366–371.
    1. Das M, et al. Recurrence of atrial tachyarrhythmia during the second month of the blanking period is associated with more extensive pulmonary vein reconnection at repeat electrophysiology study. Circ Arrhythm Electrophysiol. 2015;8(4):846–852.
    1. Kaitani K, et al. Efficacy of Antiarrhythmic Drugs Short-Term Use After Catheter Ablation for Atrial Fibrillation (EAST-AF) trial. Eur Heart J. 2016;37(7):610–618.
    1. Willems S, et al. Redefining the blanking period after catheter ablation for paroxysmal atrial fibrillation: insights from the ADVICE (Adenosine Following Pulmonary Vein Isolation to Target Dormant Conduction Elimination) trial. Circ Arrhythm Electrophysiol. 2016;9(8)
    1. Klemm HU, et al. Correlation of symptoms to ECG diagnosis following atrial fibrillation ablation. J Cardiovasc Electrophysiol. 2006;17(2):146–150.
    1. Senatore G, et al. Role of transtelephonic electrocardiographic monitoring in detecting short-term arrhythmia recurrences after radiofrequency ablation in patients with atrial fibrillation. J Am Coll Cardiol. 2005;45(6):873–876.
    1. Pokushalov E, et al. Ablation of paroxysmal and persistent atrial fibrillation: 1-year follow-up through continuous subcutaneous monitoring. J Cardiovasc Electrophysiol. 2011;22(4):369–375.
    1. Dagres N, et al. Influence of the duration of Holter monitoring on the detection of arrhythmia recurrences after catheter ablation of atrial fibrillation: implications for patient follow-up. Int J Cardiol. 2010;139(3):305–306.
    1. Winkle RA, et al. Atrial arrhythmia burden on long-term monitoring in asymptomatic patients late after atrial fibrillation ablation. Am J Cardiol. 2012;110(6):840–844.
    1. Kapa S, et al. Assessing arrhythmia burden after catheter ablation of atrial fibrillation using an implantable loop recorder: the ABACUS study. J Cardiovasc Electrophysiol. 2013;24(8):875–881.
    1. Pecha S, et al. Concomitant surgical atrial fibrillation ablation and event recorder implantation: better monitoring, better outcome? Interact Cardiovasc Thorac Surg. 2013;16(4):465–469.
    1. Takagi T, et al. Role of extended external auto-triggered loop recorder monitoring for atrial fibrillation. Circ J. 2014;78(11):2637–2642.
    1. Damiano RJ, Jr, et al. Detection of atrial fibrillation after surgical ablation: conventional versus continuous monitoring. Ann Thorac Surg. 2016;101(1):42–47. discussion 47–48.
    1. Piorkowski C, et al. Value of different follow-up strategies to assess the efficacy of circumferential pulmonary vein ablation for the curative treatment of atrial fibrillation. J Cardiovasc Electrophysiol. 2005;16(12):1286–1292.
    1. Janse PA, et al. Symptoms versus objective rhythm monitoring in patients with paroxysmal atrial fibrillation undergoing pulmonary vein isolation. Eur J Cardiovasc Nurs. 2008;7(2):147–151.
    1. Ziegler PD, Koehler JL, Mehra R. Comparison of continuous versus intermittent monitoring of atrial arrhythmias. Heart Rhythm. 2006;3(12):1445–1452.
    1. Edgerton JR, et al. Long-term monitoring after surgical ablation for atrial fibrillation: how much is enough? J Thorac Cardiovasc Surg. 2011;142(1):162–165.
    1. Mulder AA, et al. Arrhythmia detection after atrial fibrillation ablation: value of incremental monitoring time. Pacing Clin Electrophysiol. 2012;35(2):164–169.
    1. Gussak I, et al. Wireless remote monitoring of reconstructed 12-lead ECGs after ablation for atrial fibrillation using a hand-held device. J Electrocardiol. 2012;45(2):129–135.
    1. Tarakji KG, et al. Using a novel wireless system for monitoring patients after the atrial fibrillation ablation procedure: the iTransmit study. Heart Rhythm. 2015;12(3):554–559.
    1. Hindricks G, et al. Performance of a new leadless implantable cardiac monitor in detecting and quantifying atrial fibrillation: Results of the XPECT trial. Circ Arrhythm Electrophysiol. 2010;3(2):141–147.
    1. Bogachev-Prokophiev A, et al. Assessment of concomitant paroxysmal atrial fibrillation ablation in mitral valve surgery patients based on continuous monitoring: does a different lesion set matter? Interact Cardiovasc Thorac Surg. 2014;18(2):177–181. discussion 182.
    1. Ad N, et al. The Cox-Maze III procedure success rate: comparison by electrocardiogram, 24-hour holter monitoring and long-term monitoring. Ann Thorac Surg. 2009;88(1):101–105.
    1. Hanke T, et al. Twenty-four-hour holter monitor follow-up does not provide accurate heart rhythm status after surgical atrial fibrillation ablation therapy: up to 12 months experience with a novel permanently implantable heart rhythm monitor device. Circulation. 2009;120(11 Suppl):S177–S184.
    1. Liu J, et al. The value of transtelephonic electrocardiogram monitoring system during the “Blanking Period” after ablation of atrial fibrillation. J Electrocardiol. 2010;43(6):667–672.
    1. Bogachev-Prokophiev A, et al. Ablation for atrial fibrillation during mitral valve surgery: 1-year results through continuous subcutaneous monitoring. Interact Cardiovasc Thorac Surg. 2012;15(1):37–41.
    1. Pokushalov E, et al. Does atrial fibrillation burden measured by continuous monitoring during the blanking period predict the response to ablation at 12- month follow-up? Heart Rhythm. 2012;9(9):1375–1379.
    1. Perez-Castellano N, et al. The COR trial: a randomized study with continuous rhythm monitoring to compare the efficacy of cryoenergy and radiofrequency for pulmonary vein isolation. Heart Rhythm. 2014;11(1):8–14.
    1. Charitos EI, et al. Long-term outcomes after surgical ablation for atrial fibrillation in patients with continuous heart rhythm monitoring devices. Interact Cardiovasc Thorac Surg. 2015;21(6):712–721.
    1. Pecha S, et al. Implantable loop recorder monitoring after concomitant surgical ablation for atrial fibrillation (AF): insights from more than 200 continuously monitored patients. Heart Vessels. 2016;31(8):1347–1353.
    1. Eitel C, et al. Performance of an implantable automatic atrial fibrillation detection device: impact of software adjustments and relevance of manual episode analysis. Europace. 2011;13(4):480–485.
    1. Seidl K, et al. Is the atrial high rate episode diagnostic feature reliable in detecting paroxysmal episodes of atrial tachyarrhythmias? Pacing Clin Electrophysiol. 1998;21(4 Pt 1):694–700.
    1. Purerfellner H, et al. Accuracy of atrial tachyarrhythmia detection in implantable devices with arrhythmia therapies. Pacing Clin Electrophysiol. 2004;27(7):983–992.
    1. Martinek M, et al. New insights into long-term follow-up of atrial fibrillation ablation: full disclosure by an implantable pacemaker device. J Cardiovasc Electrophysiol. 2007;18(8):818–823.
    1. Steven D, et al. What is the real atrial fibrillation burden after catheter ablation of atrial fibrillation? A prospective rhythm analysis in pacemaker patients with continuous atrial monitoring. Eur Heart J. 2008;29(8):1037–1042.
    1. Puskas JD, et al. “Spot” ECGs underestimate atrial fibrillation recurrence after surgical ablation. Innovations (Phila) 2008;3(1):7–11.
    1. Kaufman ES, et al. Positive predictive value of device-detected atrial high-rate episodes at different rates and durations: an analysis from ASSERT. Heart Rhythm. 2012;9(8):1241–1246.
    1. Arbelo E, et al. The atrial fibrillation ablation pilot study: a European Survey on Methodology and results of catheter ablation for atrial fibrillation conducted by the European Heart Rhythm Association. Eur Heart J. 2014;35(22):1466–1478.
    1. O’Donnell D, et al. Delayed cure despite early recurrence after pulmonary vein isolation for atrial fibrillation. Am J Cardiol. 2003;91(1):83–85.
    1. Jiang H, et al. Predictors of early recurrence and delayed cure after segmental pulmonary vein isolation for paroxysmal atrial fibrillation without structural heart disease. J Interv Card Electrophysiol. 2006;15(3):157–163.
    1. Richter B, et al. Frequency of recurrence of atrial fibrillation within 48 hours after ablation and its impact on long-term outcome. Am J Cardiol. 2008;101(6):843–847.
    1. Reddy VY, et al. Balloon catheter ablation to treat paroxysmal atrial fibrillation: what is the level of pulmonary venous isolation? Heart Rhythm. 2008;5(3):353–360.
    1. Kirchhof P, et al. Outcome parameters for trials in atrial fibrillation: executive summary. Eur Heart J. 2007;28(22):2803–2817.
    1. Issac TT, Dokainish H, Lakkis NM. Role of inflammation in initiation and perpetuation of atrial fibrillation: a systematic review of the published data. J Am Coll Cardiol. 2007;50(21):2021–2028.
    1. Li XP, et al. Predictive value of early recurrence and delayed cure after catheter ablation for patients with chronic atrial fibrillation. Circ J. 2008;72(7):1125–1129.
    1. Andrade JG, et al. Early recurrence of atrial tachyarrhythmias following radiofrequency catheter ablation of atrial fibrillation. Pacing Clin Electrophysiol. 2012;35(1):106–116.
    1. Mugnai G, et al. Second-generation cryoballoon ablation for paroxysmal atrial fibrillation: Predictive role of atrial arrhythmias occurring in the blanking period on the incidence of late recurrences. Heart Rhythm. 2016;13(4):845–851.
    1. Roux JF, et al. Antiarrhythmics After Ablation of Atrial Fibrillation (5A Study) Circulation. 2009;120(12):1036–1040.
    1. Leong-Sit P, et al. Antiarrhythmics after ablation of atrial fibrillation (5A Study): six-month follow-up study. Circ Arrhythm Electrophysiol. 2011;4(1):11–14.
    1. Koyama T, et al. Prevention of atrial fibrillation recurrence with corticosteroids after radiofrequency catheter ablation: a randomized controlled trial. J Am Coll Cardiol. 2010;56(18):1463–1472.
    1. Kim YR, et al. Effect of short-term steroid therapy on early recurrence during the blanking period after catheter ablation of atrial fibrillation. Circ Arrhythm Electrophysiol. 2015;8(6):1366–1372.
    1. Abed HS, et al. Effect of weight reduction and cardiometabolic risk factor management on symptom burden and severity in patients with atrial fibrillation: a randomized clinical trial. JAMA. 2013;310(19):2050–2060.
    1. Imazio M, et al. Colchicine reduces postoperative atrial fibrillation: results of the Colchicine for the Prevention of the Postpericardiotomy Syndrome (COPPS) atrial fibrillation substudy. Circulation. 2011;124(21):2290–2295.
    1. Deftereos S, et al. Colchicine for prevention of early atrial fibrillation recurrence after pulmonary vein isolation: a randomized controlled study. J Am Coll Cardiol. 2012;60(18):1790–1796.
    1. Deftereos S, et al. Colchicine for prevention of atrial fibrillation recurrence after pulmonary vein isolation: mid-term efficacy and effect on quality of life. Heart Rhythm. 2014;11(4):620–628.
    1. Chilukuri K, et al. Outcomes in patients requiring cardioversion following catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2010;21(1):27–32.
    1. Baman TS, et al. Time to cardioversion of recurrent atrial arrhythmias after catheter ablation of atrial fibrillation and long-term clinical outcome. J Cardiovasc Electrophysiol. 2009;20(12):1321–1325.
    1. Malasana G, et al. A strategy of rapid cardioversion minimizes the significance of early recurrent atrial tachyarrhythmias after ablation for atrial fibrillation. J Cardiovasc Electrophysiol. 2011;22(7):761–766.
    1. Sponga S, et al. Role of an aggressive rhythm control strategy on sinus rhythm maintenance following intra-operative radiofrequency ablation of atrial fibrillation in patients undergoing surgical correction of valvular disease. J Cardiol. 2012;60(4):316–320.
    1. Sairaku A, et al. Learning curve for ablation of atrial fibrillation in medium-volume centers. J Cardiol. 2011;57(3):263–268.
    1. Sairaku A, et al. How many electrical cardioversions should be applied for repetitive recurrences of atrial arrhythmias following ablation of persistent atrial fibrillation? Europace. 2011;13(12):1703–1708.
    1. Lellouche N, et al. Early recurrences after atrial fibrillation ablation: prognostic value and effect of early reablation. J Cardiovasc Electrophysiol. 2008;19(6):599–605.
    1. Lee SH, et al. Predictors of early and late recurrence of atrial fibrillation after catheter ablation of paroxysmal atrial fibrillation. J Interv Card Electrophysiol. 2004;10(3):221–226.
    1. Thomas SP, Wallace EM, Ross DL. The effect of a residual isthmus of surviving tissue on conduction after linear ablation in atrial myocardium. J Interv Card Electrophysiol. 2000;4(1):273–281.
    1. Oral H, Knight BP, Morady F. Left atrial flutter after segmental ostial radiofrequency catheter ablation for pulmonary vein isolation. Pacing Clin Electrophysiol. 2003;26(6):1417–1419.
    1. Villacastin J, et al. Left atrial flutter after radiofrequency catheter ablation of focal atrial fibrillation. J Cardiovasc Electrophysiol. 2003;14(4):417–421.
    1. Gerstenfeld EP, et al. Reentrant and nonreentrant focal left atrial tachycardias occur after pulmonary vein isolation. Heart Rhythm. 2005;2(11):1195–1202.
    1. Gerstenfeld EP, Marchlinski FE. Mapping and ablation of left atrial tachycardias occurring after atrial fibrillation ablation. Heart Rhythm. 2007;4(3 Suppl):S65–S72.
    1. Lim TW, et al. Atrial arrhythmias after single-ring isolation of the posterior left atrium and pulmonary veins for atrial fibrillation: mechanisms and management. Circ Arrhythm Electrophysiol. 2008;1(2):120–126.
    1. Anousheh R, et al. Effect of mitral isthmus block on development of atrial tachycardia following ablation for atrial fibrillation. Pacing Clin Electrophysiol. 2010;33(4):460–468.
    1. Brooks AG, et al. Outcomes of long-standing persistent atrial fibrillation ablation: a systematic review. Heart Rhythm. 2010;7(6):835–846.
    1. Themistoclakis S, et al. Clinical predictors and relationship between early and late atrial tachyarrhythmias after pulmonary vein antrum isolation. Heart Rhythm. 2008;5(5):679–685.
    1. Nalliah CJ, et al. Clinical significance of early atrial arrhythmia type and timing after single ring isolation of the pulmonary veins. Europace. 2015;17(7):1038–1044.
    1. Satomi K. Electrophysiological characteristics of atrial tachycardia after pulmonary vein isolation of atrial fibrillation. Circ J. 2010;74(6):1051–1058.
    1. Jais P, et al. Flutter localized to the anterior left atrium after catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2006;17(3):279–285.
    1. Patel AM, et al. Atrial tachycardia after ablation of persistent atrial fibrillation: identification of the critical isthmus with a combination of multielectrode activation mapping and targeted entrainment mapping. Circ Arrhythm Electrophysiol. 2008;1(1):14–22.
    1. Jais P, et al. A deductive mapping strategy for atrial tachycardia following atrial fibrillation ablation: importance of localized reentry. J Cardiovasc Electrophysiol. 2009;20(5):480–491.
    1. Sauer WH, et al. Clinical predictors and outcomes associated with acute return of pulmonary vein conduction during pulmonary vein isolation for treatment of atrial fibrillation. Heart Rhythm. 2006;3(9):1024–1028.
    1. Marchlinski FE, et al. Efficacy and safety of targeted focal ablation versus PV isolation assisted by magnetic electroanatomic mapping. J Cardiovasc Electrophysiol. 2003;14(4):358–365.
    1. Choi JI, et al. Clinical significance of early recurrences of atrial tachycardia after atrial fibrillation ablation. J Cardiovasc Electrophysiol. 2010;21(12):1331–1337.
    1. Al-Hijji MA, et al. Trends and predictors of repeat catheter ablation for atrial fibrillation. Am Heart J. 2016;171(1):48–55.
    1. Gerstenfeld EP, et al. Incidence and location of focal atrial fibrillation triggers in patients undergoing repeat pulmonary vein isolation: implications for ablation strategies. J Cardiovasc Electrophysiol. 2003;14(7):685–690.
    1. Wasmer K, et al. Pulmonary vein reconnection and arrhythmia progression after antral linear catheter ablation of paroxysmal and persistent atrial fibrillation. Clin Res Cardiol. 2016;105(9):738–743.
    1. Bassiouny M, et al. Randomized study of persistent atrial fibrillation ablation: ablate in sinus rhythm versus ablate complex-fractionated atrial electrograms in atrial fibrillation. Circ Arrhythm Electrophysiol. 2016;9(2):e003596.
    1. Rolf S, Dagres N, Hindricks G. Voltage-based ablation: the growing evidence for the role of individually tailored substrate modification for atrial fibrillation. J Cardiovasc Electrophysiol. 2016;27(1):31–33.
    1. Dumonceau JM, et al. Acute delayed gastric emptying after ablation of atrial fibrillation: treatment with botulinum toxin injection. Endoscopy. 2006;38(5):543.
    1. Bunch TJ, et al. Vagus nerve injury after posterior atrial radiofrequency ablation. Heart Rhythm. 2008;5(9):1327–1330.
    1. Kuwahara T, et al. Clinical characteristics and management of periesophageal vagal nerve injury complicating left atrial ablation of atrial fibrillation: lessons from eleven cases. J Cardiovasc Electrophysiol. 2013;24(8):847–851.
    1. Miyazaki S, et al. Factors associated with periesophageal vagal nerve injury after pulmonary vein antrum isolation. J Am Heart Assoc. 2014;3(5):e001209.
    1. Chopra N, Shadchehr A. Achalasia cardia as a unique complication of pulmonary vein isolation. Heart Rhythm. 2014;11(12):2297–2299.
    1. Bertaglia E, et al. Does catheter ablation cure atrial fibrillation? Singleprocedure outcome of drug-refractory atrial fibrillation ablation: a 6-year multicentre experience. Europace. 2010;12(2):181–187.
    1. Sotomi Y, et al. Incidence and risk factors for very late recurrence of atrial fibrillation after radiofrequency catheter ablation. Europace. 2013;15(11):1581–1586.
    1. Steinberg JS, et al. Very long-term outcome after initially successful catheter ablation of atrial fibrillation. Heart Rhythm. 2014;11(5):771–776.
    1. Krittayaphong R, et al. A randomized clinical trial of the efficacy of radiofrequency catheter ablation and amiodarone in the treatment of symptomatic atrial fibrillation. J Med Assoc Thai. 2003;86(Suppl 1):S8–S16.
    1. Oral H, et al. Circumferential pulmonary-vein ablation for chronic atrial fibrillation. N Engl J Med. 2006;354(9):934–941.
    1. Pappone C, et al. A randomized trial of circumferential pulmonary vein ablation versus antiarrhythmic drug therapy in paroxysmal atrial fibrillation: the APAF Study. J Am Coll Cardiol. 2006;48(11):2340–2347.
    1. Stabile G, et al. Catheter ablation treatment in patients with drug-refractory atrial fibrillation: a prospective, multi-centre, randomized, controlled study (Catheter Ablation For The Cure Of Atrial Fibrillation Study) Eur Heart J. 2006;27(2):216–221.
    1. Forleo GB, et al. Catheter ablation of atrial fibrillation in patients with diabetes mellitus type 2: results from a randomized study comparing pulmonary vein isolation versus antiarrhythmic drug therapy. J Cardiovasc Electrophysiol. 2009;20(1):22–28.
    1. Mont L, et al. Catheter ablation vs. antiarrhythmic drug treatment of persistent atrial fibrillation: a multicentre, randomized, controlled trial (SARA study) Eur Heart J. 2014;35(8):501–507.
    1. Skelly A, et al. Catheter ablation for treatment of atrial fibrillation. Rockville, MD: Agency for Healthcare Research and Quality; 2015.
    1. Siontis KC, et al. Radiofrequency ablation versus antiarrhythmic drug therapy for atrial fibrillation: meta-analysis of quality of life, morbidity, and mortality. JACC: Clinical Electrophysiology. 2016;2(2):170–180.
    1. Khaykin Y, et al. Cost comparison of ablation versus antiarrhythmic drugs as first-line therapy for atrial fibrillation: an economic evaluation of the RAAFT pilot study. J Cardiovasc Electrophysiol. 2009;20(1):7–12.
    1. Cappato R, et al. Delayed cardiac tamponade after radiofrequency catheter ablation of atrial fibrillation: a worldwide report. J Am Coll Cardiol. 2011;58(25):2696–2697.
    1. Themistoclakis S, et al. Prospective European survey on atrial fibrillation ablation: clinical characteristics of patients and ablation strategies used in different countries. J Cardiovasc Electrophysiol. 2014;25(10):1074–1081.
    1. Zado E, et al. Long-term clinical efficacy and risk of catheter ablation for atrial fibrillation in the elderly. J Cardiovasc Electrophysiol. 2008;19(6):621–626.
    1. Corrado A, et al. Efficacy, safety, and outcome of atrial fibrillation ablation in septuagenarians. J Cardiovasc Electrophysiol. 2008;19(8):807–811.
    1. Tan HW, et al. Efficacy, safety and outcome of catheter ablation for atrial fibrillation in octogenarians. Int J Cardiol. 2010;145(1):147–148.
    1. Piccini JP, et al. Outcomes of Medicare beneficiaries undergoing catheter ablation for atrial fibrillation. Circulation. 2012;126(18):2200–2207.
    1. Hao SC, et al. Acute safety outcomes in younger and older patients with atrial fibrillation treated with catheter ablation. J Interv Card Electrophysiol. 2012;35(2):173–182.
    1. Guiot A, et al. Anticoagulant therapy and risk of cerebrovascular events after catheter ablation of atrial fibrillation in the elderly. J Cardiovasc Electrophysiol. 2012;23(1):36–43.
    1. Hsu LF, et al. Catheter ablation for atrial fibrillation in congestive HF. N Engl J Med. 2004;351(23):2373–2383.
    1. Olivotto I, et al. Impact of atrial fibrillation on the clinical course of hypertrophic cardiomyopathy. Circulation. 2001;104(21):2517–2524.
    1. Providencia R, et al. Catheter ablation for atrial fibrillation in hypertrophic cardiomyopathy: a systematic review and meta-analysis. Heart. 2016;102(19):1533–1543.
    1. Chun KR, et al. Catheter ablation of atrial fibrillation in the young: insights from the German Ablation Registry. Clin Res Cardiol. 2013;102(6):459–468.
    1. Humphries KH, et al. New-onset atrial fibrillation: sex differences in presentation, treatment, and outcome. Circulation. 2001;103(19):2365–2370.
    1. Ong L, et al. Gender differences and quality of life in atrial fibrillation: the mediating role of depression. J Psychosom Res. 2006;61(6):769–774.
    1. Dagres N, et al. Gender-related differences in presentation, treatment, and outcome of patients with atrial fibrillation in Europe: a report from the Euro Heart Survey on Atrial Fibrillation. J Am Coll Cardiol. 2007;49(5):572–577.
    1. Volgman AS, et al. Women with atrial fibrillation: Greater risk, less attention. Gend Med. 2009;6(3):419–432.
    1. Balk EM, et al. Predictors of atrial fibrillation recurrence after radiofrequency catheter ablation: a systematic review. J Cardiovasc Electrophysiol. 2010;21(11):1208–1216.
    1. Heist EK, et al. Predictors of atrial fibrillation termination and clinical success of catheter ablation of persistent atrial fibrillation. Am J Cardiol. 2012;110(4):545–551.
    1. Zhang XD, et al. Efficacy and safety of catheter ablation for long-standing persistent atrial fibrillation in women. Pacing Clin Electrophysiol. 2013;36(10):1236–1244.
    1. Forleo GB, et al. Gender-related differences in catheter ablation of atrial fibrillation. Europace. 2007;9(8):613–620.
    1. Takigawa M, et al. Differences in catheter ablation of paroxysmal atrial fibrillation between males and females. Int J Cardiol. 2013;168(3):1984–1991.
    1. Beck H, Curtis AB. Sex differences in outcomes of ablation of atrial fibrillation. J Atr Fibrillation. 2014;6(6):76–82.
    1. Baman TS, et al. Prevalence and predictors of complications of radiofrequency catheter ablation for atrial fibrillation. J Cardiovasc Electrophysiol. 2011;22(6):626–631.
    1. Hoyt H, et al. Demographic profile of patients undergoing catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2011;22(9):994–998.
    1. Shah RU, et al. Procedural complications, rehospitalizations, and repeat procedures after catheter ablation for atrial fibrillation. J Am Coll Cardiol. 2012;59(2):143–149.
    1. Bertaglia E, et al. Updated national multicenter registry on procedural safety of catheter ablation for atrial fibrillation. J Cardiovasc Electrophysiol. 2013;24(10):1069–1074.
    1. Su W, et al. Best practice guide for cryoballoon ablation in atrial fibrillation: The compilation experience of more than 3000 procedures. Heart Rhythm. 2015;12(7):1658–1666.
    1. Takami M, et al. Impact of freezing time and balloon size on the thermodynamics and isolation efficacy during pulmonary vein isolation using the second generation cryoballoon. Circ Arrhythm Electrophysiol. 2015;8(4):836–845.
    1. Furnkranz A, et al. Improved 1-year clinical success rate of pulmonary vein isolation with the second-generation cryoballoon in patients with paroxysmal atrial fibrillation. J Cardiovasc Electrophysiol. 2014;25(8):840–844.
    1. Di Giovanni G, et al. One-year follow-up after single procedure Cryoballoon ablation: a comparison between the first and second generation balloon. J Cardiovasc Electrophysiol. 2014;25(8):834–839.
    1. Liu J, et al. Second generation of cryoballoons can improve efficiency of cryoablation for atrial fibrillation. Pacing Clin Electrophysiol. 2015;38(1):129–135.
    1. Khoueiry Z, et al. Outcomes after cryoablation vs. radiofrequency in patients with paroxysmal atrial fibrillation: impact of pulmonary veins anatomy. Europace. 2016;18(9):1343–1351.
    1. Mugnai G, et al. Comparison of pulmonary vein isolation using cryoballoon versus conventional radiofrequency for paroxysmal atrial fibrillation. Am J Cardiol. 2014;113(9):1509–1513.
    1. Cheng X, et al. The long-term efficacy of cryoballoon vs irrigated radiofrequency ablation for the treatment of atrial fibrillation: a meta-analysis. Int J Cardiol. 2015;181:297–302.
    1. Jourda F, et al. Contact-force guided radiofrequency vs. second-generation balloon cryotherapy for pulmonary vein isolation in patients with paroxysmal atrial fibrillation-a prospective evaluation. Europace. 2015;17(2):225–231.
    1. Luik A, et al. Cryoballoon versus open irrigated radiofrequency ablation in patients with paroxysmal atrial fibrillation: the prospective, randomized, controlled, noninferiority FreezeAF study. Circulation. 2015;132(14):1311–1319.
    1. Squara F, et al. Comparison between radiofrequency with contact force-sensing and second-generation cryoballoon for paroxysmal atrial fibrillation catheter ablation: a multicentre European evaluation. Europace. 2015;17(5):718–724.
    1. Wasserlauf J, et al. Cryoballoon versus radiofrequency catheter ablation for paroxysmal atrial fibrillation. Pacing Clin Electrophysiol. 2015;38(4):483–489.
    1. Schmidt M, et al. German ablation registry: Cryoballoon vs. radiofrequency ablation in paroxysmal atrial fibrillation–One-year outcome data. Heart Rhythm. 2016;13(4):836–844.
    1. Ciconte G, et al. Pulmonary vein isolation as index procedure for persistent atrial fibrillation: One-year clinical outcome after ablation using the secondgeneration cryoballoon. Heart Rhythm. 2015;12(1):60–66.
    1. Koektuerk B, et al. Cryoballoon ablation for pulmonary vein isolation in patients with persistent atrial fibrillation: one-year outcome using second generation cryoballoon. Circ Arrhythm Electrophysiol. 2015;8(5):1073–1079.
    1. Guhl EN, et al. Efficacy of cryoballoon pulmonary vein isolation in patients with persistent atrial fibrillation. J Cardiovasc Electrophysiol. 2016;27(4):423–427.
    1. Straube F, et al. Cryoballoon ablation for persistent atrial fibrillation—Large single-center experience. J Cardiol. 2016;68(6):492–497.
    1. Su WW, et al. Novel usage of the cryoballoon catheter to achieve large area atrial substrate modification in persistent and long-standing persistent atrial fibrillation. J Interv Card Electrophysiol. 2016;46(3):275–285.
    1. Ciconte G, et al. Circumferential pulmonary vein isolation as index procedure for persistent atrial fibrillation: a comparison between radiofrequency catheter ablation and second-generation cryoballoon ablation. Europace. 2015;17(4):559–565.
    1. Spitzer SG, et al. Treatment of Recurrent Nonparoxysmal Atrial Fibrillation Using Focal Impulse and Rotor Mapping (FIRM)-Guided Rotor Ablation: Early Recurrence and Long-Term Outcomes. J Cardiovasc Electrophysiol. 2017;28(1):31–38.
    1. Berntsen RF, et al. Focal impulse and rotor modulation as a stand-alone procedure for the treatment of paroxysmal atrial fibrillation: A within-patient controlled study with implanted cardiac monitoring. Heart Rhythm. 2016;13(9):1768–1774.
    1. Lo LW, et al. Pearls and Pitfalls in Catheter Ablation of Persistent Atrial Fibrillation. Circ J. 2016;80(2):306–313.
    1. Perrotta L, et al. How to learn pulmonary vein isolation with a novel ablation device: learning curve effects using the endoscopic ablation system. J Cardiovasc Electrophysiol. 2014;25(12):1293–1298.
    1. Sediva L, et al. Visually guided laser ablation: a single-centre long-term experience. Europace. 2014;16(12):1746–1751.
    1. Gal P, et al. First Dutch experience with the endoscopic laser balloon ablation system for the treatment of atrial fibrillation. Neth Heart J. 2015;23(2):96–99.
    1. Osca J, et al. Electrical Isolation of Pulmonary Veins Using Laser Catheter in the Treatment of Paroxysmal and Persistent Atrial Fibrillation. One-year Results. Rev Esp Cardiol (Engl Ed) 2016;69(5):488–493.
    1. Sawhney N, et al. Five-year outcomes after segmental pulmonary vein isolation for paroxysmal atrial fibrillation. Am J Cardiol. 2009;104(3):366–372.
    1. Medi C, et al. Pulmonary vein antral isolation for paroxysmal atrial fibrillation: results from long-term follow-up. J Cardiovasc Electrophysiol. 2011;22(2):137–141.
    1. Reynolds MR, Ellis E, Zimetbaum P. Quality of life in atrial fibrillation: measurement tools and impact of interventions. J Cardiovasc Electrophysiol. 2008;19(7):762–768.
    1. Ware JE, et al. SF-36 health survey: manual and interpretation guide. The Health Institute, New England Medical Center; 1993.
    1. Bubien RS, et al. Effect of radiofrequency catheter ablation on health-related quality of life and activities of daily living in patients with recurrent arrhythmias. Circulation. 1996;94(7):1585–1591.
    1. Walfridsson H, et al. Radiofrequency ablation as initial therapy in paroxysmal atrial fibrillation: results on health-related quality of life and symptom burden. The MANTRA-PAF trial. Europace. 2015;17(2):215–221.
    1. Thrall G, et al. Quality of life in patients with atrial fibrillation: a systematic review. Am J Med. 2006;119(5):448 e1–448 e19.
    1. Berkowitsch A, et al. Comparison of generic health survey SF-36 and arrhythmia related symptom severity check list in relation to post-therapy AF recurrence. Europace. 2003;5(4):351–355.
    1. Reynolds MR, et al. Improvements in symptoms and quality of life in patients with paroxysmal atrial fibrillation treated with radiofrequency catheter ablation versus antiarrhythmic drugs. Circ Cardiovasc Qual Outcomes. 2010;3(6):615–623.
    1. Spertus J, et al. Development and validation of the Atrial Fibrillation Effect on QualiTy-of-Life (AFEQT) Questionnaire in patients with atrial fibrillation. Circ Arrhythm Electrophysiol. 2011;4(1):15–25.
    1. Walfridsson U, Arestedt K, Stromberg A. Development and validation of a new Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia (ASTA) with focus on symptom burden. Health Qual Life Outcomes. 2012;10:44.
    1. Fichtner S, et al. Prospective assessment of short- and long-term quality of life after ablation for atrial fibrillation. J Cardiovasc Electrophysiol. 2012;23(2):121–127.
    1. Kistler PM, et al. Electrophysiologic and electroanatomic changes in the human atrium associated with age. J Am Coll Cardiol. 2004;44(1):109–116.
    1. Wijffels MC, et al. Electrical remodeling due to atrial fibrillation in chronically instrumented conscious goats: roles of neurohumoral changes, ischemia, atrial stretch, and high rate of electrical activation. Circulation. 1997;96(10):3710–3720.
    1. Scharf C, et al. Anatomy of the pulmonary veins in patients with atrial fibrillation and effects of segmental ostial ablation analyzed by computed tomography. J Cardiovasc Electrophysiol. 2003;14(2):150–155.
    1. Jayam VK, et al. Atrial volume reduction following catheter ablation of atrial fibrillation and relation to reduction in pulmonary vein size: an evaluation using magnetic resonance angiography. J Interv Card Electrophysiol. 2005;13(2):107–114.
    1. Tsao HM, et al. Morphologic remodeling of pulmonary veins and left atrium after catheter ablation of atrial fibrillation: insight from long-term follow-up of three-dimensional magnetic resonance imaging. J Cardiovasc Electrophysiol. 2005;16(1):7–12.
    1. Canpolat U, et al. The impact of cryoballoon-based catheter ablation on left atrial structural and potential electrical remodeling in patients with paroxysmal atrial fibrillation. J Interv Card Electrophysiol. 2015;44(2):131–139.
    1. Lemola K, et al. Effect of left atrial circumferential ablation for atrial fibrillation on left atrial transport function. Heart Rhythm. 2005;2(9):923–928.
    1. Verma A, et al. Extensive ablation during pulmonary vein antrum isolation has no adverse impact on left atrial function: an echocardiography and cine computed tomography analysis. J Cardiovasc Electrophysiol. 2006;17(7):741–746.
    1. Jeevanantham V, et al. Meta-analysis of the effect of radiofrequency catheter ablation on left atrial size, volumes and function in patients with atrial fibrillation. Am J Cardiol. 2010;105(9):1317–1326.
    1. Machino-Ohtsuka T, et al. Significant improvement of left atrial and left atrial appendage function after catheter ablation for persistent atrial fibrillation. Circ J. 2013;77(7):1695–1704.
    1. Muellerleile K, et al. Cardiovascular magnetic resonance demonstrates reversible atrial dysfunction after catheter ablation of persistent atrial fibrillation. J Cardiovasc Electrophysiol. 2013;24(7):762–767.
    1. Hanazawa K, et al. Effect of radiofrequency catheter ablation of persistent atrial fibrillation on the left atrial function: assessment by 320-row multislice computed tomography. Int J Cardiol. 2015;179:449–454.
    1. Cochet H, et al. Atrial structure and function 5 years after successful ablation for persistent atrial fibrillation: an MRI study. J Cardiovasc Electrophysiol. 2014;25(7):671–679.
    1. Gibson DN, et al. Stiff left atrial syndrome after catheter ablation for atrial fibrillation: clinical characterization, prevalence, and predictors. Heart Rhythm. 2011;8(9):1364–1371.
    1. Reynolds MR, et al. Health outcomes with catheter ablation or antiarrhythmic drug therapy in atrial fibrillation: results of a propensity-matched analysis. Circ Cardiovasc Qual Outcomes. 2012;5(2):171–181.
    1. Chang CH, et al. Effect of radiofrequency catheter ablation for atrial fibrillation on morbidity and mortality: a nationwide cohort study and propensity score analysis. Circ Arrhythm Electrophysiol. 2014;7(1):76–82.
    1. Friberg L, Tabrizi F, Englund A. Catheter ablation for atrial fibrillation is associated with lower incidence of stroke and death: data from Swedish health registries. Eur Heart J. 2016;37(31):2478–2487.
    1. Abecasis J, et al. Left atrial volume calculated by multi-detector computed tomography may predict successful pulmonary vein isolation in catheter ablation of atrial fibrillation. Europace. 2009;11(10):1289–1294.
    1. McCready JW, et al. Predictors of recurrence following radiofrequency ablation for persistent atrial fibrillation. Europace. 2011;13(3):355–361.
    1. D’Ascenzo F, et al. Which are the most reliable predictors of recurrence of atrial fibrillation after transcatheter ablation? A meta-analysis. Int J Cardiol. 2013;167(5):1984–1989.
    1. Chan P, et al. Cost-effectiveness of left atrial catheter ablation, antiarrhythmic therapy, and rate control therapy for paroxysmal and chronic atrial fibrillation [abstract] Circulation. 2005:e318.
    1. Eckard N, et al. Cost-effectiveness of catheter ablation for patients with symptomatic atrial fibrillation. J Atr Fibrillation. 2009;2(2):15–24.
    1. Reynolds MR, et al. Cost-effectiveness of radiofrequency catheter ablation compared with antiarrhythmic drug therapy for paroxysmal atrial fibrillation. Circ Arrhythm Electrophysiol. 2009;2(4):362–369.
    1. Martin-Doyle W, Reynolds MR. Is AF ablation cost effective? J Atr Fibrillation. 2010;2(1):727–739.
    1. Assasi N, et al. Ablation procedures for rhythm control in patients with atrial fibrillation: clinical and cost-effectiveness analyses. CADTH Technol Overv. 2012;2(1):e2101.
    1. Neyt M, Van Brabandt H, Devos C. The cost-utility of catheter ablation of atrial fibrillation: a systematic review and critical appraisal of economic evaluations. BMC Cardiovasc Disord. 2013;13:78.
    1. Reynolds MR, et al. Cost-effectiveness of cryoballoon ablation for the management of paroxysmal atrial fibrillation. Europace. 2014;16(5):652–659.
    1. Aronsson M, et al. The cost-effectiveness of radiofrequency catheter ablation as first-line treatment for paroxysmal atrial fibrillation: results from a MANTRAPAF substudy. Europace. 2015;17(1):48–55.
    1. Winkle RA, et al. Physician-controlled costs: the choice of equipment used for atrial fibrillation ablation. J Interv Card Electrophysiol. 2013;36(2):157–165.
    1. Ladapo JA, et al. Healthcare utilization and expenditures in patients with atrial fibrillation treated with catheter ablation. J Cardiovasc Electrophysiol. 2012;23(1):1–8.
    1. McKenna C, et al. Cost-effectiveness of radiofrequency catheter ablation for the treatment of atrial fibrillation in the United Kingdom. Heart. 2009;95(7):542–549.
    1. Adragao PP, et al. Safety and long-term outcomes of catheter ablation of atrial fibrillation using magnetic navigation versus manual conventional ablation: a propensity-score analysis. J Cardiovasc Electrophysiol. 2016;27(Suppl 1):S11–S16.
    1. Anderson JL, et al. ACC/AHA statement on cost/value methodology in clinical practice guidelines and performance measures: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures and Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63(21):2304–2322.
    1. Eick OJ, Gerritse B, Schumacher B. Popping phenomena in temperature-controlled radiofrequency ablation: when and why do they occur? Pacing Clin Electrophysiol. 2000;23(2):253–258.
    1. Fisher JD, et al. Internal transcardiac pericardiocentesis for acute tamponade. Am J Cardiol. 2000;86(12):1388–1389, A6.
    1. Hsu LF, et al. Transcardiac pericardiocentesis: anemergency life-saving technique for cardiac tamponade. J Cardiovasc Electrophysiol. 2003;14(9):1001–1003.
    1. Bunch TJ, et al. Outcomes after cardiac perforation during radiofrequency ablation of the atrium. J Cardiovasc Electrophysiol. 2005;16(11):1172–1179.
    1. Hsu LF, et al. Incidence and prevention of cardiac tamponade complicating ablation for atrial fibrillation. Pacing Clin Electrophysiol. 2005;28(Suppl 1):S106–S109.
    1. Nairooz R, et al. Meta-analysis of major bleeding with uninterrupted warfarin compared to interrupted warfarin and heparin bridging in ablation of atrial fibrillation. Int J Cardiol. 2015;187:426–429.
    1. Latchamsetty R, et al. Management and outcomes of cardiac tamponade during atrial fibrillation ablation in the presence of therapeutic anticoagulation with warfarin. Heart Rhythm. 2011;8(6):805–808.
    1. Wu S, et al. Meta-analysis of efficacy and safety of new oral anticoagulants compared with uninterrupted vitamin K antagonists in patients undergoing catheter ablation for atrial fibrillation. Am J Cardiol. 2016;117(6):926–934.
    1. Michowitz Y, et al. Effects of sex on the incidence of cardiac tamponade after catheter ablation of atrial fibrillation: results froma worldwide survey in 34 943 atrial fibrillation ablation procedures. Circ Arrhythm Electrophysiol. 2014;7(2):274–280.
    1. Tsang TS, et al. Consecutive 1127 therapeutic echocardiographically guided pericardiocenteses: clinical profile, practice patterns, and outcomes spanning 21 years. Mayo Clin Proc. 2002;77(5):429–436.
    1. O’Neill MD, et al. Two techniques to avoid surgery for cardiac tamponade occurring during catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2008;19(3):323–325.
    1. Katz ES, et al. Surgical left atrial appendage ligation is frequently incomplete: a transesophageal echocardiograhic study. J Am Coll Cardiol. 2000;36(2):468–471.
    1. Di Biase L, et al. Pulmonary vein total occlusion following catheter ablation for atrial fibrillation: clinical implications after long-term follow-up. J Am Coll Cardiol. 2006;48(12):2493–2499.
    1. Prieto LR, et al. Comparison of stent versus balloon angioplasty for pulmonary vein stenosis complicating pulmonary vein isolation. J Cardiovasc Electrophysiol. 2008;19(7):673–678.
    1. Packer DL, et al. Clinical presentation, investigation, and management of pulmonary vein stenosis complicating ablation for atrial fibrillation. Circulation. 2005;111(5):546–554.
    1. Taylor GW, et al. Pathological effects of extensive radiofrequency energy applications in the pulmonary veins in dogs. Circulation. 2000;101(14):1736–1742.
    1. Arentz T, et al. Incidence of pulmonary vein stenosis 2 years after radiofrequency catheter ablation of refractory atrial fibrillation. Eur Heart J. 2003;24(10):963–969.
    1. Tse HF, et al. Pulmonary vein isolation using transvenous catheter cryoablation for treatment of atrial fibrillation without risk of pulmonary vein stenosis. J Am Coll Cardiol. 2003;42(4):752–758.
    1. Kasper L, et al. Hemoptysis and lung disease as a manifestation of pulmonary vein stenosis after cryoballoon catheter ablation for atrial fibrillation. Pol Arch Med Wewn. 2016;126(1-2):94–96.
    1. Dong J, et al. Incidence and predictors of pulmonary vein stenosis following catheter ablation of atrial fibrillation using the anatomic pulmonary vein ablation approach: results from paired magnetic resonance imaging. J Cardiovasc Electrophysiol. 2005;16(8):845–852.
    1. Hoyt RH, et al. Transvenous catheter cryoablation for treatment of atrial fibrillation: results of a feasibility study. Pacing Clin Electrophysiol. 2005;28(Suppl 1):S78–S82.
    1. Saad EB, et al. Pulmonary vein stenosis after catheter ablation of atrial fibrillation: emergence of a new clinical syndrome. Ann Intern Med. 2003;138(8):634–638.
    1. Hilbert S, et al. Pulmonary vein collateral formation as a long-term result of post-interventional pulmonary vein stenosis. Eur Heart J. 2016;37(31):2474.
    1. Hilbert S, Sommer P, Bollmann A. Pulmonary vein dilatation in a case of total pulmonary vein occlusion: contemporary approach using a combination of 3Dmapping system and image integration. Catheter Cardiovasc Interv. 2016;88(7):E227–E232.
    1. Fender EA, et al. Severe pulmonary vein stenosis resulting from ablation for atrial fibrillation: presentation, management, and clinical outcomes. Circulation. 2016;134(23):1812–1821.
    1. De Potter TJ, et al. Drug-eluting stents for the treatment of pulmonary vein stenosis after atrial fibrillation ablation. Europace. 2011;13(1):57–61.
    1. Kanter KR, Kirshbom PM, Kogon BE. Surgical repair of pulmonary venous stenosis: a word of caution. Ann Thorac Surg. 2014;98(5):1687–1691. discussion 1691–1692.
    1. Patel NS, et al. Successful surgical repair of iatrogenic pulmonary vein stenosis. J Cardiovasc Electrophysiol. 2012;23(6):656–658.
    1. Bharat A, et al. Lung transplant is a viable treatment option for patients with congenital and acquired pulmonary vein stenosis. J Heart Lung Transplant. 2013;32(6):621–625.
    1. Ponamgi SP, et al. Catheter-based intervention for pulmonary vein stenosis due to fibrosing mediastinitis: the Mayo Clinic experience. Int J Cardiol Heart Vasc. 2015;8:103–107.
    1. Kumar S, et al. Esophageal hematoma after atrial fibrillation ablation: incidence, clinical features, and sequelae of esophageal injury of a different sort. Circ Arrhythm Electrophysiol. 2012;5(4):701–705.
    1. Gillinov AM, Pettersson G, Rice TW. Esophageal injury during radiofrequency ablation for atrial fibrillation. J Thorac Cardiovasc Surg. 2001;122(6):1239–1240.
    1. Mohr FW, et al. Curative treatment of atrial fibrillation with intraoperative radiofrequency ablation: short-term and midterm results. J Thorac Cardiovasc Surg. 2002;123(5):919–927.
    1. Doll N, et al. Esophageal perforation during left atrial radiofrequency ablation: Is the risk too high? J Thorac Cardiovasc Surg. 2003;125(4):836–842.
    1. Sonmez B, et al. A fatal complication due to radiofrequency ablation for atrial fibrillation: atrio-esophageal fistula. Ann Thorac Surg. 2003;76(1):281–283.
    1. Scanavacca MI, et al. Left atrial-esophageal fistula following radiofrequency catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2004;15(8):960–962.
    1. Borchert B, et al. Lethal atrioesophageal fistula after pulmonary vein isolation using high-intensity focused ultrasound (HIFU) Heart Rhythm. 2008;5(1):145–148.
    1. Ghia KK, et al. A nationwide survey on the prevalence of atrioesophageal fistula after left atrial radiofrequency catheter ablation. J Interv Card Electrophysiol. 2009;24(1):33–36.
    1. Gilcrease GW, Stein JB. A delayed case of fatal atrioesophageal fistula following radiofrequency ablation for atrial fibrillation. J Cardiovasc Electrophysiol. 2010;21(6):708–711.
    1. Stockigt F, et al. Atrioesophageal fistula after cryoballoon pulmonary vein isolation. J Cardiovasc Electrophysiol. 2012;23(11):1254–1257.
    1. Yousuf O, Calkins H. Sounding the warning on the potential for oesophageal injury resulting from use of the nMARQ for ablation of atrial fibrillation. Europace. 2015;17(3):343–344.
    1. Jackson, et al. The vagus plays a role in the anti-reflux barrier by controlling both the lower esophageal sphincter pressure and crural diaphragm activity. J Am Coll Surg. 2005;201((3)(Suppl)):S11.
    1. Nolker G, et al. Esophageal acid levels after pulmonary vein isolation for atrial fibrillation. Pacing Clin Electrophysiol. 2009;32(Suppl 1):S228–S230.
    1. Medeiros De Vasconcelos JT, et al. Atrial-oesophageal fistula following percutaneous radiofrequency catheter ablation of atrial fibrillation: the risk still persists. Europace. 2017;19(2):250–258.
    1. Rillig A, et al. Modified energy settings are mandatory to minimize oesophageal injury using the novel multipolar irrigated radiofrequency ablation catheter for pulmonary vein isolation. Europace. 2015;17(3):396–402.
    1. Chavez P, et al. Atrioesophageal fistula following ablation procedures for atrial fibrillation: systematic review of case reports. Open Heart. 2015;2(1):e000257.
    1. Mateos JC, et al. Simplified method for esophagus protection during radiofrequency catheter ablation of atrial fibrillation–prospective study of 704 cases. Rev Bras Cir Cardiovasc. 2015;30(2):139–147.
    1. Shim HB, et al. Successful management of atrio-esophageal fistula after cardiac radiofrequency catheter ablation. Korean J Thorac Cardiovasc Surg. 2013;46(2):142–145.
    1. Schwartz TW, et al. Pancreatic-polypeptide response to food in duodenal-ulcer patients before and after vagotomy. Lancet. 1976;1(7969):1102–1105.
    1. Ajaj W, et al. Real time high resolution magnetic resonance imaging for the assessment of gastric motility disorders. Gut. 2004;53(9):1256–1261.
    1. Pisani CF, et al. Gastric hypomotility following epicardial vagal denervation ablation to treat atrial fibrillation. J Cardiovasc Electrophysiol. 2008;19(2):211–213.
    1. Kanaeda T, et al. Evaluation of periesophageal nerve injury after pulmonary vein isolation using the (13)C-acetate breath test. J Arrhythm. 2015;31(6):364–370.
    1. Lo LW, et al. A novel finding—impairment of gastric myoelectricity after catheter ablation of atrial fibrillation. Circ J. 2013;77(8):2014–2023.
    1. Janssens J, et al. Improvement of gastric emptying in diabetic gastroparesis by erythromycin. Preliminary studies. N Engl J Med. 1990;322(15):1028–1031.
    1. Jones MP, Maganti K. A systematic review of surgical therapy for gastroparesis. Am J Gastroenterol. 2003;98(10):2122–2129.
    1. Earley MJ, et al. Radiofrequency ablation of arrhythmias guided by nonfluoroscopic catheter location: a prospective randomized trial. Eur Heart J. 2006;27(10):1223–1229.
    1. Sarabanda AV, et al. Efficacy and safety of circumferential pulmonary vein isolation using a novel cryothermal balloon ablation system. J Am Coll Cardiol. 2005;46(10):1902–1912.
    1. Guiot A, et al. Collateral nervous damages after cryoballoon pulmonary vein isolation. J Cardiovasc Electrophysiol. 2012;23(4):346–351.
    1. Metzner A, et al. The incidence of phrenic nerve injury during pulmonary vein isolation using the second-generation 28 mm cryoballoon. J Cardiovasc Electrophysiol. 2014;25(5):466–470.
    1. Okumura Y, et al. Distortion of right superior pulmonary vein anatomy by balloon catheters as a contributor to phrenic nerve injury. J Cardiovasc Electrophysiol. 2009;20(10):1151–1157.
    1. Arruda M, et al. Electrical isolation of the superior vena cava: an adjunctive strategy to pulmonary vein antrum isolation improving the outcome of AF ablation. J Cardiovasc Electrophysiol. 2007;18(12):1261–1266.
    1. Miyazaki S, et al. Prevalence and clinical outcome of phrenic nerve injury during superior vena cava isolation and circumferential pulmonary vein antrum isolation using radiofrequency energy. Am Heart J. 2014;168(6):846–853.
    1. Wissner E, et al. Catheter ablation of atrial fibrillation in patients with persistent left superior vena cava is associated with major intraprocedural complications. Heart Rhythm. 2010;7(12):1755–1760.
    1. Elayi CS, et al. Left superior vena cava isolation in patients undergoing pulmonary vein antrum isolation: impact on atrial fibrillation recurrence. Heart Rhythm. 2006;3(9):1019–1023.
    1. Liu H, et al. Electrogram-guided isolation of the left superior vena cava for treatment of atrial fibrillation. Europace. 2007;9(9):775–780.
    1. Yong Ji S, et al. Phrenic nerve injury: An underrecognized and potentially preventable complication of pulmonary vein isolation using a wide-area circumferential ablation approach. J Cardiovasc Electrophysiol. 2013;24(10):1086–1091.
    1. Franceschi F, et al. Phrenic nerve monitoring with diaphragmatic electromyography during cryoballoon ablation for atrial fibrillation: the first human application. Heart Rhythm. 2011;8(7):1068–1071.
    1. Miyazaki S, et al. Prospective evaluation of bilateral diaphragmatic electromyograms during cryoballoon ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2015;26(6):622–628.
    1. Mondesert B, et al. Clinical experience with a novel electromyographic approach to preventing phrenic nerve injury during cryoballoon ablation in atrial fibrillation. Circ Arrhythm Electrophysiol. 2014;7(4):605–611.
    1. Sacher F, et al. Phrenic nerve injury after atrial fibrillation catheter ablation: characterization and outcome in a multicenter study. J Am Coll Cardiol. 2006;47(12):2498–2503.
    1. Andrade JG, et al. Histopathology of cryoballoon ablation-induced phrenic nerve injury. J Cardiovasc Electrophysiol. 2014;25(2):187–194.
    1. Patel D, et al. Long-term functional and neurocognitive recovery in patients who had an acute cerebrovascular event secondary to catheter ablation for atrial fibrillation. J Cardiovasc Electrophysiol. 2010;21(4):412–417.
    1. Kochhauser S, et al. Comparison of outcomes after cardioversion or atrial fibrillation ablation in patients with differing periprocedural anticoagulation regimens. Can J Cardiol. 2014;30(12):1541–1546.
    1. Kosiuk J, et al. Early cerebral thromboembolic complications after radiofrequency catheter ablation of atrial fibrillation: incidence, characteristics, and risk factors. Heart Rhythm. 2014;11(11):1934–1940.
    1. Merchant FM, Delurgio DB. Catheter ablation of atrial fibrillation and risk of asymptomatic cerebral embolism. Pacing Clin Electrophysiol. 2014;37(3):389–397.
    1. Lickfett L, et al. Cerebral diffusion-weighted magnetic resonance imaging: a tool to monitor the thrombogenicity of left atrial catheter ablation. J Cardiovasc Electrophysiol. 2006;17(1):1–7.
    1. Gaita F, et al. Radiofrequency catheter ablation of atrial fibrillation: a cause of silent thromboembolism? Magnetic resonance imaging assessment of cerebral thromboembolism in patients undergoing ablation of atrial fibrillation. Circulation. 2010;122(17):1667–1673.
    1. Schrickel JW, et al. Incidence and predictors of silent cerebral embolism during pulmonary vein catheter ablation for atrial fibrillation. Europace. 2010;12(1):52–57.
    1. Deneke T, et al. Postablation asymptomatic cerebral lesions: long-term follow-up using magnetic resonance imaging. Heart Rhythm. 2011;8(11):1705–1711.
    1. Sauren LD, et al. Transcranial measurement of cerebral microembolic signals during endocardial pulmonary vein isolation: comparison of three different ablation techniques. J Cardiovasc Electrophysiol. 2009;20(10):1102–1107.
    1. Wieczorek M, et al. Investigation into causes of abnormal cerebral MRI findings following PVAC duty-cycled, phased RF ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2013;24(2):121–128.
    1. Bendszus M, Stoll G. Silent cerebral ischaemia: hidden fingerprints of invasive medical procedures. Lancet Neurol. 2006;5(4):364–372.
    1. Kruis RW, Vlasveld FA, Van Dijk D. The (un)importance of cerebral microemboli. Semin Cardiothorac Vasc Anesth. 2010;14(2):111–118.
    1. Medi C, et al. Subtle post-procedural cognitive dysfunction after atrial fibrillation ablation. J Am Coll Cardiol. 2013;62(6):531–539.
    1. Ichiki H, et al. The incidence of asymptomatic cerebral microthromboembolism after atrial fibrillation ablation: comparison of warfarin and dabigatran. Pacing Clin Electrophysiol. 2013;36(11):1328–1335.
    1. Nagy-Balo E, et al. Transcranial measurement of cerebral microembolic signals during pulmonary vein isolation: a comparison of two ablation techniques. Circ Arrhythm Electrophysiol. 2013;6(3):473–480.
    1. Vermeer SE, et al. Silent brain infarcts and the risk of dementia and cognitive decline. N Engl J Med. 2003;348(13):1215–1222.
    1. Helps SC, et al. The effect of gas emboli on rabbit cerebral blood flow. Stroke. 1990;21(1):94–99.
    1. Krivonyak GS, Warren SG. Cerebral arterial air embolism treated by a vertical head-down maneuver. Catheter Cardiovasc Interv. 2000;49(2):185–187.
    1. Cauchemez B, et al. High-flow perfusion of sheaths for prevention of thromboembolic complications during complex catheter ablation in the LA. J Cardiovasc Electrophysiol. 2004;15(3):276–283.
    1. Kuwahara T, et al. Clinical characteristics of massive air embolism complicating left atrial ablation of atrial fibrillation: lessons from five cases. Europace. 2012;14(2):204–208.
    1. Franzen OW, et al. Mechanisms underlying air aspiration in patients undergoing left atrial catheterization. Catheter Cardiovasc Interv. 2008;71(4):553–558.
    1. Ryu KH, et al. Heparin reduces neurological impairment after cerebral arterial air embolism in the rabbit. Stroke. 1996;27(2):303–309. discussion 310.
    1. Aldhoon B, et al. Complications of catheter ablation for atrial fibrillation in a high-volume centre with the use of intracardiac echocardiography. Europace. 2013;15(1):24–32.
    1. Mugnai G, et al. Complications in the setting of percutaneous atrial fibrillation ablation using radiofrequency and cryoballoon techniques: A single-center study in a large cohort of patients. Int J Cardiol. 2015;196:42–49.
    1. Murakawa Y, et al. Nationwide survey of catheter ablation for atrial fibrillation: The Japanese catheter ablation registry of atrial fibrillation (J-CARAF)-A report on periprocedural oral anticoagulants. J Arrhythm. 2015;31(1):29–32.
    1. Palaniswamy C, et al. Catheter ablation of postinfarction ventricular tachycardia: ten-year trends in utilization, in-hospital complications, and inhospital mortality in the United States. Heart Rhythm. 2014;11(11):2056–2063.
    1. Peichl P, et al. Complications of catheter ablation of ventricular tachycardia: a single-center experience. Circ Arrhythm Electrophysiol. 2014;7(4):684–690.
    1. Waigand J, et al. Percutaneous treatment of pseudoaneurysms and arteriovenous fistulas after invasive vascular procedures. Catheter Cardiovasc Interv. 1999;47(2):157–164.
    1. Lakkireddy D, et al. Feasibility and safety of uninterrupted rivaroxaban for periprocedural anticoagulation in patients undergoing radiofrequency ablation for atrial fibrillation: results from a multicenter prospective registry. J Am Coll Cardiol. 2014;63(10):982–988.
    1. Tanaka-Esposito CC, et al. Real-time ultrasound guidance reduces total and major vascular complications in patients undergoing pulmonary vein antral isolation on therapeutic warfarin. J Interv Card Electrophysiol. 2013;37(2):163–168.
    1. Errahmouni A, et al. Ultrasound-guided venous puncture in electrophysiological procedures: a safe method, rapidly learned. Pacing Clin Electrophysiol. 2014;37(8):1023–1028.
    1. Chugh A, et al. Manifestations of coronary arterial injury during catheter ablation of atrial fibrillation and related arrhythmias. Heart Rhythm. 2013;10(11):1638–1645.
    1. Makimoto H, et al. Aborted sudden cardiac death due to radiofrequency ablation within the coronary sinus and subsequent total occlusion of the circumflex artery. J Cardiovasc Electrophysiol. 2013;24(8):929–932.
    1. Kitamura T, et al. Transient sinus node dysfunction following sinus node artery occlusion due to radiofrequency catheter ablation of the septal superior vena cava-right atrium junction. J Electrocardiol. 2016;49(1):18–22.
    1. Ouali S, et al. Acute coronary occlusion during radiofrequency catheter ablation of typical atrial flutter. J Cardiovasc Electrophysiol. 2002;13(10):1047–1049.
    1. Mykytsey A, et al. Right coronary artery occlusion during RF ablation of typical atrial flutter. J Cardiovasc Electrophysiol. 2010;21(7):818–821.
    1. Sticherling C, Pfister O, Osswald S. Thrombo-embolic occlusion of the left anterior descending coronary artery complicating left atrial radiofrequency ablation. Europace. 2009;11(1):117–118.
    1. Wong KC, et al. High incidence of acute sub-clinical circumflex artery ‘injury’ following mitral isthmus ablation. Eur Heart J. 2011;32(15):1881–1890.
    1. Fayad G, et al. Circumflex artery stenosis induced by intraoperative radiofrequency ablation. Ann Thorac Surg. 2003;76(4):1291–1293.
    1. Calkins H, et al. Radiation exposure during radiofrequency catheter ablation of accessory atrioventricular connections. Circulation. 1991;84(6):2376–2382.
    1. Lindsay BD, et al. Radiation exposure to patients and medical personnel during radiofrequency catheter ablation for supraventricular tachycardia. Am J Cardiol. 1992;70(2):218–223.
    1. Kovoor P, et al. Risk to patients from radiation associated with radiofrequency ablation for supraventricular tachycardia. Circulation. 1998;98(15):1534–1540.
    1. Macle L, et al. Radiation exposure during radiofrequency catheter ablation for atrial fibrillation. Pacing Clin Electrophysiol. 2003;26(1 Pt 2):288–291.
    1. Lickfett L, et al. Radiation exposure during catheter ablation of atrial fibrillation. Circulation. 2004;110(19):3003–3010.
    1. Ector J, et al. Obesity is a major determinant of radiation dose in patients undergoing pulmonary vein isolation for atrial fibrillation. J Am Coll Cardiol. 2007;50(3):234–242.
    1. Chen J, et al. Cumulative exposure to ionizing radiation from diagnostic and therapeutic cardiac imaging procedures: a population-based analysis. J Am Coll Cardiol. 2010;56(9):702–711.
    1. Khaykin Y, et al. CARTO-guided vs. NavX-guided pulmonary vein antrum isolation and pulmonary vein antrum isolation performed without 3-D mapping: effect of the 3-D mapping system on procedure duration and fluoroscopy time. J Interv Card Electrophysiol. 2011;30(3):233–240.
    1. Stabile G, et al. Reduced fluoroscopy exposure during ablation of atrial fibrillation using a novel electroanatomical navigation system: a multicentre experience. Europace. 2012;14(1):60–65.
    1. De Ponti R, et al. Simulator training reduces radiation exposure and improves trainees’ performance in placing electrophysiologic catheters during patientbased procedures. Heart Rhythm. 2012;9(8):1280–1285.
    1. Kleemann T, et al. Development of radiation exposure in patients undergoing pulmonary vein isolation in Germany between 2007 and 2014: great potential to minimize radiation dosage. Clin Res Cardiol. 2016;105(10):858–864.
    1. Steven D, et al. Reduced fluoroscopy during atrial fibrillation ablation: benefits of robotic guided navigation. J Cardiovasc Electrophysiol. 2010;21(1):6–12.
    1. Weiss JP, et al. A comparison of remote magnetic irrigated tip ablation versus manual catheter irrigated tip catheter ablation with and without force sensing feedback. J Cardiovasc Electrophysiol. 2016;27(Suppl 1):S5–S10.
    1. Dragusin O, et al. Evaluation of a radiation protection cabin for invasive electrophysiological procedures. Eur Heart J. 2007;28(2):183–189.
    1. Reddy VY, et al. Catheter ablation of atrial fibrillation without the use of fluoroscopy. Heart Rhythm. 2010;7(11):1644–1653.
    1. Bulava A, Hanis J, Eisenberger M. Catheter ablation of atrial fibrillation using zero-fluoroscopy technique: a randomized trial. Pacing Clin Electrophysiol. 2015;38(7):797–806.
    1. Stabile G, et al. Low incidence of permanent complications during catheter ablation for atrial fibrillation using open-irrigated catheters: a multicentre registry. Europace. 2014;16(8):1154–1159.
    1. Luckie M, et al. Dressler’s syndrome following pulmonary vein isolation for atrial fibrillation. Acute Card Care. 2008;10(4):234–235.
    1. Lambert T, et al. Cardiac tamponade following pericarditis 18 days after catheter ablation of atrial fibrillation. Clin Res Cardiol. 2010;99(9):595–597.
    1. Torihashi S, et al. Two cases of delayed cardiac tamponade due to pericarditis after pulmonary vein (PV) isolation for atrial fibrillation. Intern Med. 2015;54(7):791–796.
    1. Kim DR, et al. Comparison of two different doses of single bolus steroid injection to prevent atrial fibrillation recurrence after radiofrequency catheter ablation. Yonsei Med J. 2015;56(2):324–331.
    1. Kesek M, et al. Entrapment of circular mapping catheter in the mitral valve. Heart Rhythm. 2007;4(1):17–19.
    1. Tavernier R, Duytschaever M, Taeymans Y. Fracture of a circular mapping catheter after entrapment in the mitral valve apparatus during segmental pulmonary vein isolation. Pacing Clin Electrophysiol. 2003;26(8):1774–1775.
    1. Grove R, et al. Demand for open heart surgery due to entrapment of a circular mapping catheter in the mitral valve in a patient undergoing atrial fibrillation ablation. Clin Res Cardiol. 2008;97(9):628–629.
    1. Lakkireddy D, et al. Radiofrequency ablation of atrial fibrillation in patients with mitral or aortic mechanical prosthetic valves: a feasibility, safety, and efficacy study. Heart Rhythm. 2011;8(7):975–980.
    1. Zeljko HM, et al. Entrapment of the circular mapping catheter in the mitral valve in two patients undergoing atrial fibrillation ablation. Europace. 2011;13(1):132–133.
    1. Desimone CV, et al. Catheter ablation related mitral valve injury: the importance of early recognition and rescue mitral valve repair. J Cardiovasc Electrophysiol. 2014;25(9):971–975.
    1. Gurbuz O, et al. Case report: paravalvular leak as a complication of percutaneous catheter ablation for atrial fibrillation. J Cardiothorac Surg. 2014;9:187.
    1. Mansour M, et al. Successful release of entrapped circumferential mapping catheters in patients undergoing pulmonary vein isolation for atrial fibrillation. Heart Rhythm. 2004;1(5):558–561.
    1. Shoemaker MB, et al. Left atrial hypertension after repeated catheter ablations for atrial fibrillation. J Am Coll Cardiol. 2011;57(19):1918–1919.
    1. Welch TD, et al. Symptomatic pulmonary hypertension with giant left atrial v waves after surgical maze procedures: evaluation by comprehensive hemodynamic catheterization. Heart Rhythm. 2013;10(12):1839–1842.
    1. Witt C, et al. Recurrent dyspnea following multiple ablations for atrial fibrillation explained by the “stiff left atrial syndrome”. Catheter Cardiovasc Interv. 2013;82(5):E747–E749.
    1. Pilote L, et al. Stiff left atrial syndrome. Can J Cardiol. 1988;4(6):255–257.
    1. Khurram IM, et al. Association between left atrial stiffness index and atrial fibrillation recurrence in patients undergoing left atrial ablation. Circ Arrhythm Electrophysiol. 2016;9(3)
    1. Kosiuk J, et al. Prevalence and predictors of worsened left ventricular diastolic dysfunction after catheter ablation of atrial fibrillation. Int J Cardiol. 2013;168(4):3613–3615.
    1. Wong GR, et al. Novel use of sildenafil in the management of pulmonary hypertension due to post-catheter ablation ‘stiff left atrial syndrome’. Int J Cardiol. 2015;181:55–56.
    1. Aryana A, et al. Impact of Pulmonary Vein Cryoballoon Ablation on Bronchial Injury. J Cardiovasc Electrophysiol. 2016;27(7):861–867.
    1. Verma N, et al. Ice formation in the left mainstem bronchus during cryoballoon ablation for the treatment of atrial fibrillation. Heart Rhythm. 2016;13(3):814–815.
    1. Kang KW, et al. Long-term changes in heart rate variability after radiofrequency catheter ablation for atrial fibrillation: 1-year follow-up study with irrigation tip catheter. J Cardiovasc Electrophysiol. 2014;25(7):693–700.
    1. Bunch TJ, et al. Mechanisms of phrenic nerve injury during radiofrequency ablation at the pulmonary vein orifice. J Cardiovasc Electrophysiol. 2005;16(12):1318–1325.
    1. Bai R, et al. Phrenic nerve injury after catheter ablation: should we worry about this complication? J Cardiovasc Electrophysiol. 2006;17(9):944–948.
    1. De Ponti R, et al. Superiority of simulator-based training compared with conventional training methodologies in the performance of transseptal catheterization. J Am Coll Cardiol. 2011;58(4):359–363.
    1. Talbot H, et al. Interactive training system for interventional electrocardiology procedures. Med Image Anal. 2016;35:225–237.
    1. Zipes DP, et al. 2015 ACC/AHA/HRS advanced training statement on clinical cardiac electrophysiology (a revision of the ACC/AHA 2006 update of the clinical competence statement on invasive electrophysiology studies, catheter ablation, and cardioversion) J Am Coll Cardiol. 2015;66(24):2767–2802.
    1. Wojcik M, et al. Learning curve in cryoballoon ablation of atrial fibrillation: eight-year experience. Circ J. 2014;78(7):1612–1618.
    1. Martirosyan M, et al. Learning curve in circular multipolar phased radiofrequency ablation of atrial fibrillation. Cardiol J. 2015;22(3):260–266.
    1. Cox JL, Ad N, Palazzo T. Impact of the maze procedure on the stroke rate in patients with atrial fibrillation. J Thorac Cardiovasc Surg. 1999;118(5):833–840.
    1. Feinberg MS, et al. Restoration of atrial function after the maze procedure for patients with atrial fibrillation. Assessment by Doppler echocardiography. Circulation. 1994;90(5 Pt 2):II285–II292.
    1. Prasad SM, et al. The Cox maze III procedure for atrial fibrillation: long-term efficacy in patients undergoing lone versus concomitant procedures. J Thorac Cardiovasc Surg. 2003;126(6):1822–1828.
    1. U.S. Food and Drug Administration. Summary of Safety and Effectiveness Data: AtriCure Synergy Ablation System. PMA P100046. 2011
    1. Demaria RG, et al. Surgical radiofrequency ablation induces coronary endothelial dysfunction in porcine coronary arteries. Eur J Cardiothorac Surg. 2003;23(3):277–282.
    1. Laczkovics A, Khargi K, Deneke T. Esophageal perforation during left atrial radiofrequency ablation. J Thorac Cardiovasc Surg. 2003;126(6):2119–2120.
    1. Doll N, et al. Epicardial treatment of atrial fibrillation using cryoablation in an acute off-pump sheep model. Thorac Cardiovasc Surg. 2003;51(5):267–273.
    1. Santiago T, et al. Epicardial radiofrequency applications: in vitro and in vivo studies on human atrial myocardium. Eur J Cardiothorac Surg. 2003;24(4):481–486. discussion 486.
    1. Thomas SP, et al. Comparison of epicardial and endocardial linear ablation using handheld probes. Ann Thorac Surg. 2003;75(2):543–548.
    1. van Brakel TJ, et al. Evaluation of epicardial microwave ablation lesions: histology versus electrophysiology. Ann Thorac Surg. 2004;78(4):1397–1402. discussion 1397–1402.
    1. Deneke T, et al. Histopathology of intraoperatively induced linear radiofrequency ablation lesions in patients with chronic atrial fibrillation. Eur Heart J. 2005;26(17):1797–1803.
    1. Schuessler RB, et al. Animal studies of epicardial atrial ablation. Heart Rhythm. 2009;6(12 Suppl):S41–S45.
    1. Melby SJ, et al. Epicardial microwave ablation on the beating heart for atrial fibrillation: the dependency of lesion depth on cardiac output. J Thorac Cardiovasc Surg. 2006;132(2):355–360.
    1. Gammie JS, et al. Atrial fibrillation correction surgery: lessons from the Society of Thoracic Surgeons National Cardiac Database. Ann Thorac Surg. 2008;85(3):909–914.
    1. Damiano RJ, Jr, et al. The Cox maze IV procedure: predictors of late recurrence. J Thorac Cardiovasc Surg. 2011;141(1):113–121.
    1. Ad N, et al. Impact of follow-up on the success rate of the cryosurgical maze procedure in patients with rheumatic heart disease and enlarged atria. J Thorac Cardiovasc Surg. 2006;131(5):1073–1079.
    1. Gammie JS, et al. A multi-institutional experience with the CryoMaze procedure. Ann Thorac Surg. 2005;80(3):876–880. discussion 880.
    1. Gaynor SL, et al. A prospective, single-center clinical trial of a modified Cox maze procedure with bipolar radiofrequency ablation. J Thorac Cardiovasc Surg. 2004;128(4):535–542.
    1. Weimar T, et al. The Cox-maze IV procedure for lone atrial fibrillation: a single center experience in 100 consecutive patients. J Interv Card Electrophysiol. 2011;31(1):47–54.
    1. Henn MC, et al. Late outcomes after the Cox maze IV procedure for atrial fibrillation. J Thorac Cardiovasc Surg. 2015;150(5):1168–1176. 1178 e1–2.
    1. Lall SC, et al. The effect of ablation technology on surgical outcomes after the Cox-maze procedure: a propensity analysis. J Thorac Cardiovasc Surg. 2007;133(2):389–396.
    1. Voeller RK, et al. Isolating the entire posterior left atrium improves surgical outcomes after the Cox maze procedure. J Thorac Cardiovasc Surg. 2008;135(4):870–877.
    1. Blackshear JL, Odell JA. Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation. Ann Thorac Surg. 1996;61(2):755–759.
    1. McCarthy PM, et al. The Cox-Maze procedure: the Cleveland Clinic experience. Semin Thorac Cardiovasc Surg. 2000;12(1):25–29.
    1. Stulak JM, et al. Ten-year experience with the Cox-maze procedure for atrial fibrillation: how do we define success? Ann Thorac Surg. 2007;83(4):1319–1324.
    1. Buber J, et al. Left atrial contractile function following a successful modified Maze procedure at surgery and the risk for subsequent thromboembolic stroke. J Am Coll Cardiol. 2011;58(15):1614–1621.
    1. Holmes DR, et al. Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial. Lancet. 2009;374(9689):534–542.
    1. Holmes DR, Jr, et al. Prospective randomized evaluation of the Watchman Left Atrial Appendage Closure device in patients with atrial fibrillation versus longterm warfarin therapy: the PREVAIL trial. J Am Coll Cardiol. 2014;64(1):1–12.
    1. Gillinov AM, Pettersson G, Cosgrove DM. Stapled excision of the left atrial appendage. J Thorac Cardiovasc Surg. 2005;129(3):679–680.
    1. Healey JS, et al. Left Atrial Appendage Occlusion Study (LAAOS): results of a randomized controlled pilot study of left atrial appendage occlusion during coronary bypass surgery in patients at risk for stroke. Am Heart J. 2005;150(2):288–293.
    1. Romanov A, et al. Effect of left atrial appendage excision on procedure outcome in patients with persistent atrial fibrillation undergoing surgical ablation. Heart Rhythm. 2016;13(9):1803–1809.
    1. Kanderian AS, et al. Success of surgical left atrial appendage closure: assessment by transesophageal echocardiography. J Am Coll Cardiol. 2008;52(11):924–929.
    1. Lee R, et al. A randomized, prospective pilot comparison of 3 atrial appendage elimination techniques: internal ligation, stapled excision, and surgical excision. J Thorac Cardiovasc Surg. 2016;152(4):1075–1080.
    1. Bartus K, et al. Percutaneous left atrial appendage suture ligation using the LARIAT device in patients with atrial fibrillation: initial clinical experience. J Am Coll Cardiol. 2013;62(2):108–118.
    1. Price MJ, et al. Early safety and efficacy of percutaneous left atrial appendage suture ligation: results from the U.S. transcatheter LAA ligation consortium. J Am Coll Cardiol. 2014;64(6):565–572.
    1. Pillarisetti J, et al. Endocardial (Watchman) vs epicardial (Lariat) left atrial appendage exclusion devices: Understanding the differences in the location and type of leaks and their clinical implications. Heart Rhythm. 2015;12(7):1501–1507.
    1. Ailawadi G, et al. Exclusion of the left atrial appendage with a novel device: early results of a multicenter trial. J Thorac Cardiovasc Surg. 2011;142(5):1002–1009, 1009.e1.
    1. Emmert MY, et al. Safe, effective and durable epicardial left atrial appendage clip occlusion in patients with atrial fibrillation undergoing cardiac surgery: first long-term results from a prospective device trial. Eur J Cardiothorac Surg. 2014;45(1):126–131.
    1. Lee R, et al. Late neurologic events after surgery for atrial fibrillation: rare but relevant. Ann Thorac Surg. 2013;95(1):126–131. discussion 131–132.
    1. Badhwar V, et al. The Society of Thoracic Surgeons Mitral Repair/Replacement Composite Score: a report of the Society of Thoracic Surgeons Quality Measurement Task Force. Ann Thorac Surg. 2016;101(6):2265–2271.
    1. Abreu Filho CA, et al. Effectiveness of the maze procedure using cooled-tip radiofrequency ablation in patients with permanent atrial fibrillation and rheumatic mitral valve disease. Circulation. 2005;112(9 Suppl):I20–I25.
    1. Doukas G, et al. Left atrial radiofrequency ablation during mitral valve surgery for continuous atrial fibrillation: a randomized controlled trial. JAMA. 2005;294(18):2323–2329.
    1. Blomstrom-Lundqvist C, et al. A randomized double-blind study of epicardial left atrial cryoablation for permanent atrial fibrillation in patients undergoing mitral valve surgery: the SWEDish Multicentre Atrial Fibrillation study (SWEDMAF) Eur Heart J. 2007;28(23):2902–2908.
    1. Chevalier P, et al. Left atrial radiofrequency ablation during mitral valve surgery: a prospective randomized multicentre study (SAFIR) Arch Cardiovasc Dis. 2009;102(11):769–775.
    1. Cheng DC, et al. Surgical ablation for atrial fibrillation in cardiac surgery: a meta-analysis and systematic review. Innovations (Phila) 2010;5(2):84–96.
    1. Budera P, et al. Comparison of cardiac surgery with left atrial surgical ablation vs. cardiac surgery without atrial ablation in patients with coronary and/or valvular heart disease plus atrial fibrillation: final results of the PRAGUE-12 randomized multicentre study. Eur Heart J. 2012;33(21):2644–2652.
    1. Phan K, et al. Surgical ablation for treatment of atrial fibrillation in cardiac surgery: a cumulative meta-analysis of randomised controlled trials. Heart. 2014;100(9):722–730.
    1. Gillinov AM, et al. Surgical ablation of atrial fibrillation during mitral-valve surgery. N Engl J Med. 2015;372(15):1399–1409.
    1. Rankin JS, et al. The Society of Thoracic Surgeons risk model for operative mortality after multiple valve surgery. Ann Thorac Surg. 2013;95(4):1484–1490.
    1. Louagie Y, et al. Improved patient survival with concomitant Cox Maze III procedure compared with heart surgery alone. Ann Thorac Surg. 2009;87(2):440–446.
    1. Chiappini B, Di Bartolomeo R, Marinelli G. Radiofrequency ablation for atrial fibrillation: different approaches. Asian Cardiovasc Thorac Ann. 2004;12(3):272–277.
    1. Barnett SD, Ad N. Surgical ablation as treatment for the elimination of atrial fibrillation: a meta-analysis. J Thorac Cardiovasc Surg. 2006;131(5):1029–1035.
    1. Edgerton JR, Jackman WM, Mack MJ. A new epicardial lesion set for minimal access left atrial maze: the Dallas lesion set. Ann Thorac Surg. 2009;88(5):1655–1657.
    1. Edgerton JR, et al. Totally thorascopic surgical ablation of persistent AF and long-standing persistent atrial fibrillation using the “Dallas” lesion set. Heart Rhythm. 2009;6(12 Suppl):S64–S70.
    1. Lockwood D, et al. Linear left atrial lesions in minimally invasive surgical ablation of persistent atrial fibrillation: techniques for assessing conduction block across surgical lesions. Heart Rhythm. 2009;6(12 Suppl):S50–S63.
    1. Malaisrie SC, et al. Atrial fibrillation ablation in patients undergoing aortic valve replacement. J Heart Valve Dis. 2012;21(3):350–357.
    1. Cherniavsky A, et al. Assessment of results of surgical treatment for persistent atrial fibrillation during coronary artery bypass grafting using implantable loop recorders. Interact Cardiovasc Thorac Surg. 2014;18(6):727–731.
    1. Yoo JS, et al. Impact of concomitant surgical atrial fibrillation ablation in patients undergoing aortic valve replacement. Circ J. 2014;78(6):1364–1371.
    1. Damiano RJ, Jr, et al. The long-term outcome of patients with coronary disease and atrial fibrillation undergoing the Cox maze procedure. J Thorac Cardiovasc Surg. 2003;126(6):2016–2021.
    1. Akpinar B, et al. Combined off-pump coronary artery bypass grafting surgery and ablative therapy for atrial fibrillation: early and mid-term results. Ann Thorac Surg. 2006;81(4):1332–1337.
    1. Geidel S, et al. Permanent atrial fibrillation ablation surgery in CABG and aortic valve patients is at least as effective as in mitral valve disease. Thorac Cardiovasc Surg. 2006;54(2):91–95.
    1. Geidel S, et al. Persistent atrial fibrillation ablation concomitant to coronary surgery. Thorac Cardiovasc Surg. 2011;59(4):207–212.
    1. Krul SP, et al. Navigating the mini-maze: systematic review of the first results and progress of minimally-invasive surgery in the treatment of atrial fibrillation. Int J Cardiol. 2013;166(1):132–140.
    1. Kainuma S, et al. Dilated left atrium as a predictor of late outcome after pulmonary vein isolation concomitant with aortic valve replacement and/or coronary artery bypass grafting. Eur J Cardiothorac Surg. 2015;48(5):765–777. discussion 777.
    1. Cox JL, et al. The surgical treatment of atrial fibrillation. III. Development of a definitive surgical procedure. J Thorac Cardiovasc Surg. 1991;101(4):569–583.
    1. Rodriguez E, et al. Minimally invasive bi-atrial CryoMaze operation for atrial fibrillation. Oper Tech Thorac Cardiovasc Surg. 2009;14(3):208–223.
    1. Wolf RK, et al. Video-assisted bilateral pulmonary vein isolation and left atrial appendage exclusion for atrial fibrillation. J Thorac Cardiovasc Surg. 2005;130(3):797–802.
    1. Edgerton JR, et al. Minimally invasive pulmonary vein isolation and partial autonomic denervation for surgical treatment of atrial fibrillation. Ann Thorac Surg. 2008;86(1):35–38. discussion 39.
    1. Edgerton JR, et al. Minimally invasive surgical ablation of atrial fibrillation: sixmonth results. J Thorac Cardiovasc Surg. 2009;138(1):109–113. discussion 114.
    1. Beyer E, Lee R, Lam BK. Point: Minimally invasive bipolar radiofrequency ablation of lone atrial fibrillation: early multicenter results. J Thorac Cardiovasc Surg. 2009;137(3):521–526.
    1. Kearney K, et al. A systematic review of surgical ablation versus catheter ablation for atrial fibrillation. Ann Cardiothorac Surg. 2014;3(1):15–29.
    1. Ad N, et al. Surgical ablation of atrial fibrillation trends and outcomes in North America. J Thorac Cardiovasc Surg. 2012;144(5):1051–1060.
    1. Driessen AH, et al. Electrophysiologically guided thoracoscopic surgery for advanced atrial fibrillation: 5-year follow-up. J Am Coll Cardiol. 2017;69(13):1753–1754.
    1. Khargi K, et al. Surgical treatment of atrial fibrillation; a systematic review. Eur J Cardiothorac Surg. 2005;27(2):258–265.
    1. Wazni OM, et al. Atrial arrhythmias after surgical maze: findings during catheter ablation. J Am Coll Cardiol. 2006;48(7):1405–1409.
    1. Magnano AR, et al. Mechanisms of atrial tachyarrhythmias following surgical atrial fibrillation ablation. J Cardiovasc Electrophysiol. 2006;17(4):366–373.
    1. McElderry HT, et al. Proarrhythmic aspects of atrial fibrillation surgery: mechanisms of postoperative macroreentrant tachycardias. Circulation. 2008;117(2):155–162.
    1. McCarthy PM, et al. Where does atrial fibrillation surgery fail? Implications for increasing effectiveness of ablation. J Thorac Cardiovasc Surg. 2010;139(4):860–867.
    1. Zeng Y, et al. Recurrent atrial arrhythmia after minimally invasive pulmonary vein isolation for atrial fibrillation. Ann Thorac Surg. 2010;90(2):510–515.
    1. Lee R, et al. Surgical treatment for isolated atrial fibrillation: minimally invasive vs. classic cut and sew maze. Innovations (Phila) 2011;6(6):373–377.
    1. Edgerton JR, et al. Totally thoracoscopic surgical ablation or catheter ablation of atrial fibrillation: a systematic review and preliminary meta-analysis. Card Electrophysiol Clin. 2012;4(3):413–423.
    1. Edgerton Z, et al. Hybrid procedure (endo/epicardial) versus standard manual ablation in patients undergoing ablation of long-standing persistent atrial fibrillation: results from a single center. J Cardiovasc Electrophysiol. 2016;27(5):524–530.
    1. Wright M, et al. State of the art: catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2008;19(6):583–592.
    1. Sueda T, et al. Long-term results after the box pulmonary vein isolation procedure for chronic atrial fibrillation in mitral valve surgery. Ann Thorac Cardiovasc Surg. 2012;18(2):101–108.
    1. Maagh P, et al. Pulmonary vein isolation in 2012: is it necessary to perform a time consuming electrophysical mapping or should we focus on rapid and safe therapies? A retrospective analysis of different ablation tools. Int J Med Sci. 2013;10(1):24–33.
    1. Bisleri G, et al. The need of a hybrid approach for the treatment of atrial fibrillation. Heart Surg Forum. 2005;8(5):E326–E330.
    1. Nitta T. Surgery for atrial fibrillation: a worldwide review. Semin Thorac Cardiovasc Surg. 2007;19(1):3–8.
    1. Byrne JG, et al. Hybrid cardiovascular procedures. JACC Cardiovasc Interv. 2008;1(5):459–468.
    1. La Meir M, et al. The hybrid approach for the surgical treatment of lone atrial fibrillation: one-year results employing a monopolar radiofrequency source. J Cardiothorac Surg. 2012;7:71.
    1. Prasad SM, et al. Chronic transmural atrial ablation by using bipolar radiofrequency energy on the beating heart. J Thorac Cardiovasc Surg. 2002;124(4):708–713.
    1. Kiser AC, et al. The convergent procedure: a multidisciplinary atrial fibrillation treatment. Heart Surg Forum. 2010;13(5):E317–E321.
    1. Kiser AC, et al. Simultaneous catheter and epicardial ablations enable a comprehensive atrial fibrillation procedure. Innovations (Phila) 2011;6(4):243–247.
    1. Natale A, et al. Hybrid procedure (endo/epicardial) versus standard manual ablation in patients undergoing ablation of long-standing persistent atrial fibrillation: results from a single center [abstract] Heart Rhythm. 2011;8(Suppl 5):S79.
    1. Belden W, Moraca R. The convergent procedure for AF: experience at Allegheny General Hospital. EP Lab Digest. 2013;13(5)
    1. Civello KC, Smith CA, Boedefeld W. Combined endocardial and epicardial ablation for symptomatic atrial fibrillation: single center experience in 100+ consecutive patients. Journal of Innovations in Cardiac Rhythm Management. 2013:1–7.
    1. Robinson M, et al. Maximizing ablation, limiting invasiveness, and being realistic about atrial fibrillation: the convergent hybrid ablation procedure for advanced AF. EP Lab Digest. 2013;13(6)
    1. Thosani AJ, et al. Closed chest convergent epicardial-endocardial ablation of non-paroxysmal atrial fibrillation—a case series and literature review. Arrhythm Electrophysiol Rev. 2013;2(1):65–68.
    1. Je HG, Shuman DJ, Ad N. A systematic review of minimally invasive surgical treatment for atrial fibrillation: a comparison of the Cox-Maze procedure, beating-heart epicardial ablation, and the hybrid procedure on safety and efficacy. Eur J Cardiothorac Surg. 2015;48(4):531–540. discussion 540–541.
    1. Farina E, et al. Neuropsychological deficits in asymptomatic atrial fibrillation. Acta Neurol Scand. 1997;96(5):310–316.
    1. De Groot JC, et al. Periventricular cerebral white matter lesions predict rate of cognitive decline. Ann Neurol. 2002;52(3):335–341.
    1. Sacco RL, et al. An updated definition of stroke for the 21st century: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013;44(7):2064–2089.
    1. Wardlaw JM, et al. Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration. Lancet Neurol. 2013;12(8):822–838.
    1. Wang X, et al. Early recurrences after paroxysmal atrial fibrillation ablation: when is the proper timing for reablation? Pacing Clin Electrophysiol. 2011;34(6):709–716.
    1. Healey JS, et al. Subclinical atrial fibrillation and the risk of stroke. N Engl J Med. 2012;366(2):120–129.
    1. Mantovan R, et al. Relationship of quality of life with procedural success of atrial fibrillation (AF) ablation and postablation AF burden: substudy of the STAR AF randomized trial. Can J Cardiol. 2013;29(10):1211–1217.
    1. Suman-Horduna I, et al. Quality of life and functional capacity in patients with atrial fibrillation and congestive HF. J Am Coll Cardiol. 2013;61(4):455–460.
    1. Arya A, et al. Clinical implications of various follow up strategies after catheter ablation of atrial fibrillation. Pacing Clin Electrophysiol. 2007;30(4):458–462.
    1. Glotzer TV, et al. Atrial high rate episodes detected by pacemaker diagnostics predict death and stroke: report of the Atrial Diagnostics Ancillary Study of the MOde Selection Trial (MOST) Circulation. 2003;107(12):1614–1619.
    1. Di Biase L, et al. Feasibility and safety of uninterrupted periprocedural apixaban administration in patients undergoing radiofrequency catheter ablation for atrial fibrillation: results from a multicenter study. Heart Rhythm. 2015;12(6):1162–1168.
    1. Wu RC, et al. Circular mapping catheter entrapment in the mitral valve apparatus: a previously unrecognized complication of focal atrial fibrillation ablation. J Cardiovasc Electrophysiol. 2002;13(8):819–821.
    1. Natale A, et al. Prospective randomized comparison of antiarrhythmic therapy versus first-line radiofrequency ablation in patients with atrial flutter. J Am Coll Cardiol. 2000;35(7):1898–1904.
    1. Black-Maier E, et al. Risk of atrioesophageal fistula formation with contact-force sensing catheters. Heart Rhythm. 2017:30452–30456.
    1. Thygesen K, et al. Universal definition of myocardial infarction. J Am Coll Cardiol. 2007;50(22):2173–2195.

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir