Practical Guide to Catheter Ablation of Atrial Fibrillation -- Contents -- Contributors -- Chapter 1: Indications for Catheter and Surgical Ablation of Atrial Fibrillation -- Introduction -- The 2012 HRS/EHRA/ECAS consensus document on Catheter ablation of atrial fibrillation -- Concomitant surgical ablation of atrial fibrillation -- Stand-alone surgical ablation of atrial fibrillation -- Indications for catheter ablation of atrial fibrillation as defined by the 2010 European Society of Cardiology guidelines for atrial fibrillation management -- Considerations on the published guidelines for AF ablation -- Considerations on discussions of the risks and benefits of AF ablation with patients -- Conclusions -- References -- Chapter 2: Catheter Ablation for Atrial Fibrillation: Past, Present, and Future -- Introduction -- Catheter-based treatment for atrial fibrillation -- The past -- The present -- The present - Johns Hopkins Hospital -- The future -- Conclusions -- References -- Chapter 3: Staffing, Training, and Ongoing Volume Requirements -- Staffing -- Training -- Indications, patient selection, and procedural issues -- Basic theoretical and anatomical knowledge -- Technical skills -- Transseptal puncture -- Follow-up -- Volume requirements -- Basic training -- Training strategies: New technologies -- References -- Chapter 4: Equipment Options for the Ablation of Atrial Fibrillation -- Sedation -- General anesthesia -- Anticoagulation -- Esophageal probe -- X-ray equipment and shielding -- Fluoroscopy -- Radiation protection -- EP recording and pacing systems -- Equipment for transseptal puncture -- Brockenbrough needle -- Echocardiography -- Catheters, ablation generators, and electroanatomic mapping -- Radiofrequency ablation catheters and generators -- Non-RF systems -- Conclusions -- References.

Chapter 5: Preprocedure Preparation for Catheter-Based Ablation of Atrial Fibrillation -- Introduction -- ECG and ambulatory ECG recordings -- Transthoracic and transesophageal echocardiogram -- Cardiac CT and MRI -- Drug therapy -- References -- Chapter 6: Intracardiac Ultrasound -- Technical requirements: imaging equipment and transducer -- Historical perspective -- Ultrasound principles and techniques -- Technique for visualization of critical anatomic structures -- Transseptal catheterization -- Transseptal technique -- Methodological variations -- Pulmonary vein anatomy -- Catheter vizualization, contact, and lesion-formation monitoring -- Early detection and treatment of complications -- Pericardial effusion -- Intra-atrial thrombus -- Pulmonary vein stenosis -- Inadvertent puncture of aorta during transseptal catheterization -- Other preventative measures -- Catheter ablation of atrial fibrillation without fluoroscopy -- Future directions -- References -- Chapter 7: Electroanatomic Mapping Systems -- Introduction to electroanatomic mapping systems -- CARTO system -- CARTO-guided ablation in atrial fibrillation -- EnSite NaVX -- EnSite NaVX-guided ablation of atrial fibrillation -- Rhythmia medical system -- Noncontact mapping -- Real-time position management (RPM) system -- Contact force-guided radiofrequency ablation -- Conclusions -- References -- Chapter 8: Magnetic and Robotic Catheter Navigation -- Introduction -- Remote magnetic catheter navigation -- Performance -- Safety -- Other considerations -- Advantages and disadvantages -- Robotic catheter manipulation -- Performance -- Safety -- Advantages and disadvantages -- Summary -- References -- Chapter 9: MRI-Guided Procedures -- Preprocedure MRI for EP procedure guidance -- 3D angiography -- Ablation lesion imaging -- Atrial substrate imaging -- Fully MRI-guided EP procedures.

Studies using real-time MRI guidance -- Studies using MRI electroanatomic mapping guidance -- Ongoing work toward fully MRI-guided clinical procedures -- Intraprocedure ablation lesion imaging -- Device visualization and navigation -- Integrated visualization of real-time imaging, 3D anatomy, electrograms -- Full-featured electrogram recording and pacing systems -- MRI safety -- Conclusions -- References -- Chapter 10: MRI Definition of Atrial Substrate -- Introduction -- Delayed enhancement MRI in atrial fibrillation -- Preablation LA fibrosis quantification -- Relationship between LA fibrosis, LA enhancement, and AF -- Left atrial fibrosis and clinical AF -- LA fibrosis and stroke -- LA fibrosis and AF management: Utah classification and management algorithm -- Lesion assessment after ablation -- Conclusions -- References -- Chapter 11: The Utility of Noninvasive Mapping in Persistent Atrial Fibrillation Ablation -- Introduction -- Methodology of noninvasive mapping -- Persistent AF ablation guided by noninvasive mapping -- AF drivers revealed by noninvasive mapping -- Electrogram characteristics of AF driver regions -- AF drivers, fractionation, and atrial fibrosis -- Ablation strategy for AF drivers -- Clinical outcomes -- Noninvasive mapping of AT post-AF ablation -- Technical limitations of noninvasive mapping -- Future areas of investigation -- Conclusions -- Acknowledgments -- Relevant disclosures -- References -- Chapter 12: Interpretation of Circular Mapping Catheter Recordings -- Interpretation of circular mapping catheter recordings -- Role of the pulmonary veins -- Circular mapping catheters -- PV electrogram interpretation -- Pacing maneuvers -- Decremental pacing -- Differential (CS) pacing -- Site-specific pacing -- Simultaneous or combination pacing -- Pulmonary vein-specific electrogram interpretation -- Left superior pulmonary vein.

Left inferior pulmonary vein -- Right superior pulmonary vein -- Right inferior pulmonary vein -- Identifying arrhythmogenic veins -- PV recordings during ablation -- End points of ablation -- Entrance block -- Exit block -- PVI during sustained AF -- Conclusions -- References -- Controversy: Differing Energy Sources - The Use of Radiofrequency Energy -- Introduction -- Mechanisms of action -- Efficacy -- Integration with three-dimensional (3D) mapping -- Integration with remote navigation systems -- Future directions -- References -- Controversy: Differing Energy Sources/Use of Cryo-Energy -- Introduction -- Preclinical studies -- Importance of the energy delivery platform -- Acute procedural outcomes -- Long-term clinical outcomes -- Safety of cryoballoon ablation -- Conclusions -- References -- Chapter 13: Circumferential Ablation with Pulmonary Vein Isolation Guided by Lasso Catheter -- Introduction -- Complete PV isolation using 3D mapping and Lasso technique -- Transseptal puncture -- LA reconstruction -- Selective PV angiography and identification of PV ostium -- Single and double Lasso technique -- CCLs surrounding the ipsilateral PVs -- Procedural end point -- Lasso catheter findings during CCLs -- Complete PV isolation by CCLs -- Inducibility of AF after CCL-based PV Isolation -- Circumferential PV isolation with single Lasso -- Complications -- Long-term clinical outcome after CCLs in patients with paroxysmal AF -- Conclusions -- Acknowledgments -- References -- Controversy: Circumferential Versus Segmental Pulmonary Vein Isolation/Circumferential PVI -- References -- Controversy: Circumferential Versus Segmental Pulmonary Vein Isolation/Segmental PVI -- Introduction -- AF suppression after SOCA versus CPVA for PVI -- Atrial tachyarrhythmias after SOCA versus CPVA for treatment of AF -- Summary -- References.

Chapter 14: How to Select Target Sites in Electrogram-Guided Ablation: Options, Techniques, and Results -- Introduction -- Mechanisms of atrial fibrillation -- The clinical importance of AF termination -- Complex fractionated atrial electrogram ablation -- Definitions and Development of the CFAE technique -- Mechanisms of CFAE -- Dominant frequency ablation -- Techniques for dominant frequency analysis in the electrophysiology laboratory -- Dominant frequency analysis in AF -- Relationship of DF sites to CFAE -- Spatiotemporal stability of DF locations -- Limitations of dominant frequency analysis -- Impact of ablation at high DF sites -- DF ablation: conclusions -- Emerging techniques in EGM-guided ablation -- Conclusions -- References -- Controversy: Electrogram-Guided Ablation: Valuable Technique -- Introduction -- Electrophysiologic mechanisms underlying CFAEs -- Electrogram-guided ablation: which CFAE to be ablated? -- Ablation end points and AF termination by CFAE ablation -- Relationship between CFAE and rotor -- Relationship between clinical outcomes and unintentional pulmonary vein isolation during substrate ablation of AF guided solely by CFAE mapping -- Clinical outcomes of electrogram-guided ablation -- Conclusions -- Disclosures -- References -- Controversy: Electrogram-Guided Ablation: Limited Contribution to Successful Outcome -- References -- Chapter 15: Left Atrial Linear Lesions -- Introduction -- Techniques -- Materials and ablation settings -- Confirmation of complete bidirectional block by differential pacing -- Left atrial linear lesions -- Mitral isthmus ablation -- Roof line ablation -- Anterior mitral isthmus ablation -- Conclusions -- References -- Chapter 16: Ablation of Autonomic Ganglia -- Introduction -- Role of the autonomic nervous system in initiation and maintenance of AF: justification for ablation of GP.

Localization of left atrial GP.