Ablation guided by propagational analysis for arrhythmogenic conduction elimination to prevent atrial flutter and fibrillation (panacea- af study): a novel strategy to target wavefront discontinuities

The optimal adjunctive catheter ablation strategy in patients with recurrent AF/AFL in addition to initial pulmonary vein isolation (PVI) remains unknown. Ablation of complex fractionated electrograms or addition of lines have not been shown to be effective and may be pro-arrhythmic. Ablation of deceleration zones (DZ) identified by ultra-high density mapping (UHD) is an effective treatment strategy for reentrant ventricular arrhythmias but its role in reentrant atrial arrhythmias is unknown.