Small solitary atrial fractionated electrogram zone as a novel ablation target for persistent atrial fibrillation

Introduction Various adjunctive approaches to pulmonary vein isolation (PVI) have been attempted for persistent atrial fibrillation (perAF) and longstanding persistent AF (ls‐perAF). We aimed to identify the novel zones responsible for perpetuation of AF. Methods To identify novel zones acting as a source of perAF and ls‐perAF after PVI/re‐PVI, we performed fractionation mapping in 258 consecutive patients with perAF (n = 207) and ls‐perAF (n = 51) in whom PVI/re‐PVI failed to restore sinus rhythm. Results In 15 patients with perAF (5.8%: 15/258), fractionation mapping identified a small solitary zone (