I have decided that I will apply to Bordeaux for a touch-up ablation for my short-duration, continuous AF ( for plenty more background, you can see "My Wolf mini-maze" at af-ideas.com). Briefly, I had the Wolf procedure on January 5, 2006, and it may not have worked. AF returned one week post-op. I was placed on flecainide 50 mg bid. AFL appeared in late July. I was CVed and am now on 100 mg flecainide bid.

Bordeaux, of course, has been one of the top ablation centers for some time, currently reporting a 90% success rate (I do not know the mix of paroxysmal and continuous, the follow-up time, or any other aspects of their measurement of success. I do believe they define success as "off medication".)

You will find more specific information regarding their treatment for continuous AF in the report on the 2006 Boston Symposium at

a-fib.com.

Their approach to continuous AF stands out in several ways:

1) Their success rate (87% of 60 Ss in a study of their latest technique -- see http://www.medscape.com/viewarticle/515973)

2) Their apparent relative comfort with the difficult PV-mitral annulus lesion, which they (and Dr Cox, to the extent this ablation lesion equals his surgical one) say may well be necessary in most cases of continuous AF

3) Their targeting of areas of high frequency actvity adjacent to CFAE's rather than the CFAE's themselves, reflecting the latest research as reported be Dr Jalife at the Boston Symposium (see the above-mentioned report at a-fib.com).

Another possible advantage my be their use of the Agilus Steerable Guide Catheter, which may help them to do some difficult lesions, although I don't believe they could have used this on very many cases.

There is the  question of whether there are other procedures/doctors who would be likely to do as well with continuous AF. Any judgement would have to be made on the basis of process analysis; it is too early for definitive outcome studies.