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Objective: To investigate the efficacy of CARTO-guided stepwise ablation approaches for treatment of patients with nonparoxysmal atrial fibrillation(AF)., Methods: Stepwise ablation approaches were performed in 40 patients with nonparoxysmal atrial fibrillation. Pulmonary vein atrium isolation (PVAI), linear ablation in atria, complex fractionated atrial electrograms (CFAEs) ablation and cardioversion were applied sequentially till sinus rhythm (SR) restoration. All patients were followed up 6 to 18 months., Results: SR was restored in 11 patients after PVAI, in 11 patients after linear ablation and in 6 patients after CFEAs ablation. SR was restored in the remaining 13 patients post cardioversion. During follow-up, 3 atrial fibrillation, 3 atrial tachycardia and 5 atrial flutter were evidenced. Seven out of the 11 patients with reoccurred arrhythmia were treated only by PVAI., Conclusions: CARTO-guided stepwise ablation approaches are safe and effective in the treatment of patients with nonparoxysmal atrial fibrillation. PVAI approach was associated with lower successful rate and high recurrence rate.

Objective: To investigate whether polymorphisms in CYP11B2 gene are associated with nonfamilial structural atrial fibrillation (AF) in Chinese Han population., Methods: A fine-designed pair-matched hospital based case-control study was performed in 297 cases and 297 controls. We investigated two tagging single nucleotide polymorphisms (tSNPs)-rs4545, rs3802228 in CYP11B2 gene by using GenomeLab SNPstream technique., Results: Two tSNPs were consistent with Hardy-Weinberg expectations in case and control groups. Compared with controls, the left atrial diameter of cases was significantly higher (P < 0.0001). No significant difference in genotype or allele frequencies of tSNPs in CYP11B2 gene was observed. However, at the site of rs3802228 in 3'UTR of the case group, the left atrial diameter in AF patients with GG genotype was significantly higher than others. After adjusted for covariates age, smoking, Body mass index and hypertension, we did not observe the association of rs4545, rs3802228 with AF., Conclusion: Our result suggested that polymorphisms of rs4545 in CYP11B2 gene might not be associated with atrial fibrillation but polymorphism of 3'UTR rs3802228 locus in CYP11B2 gene might be associated with atrial structural remodeling.