Table 7‐3.

Consensus recommendations

Use of 3D mapping: Three‐dimensional mapping‐guided catheter ablation of atrial fibrillation
Recommendation	Class	LOE	References
Careful identification of the PV ostia and left atrial geometry using a 3D mapping system is recommended to avoid ablation within the PVs, and obtain durable PV ablation.	I	B‐NR	39, 111, 131, 132, 133, 134, 135
If linear ablation lesions are applied, 3D mapping and pacing maneuvers is recommended to assess for line completeness.a	I	C‐LD	39, 125, 147, 153, 154, 155
If non‐PV triggers initiating AF are identified, using a 3D mapping system to locate the potential origin of extrapulmonary sources of AF can be useful.	IIa	C‐LD	125, 161
Use of a 3D mapping system to delineate the substrate, identify the low‐voltage zone, and identify the rotational activity or focal sources of AF is reasonable.	IIa	B‐NR	125, 146, 151, 160, 161, 162, 163
For patients with persistent or long‐standing persistent AF, 3D mapping‐guided linear ablation as an initial or repeat ablation strategy is not well established.	IIb	B‐R	39, 125, 147, 153, 154, 155
For patients with persistent or long‐standing persistent AF, 3D mapping‐guided ablation of rotational activity or reentrant sources is not well established.	IIb	B‐NR	125, 146, 167, 168, 169, 170
For patients with persistent or long‐standing persistent AF, the usefulness of 3D mapping and ablation of areas of abnormal myocardial tissue identified with voltage mapping or MRI as an initial or repeat ablation strategy is not well established.	IIb	B‐R	125, 151, 172, 173, 174
For patients with persistent or long‐standing persistent AF, the usefulness of 3D mapping and ablation of complex fractionated atrial electrograms as an initial or repeat ablation strategy is not well established.	IIb	B‐R	39, 125, 149

Abbreviations: 3D, three‐dimensional; AF, atrial fibrillation; PV, pulmonary vein; MRI, magnetic resonance imaging.

^a3D mapping is not necessary for confirmation of CTI line block.