Treatment of atrial fibrillation (AF), by targeting the triggering autonomic nerve structures, have been shown high efficacy for converting the AF to sinus rhythm. However, the efficacy is limited to a short time (<3 months) with a high degree of recurrence of atrial arrhythmias. The recurrence rate was directly correlated to the time of follow-up which would support the role of the autonomic nerve regenerative (or re-establishment) activities for the incidence of the recurrence of atrial arrhythmias (ex. persistent atrial fibrillation). Furthermore, the recurrence degree of AF is high to all currently used catheter methods. Atrial Fibrosis as defined by Delayed Enhanced Magnetic Resonance Imaging (DEMRI) is associated with slower and more organized electrical activity but with lower voltage compared to the healthy sites of the atrium. 90 % of continous Complex Fractionaed Atrial Electrograms (CFAE) sites occurs at non-DE and patchy DE of the Left Atrial (LA) sites. These findings are important to determine a strategy for catheter ablating procedure during the treatment of persistent AF. MRI combined to FFT – software enabling the physician to distinghish between fibrosis and Ganglionated Plexi (GP) sites for the treatment of sustained AF. Previous investigators have shown relationship between fibrosis imaged by DEMRI and atrial electrograms during persistent atrial fibrillation episodes used MRI & NavX algorithm that quantify EGM fractionated. Severals studies have showed that the activation of the autonomic ganglia in the atrium could lead to sustained AF. Therefore, using an approach of combined MRI – NavX to detect the ganglia site will represent an optimum target for the catheter ablation procedure and for the atrial site for ICD / device sensing/stimulating. Furthermore, by using a ‘neurostimulator’ device to detect whether the complete GP atrial autonomic insolution is acheived would prevent the early recurrence of AF episodes. These findings are important when choosing the ablation strategy in persistent AF. In addition, this study would reveal major scientific and genetic discoveries such as the relation between GP – induced AF, the risk of ischemic stroke, the large artery stroke and CAD. Those new findings would also be useful for advanced the development of pharmacogenetics drugs for the treatment of cardiovascular and neurovascular diseases such as GP-induced AF and CAD. Thus, it would also be used as a combined treatment to the existing antiarrhythmic drugs, antithrombotic agents, beta-blocker agents, statins, angiotensin-converting enzyme inhibitor.

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