Left atrial posterior wall isolation techniques, anatomical considerations, advantages, and pitfalls are detailed to assist clinical electrophysiologists in treating persistent atrial fibrillation.
This review provides a detailed guide on the anatomical considerations and techniques for performing left atrial posterior wall isolation as an adjunct to pulmonary vein isolation in patients with persistent atrial fibrillation.
Catheter ablation has become standard of care in patients with symptomatic atrial fibrillation (AF). Although there have been significant advances in our understanding and technology, a substantial proportion of patients have ongoing AF requiring repeat procedures. Pulmonary vein isolation (PVI) is the cornerstone of AF ablation; however, it is less effective in patients with persistent as opposed to paroxysmal atrial fibrillation. Left atrial posterior wall isolation (PWI) is commonly performed as an adjunct to PVI in patients with persistent AF with nonrandomized studies showing improved outcomes. Anatomical considerations and detailed outline of the various approaches and techniques to performing PWI are detailed, and advantages and pitfalls to assist the clinical electrophysiologist successfully and safely complete PWI are described.
Sugumar et al. (Mon,) conducted a review in Atrial fibrillation. Left atrial posterior wall isolation (PWI) was evaluated. Left atrial posterior wall isolation techniques, anatomical considerations, advantages, and pitfalls are detailed to assist clinical electrophysiologists in treating persistent atrial fibrillation.
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