Key result
Circumferential PV antrum ablation eliminates recurrent paroxysmal AF for 84 months in a single patient.
Why the study?
Pulmonary vein isolation is the cornerstone of AF ablation, but the optimal site for ablation remains controversial.
Case Report (n=1)
Isolation of the pulmonary vein antrum may be necessary for patients with atrial fibrillation recurrence after successful ostial pulmonary vein isolation.
May require antral ablation despite ostial isolation in repeat paroxysmal AF; leaves open optimal ablation strategy.
BACKGROUND: Pulmonary vein isolation (PVI) is the cornerstone of atrial fibrillation (AF) ablation, although the optimal site for ablation remains controversial. METHODS AND RESULTS: We reported a 52- year-old woman with the third paroxysmal AF ablation. Mapping showed that the ostial PV ， but not the PV antrum ，was isolated. During circumferential PV antrum ablation, the atrial arrhythmias were eliminated. The roof line and superior vena cava isolation was empirically performed. During the 84-month follow-up, she was free of arrhythmias without antiarrhythmics. CONCLUSION: Isolation of the PV antrum, which was easily to be identify by image integration, should be checked and achieved for patients with AF recurrence after "successful and durable ostial PVI". CLINICAL TRIAL REGISTRATION STATEMENT: No clinical trial registration number is applicable.
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Xu et al. (2026) conducted a case report in Paroxysmal atrial fibrillation (n=1). Circumferential pulmonary vein antrum ablation was evaluated on Freedom from arrhythmias without antiarrhythmics. Circumferential pulmonary vein antrum ablation eliminated atrial arrhythmias in a patient with recurrent paroxysmal AF, maintaining freedom from arrhythmias at 84 months.
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