Why the study?
Complete posterior wall isolation can be technically challenging, with gaps along the roof line not being rare.
This case report describes the successful radiofrequency ablation of an epicardial conduction breakthrough site, likely via the septopulmonary bundle, highlighting a technique to address gaps during posterior wall isolation.
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Hypothesis-generating for targeting septopulmonary bundle gaps in AF ablation; does not yet alter standard posterior wall isolation practice.
Catheter ablation (CA) of atrial fibrillation (AF) has become widely accepted and has become an effective alternative to drug therapy. Pulmonary vein isolation (PVI) is the cornerstone of the CA of AF.1 Further, the posterior wall (PW) of the left atrium (LA) plays a role in the initiation and maintenance of AF. Therefore, a posterior wall isolation (PWI) may be helpful in patients in whom a PVI alone fails.2 However, a complete PWI can be technically challenging. Gaps along the roof line are not rare.
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Yokoyama et al. (2021) studied this question.
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