Key result
Novel ablation tools and advanced mapping may improve ablation success by overcoming PV reconnection.
Why the study?
Further improvement of catheter ablation technologies is desirable for atrial fibrillation, particularly for patients with persistent and long-standing persistent AF.
Novel ablation technologies, including contact-force catheters and balloon-based systems, hold promise for improving the efficacy and safety of atrial fibrillation ablation.
Answers are grounded in this paper and cite their sources.
Should not yet change AF ablation practice; hypothesis-generating for RCTs of novel tools.
INTRODUCTION: Catheter ablation (CA) for atrial fibrillation (AF) is an effective treatment option with encouraging clinical outcome data. Further improvement of catheter technologies is desirable, in particular for patients with persistent and long-standing persistent AF. The aim of this review is to provide an overview of novel ablation tools in AF-ablation. AREAS COVERED: The most widely used ablation tool still is the single-tip catheter for radiofrequency (RF) ablation. Contact-force (CF) catheters and the introduction of individualized ablation protocols may overcome limitations of single-tip RF-based ablation. Furthermore, balloon-based pulmonary vein isolation (PVI) - first and foremost the cryoballoon (CB) - based ablation - moved into the foreground especially for the treatment of paroxysmal AF, because of its ease of use and proven safety. Upcoming RF balloon technologies are also promising. Moreover, new mapping and imaging technologies might help to identify non-PV-triggers in patients with arrhythmia recurrence and may have the potential to enable real-time therapy assessment. EXPERT OPINION: New ablation tools such as CF-sensing catheters or novel balloon-devices could help to overcome the major limitation of PV-reconnection and lead to improved outcomes. Moreover, novel mapping tools to identify extra-PV-triggers may improve ablation success in patients with persistent and long-standing persistent AF.
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Rottner et al. (2020) conducted a review in Atrial fibrillation. Novel ablation tools was evaluated. Novel ablation tools, including contact-force sensing catheters and balloon devices, along with advanced mapping technologies, may overcome pulmonary vein reconnection and improve ablation success.
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