Why the study?
This review aims to describe how paroxysmal atrial fibrillation ablation has evolved over the last twenty years, focusing on techniques, mechanistic understanding, and tailored approaches.
This review summarizes the evolution, available techniques, and mechanistic understanding of pulmonary vein isolation for paroxysmal atrial fibrillation over the past twenty years.
Provides synthesis of PVI evolution for paroxysmal AF; leaves open optimal technique selection for future trials.
Pulmonary vein isolation (PVI) is the established cornerstone for atrial fibrillation (AF) ablation, indeed current guidelines recognize PVI as the gold standard for first-time AF ablation, regardless of if it is paroxysmal or persistent. Since 1998 when Haïssaguerre pioneered AF ablation demonstrating a burden reduction after segmental pulmonary vein (PV) ablation, our approach to PVI was superior in terms of methodology and technology. This review aims to describe how paroxysmal atrial fibrillation ablation has evolved over the last twenty years. We will focus on available techniques, a mechanistic understanding of paroxysmal AF genesis and the possibility of a tailored approach for the treatment of AF, before concluding with a future perspective.
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Robles et al. (2024) studied this question.
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