Key result
This review summarizes current knowledge on the electrophysiological characteristics, mapping, ablation strategies, and safety and efficacy of catheter ablation for non-pulmonary vein atrial fibrillation.
This review highlights the importance of identifying and ablating non-pulmonary vein ectopic foci in patients with paroxysmal atrial fibrillation, particularly those with recurrence after pulmonary vein isolation.
May guide ablation in recurrent paroxysmal AF; leaves open optimal non-PV strategies pending randomized data.
Pulmonary veins (PVs) are a major source of ectopic beats that initiate AF. PV isolation from the left atrium is an effective therapy for the majority of paroxysmal AF. However, investigators have reported that ectopy originating from non-PV areas can also initiate AF. Patients with recurrent AF after persistent PV isolation highlight the need to identify non-PV ectopy. Furthermore, adding non-PV ablation after multiple AF ablation procedures leads to lower AF recurrence and a higher AF cure rate. These findings suggest that non-PV ectopy is important in both the initiation and recurrence of AF. This article summarises current knowledge about the electrophysiological characteristics of non-PV AF, suitable mapping and ablation strategies, and the safety and efficacy of catheter ablation of AF initiated by ectopic foci originating from non-PV areas.
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Higa et al. (2018) conducted a review in Paroxysmal Atrial Fibrillation. Catheter ablation of non-pulmonary vein areas was evaluated. This review summarizes current knowledge on the electrophysiological characteristics, mapping, ablation strategies, and safety and efficacy of catheter ablation for non-pulmonary vein atrial fibrillation.
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