Key result
Ablation of persistent and long-standing persistent atrial fibrillation often requires a more extensive approach than pulmonary vein isolation alone due to progressive electromechanical remodeling.
This review discusses current approaches and recent advances in ablation strategies for persistent and long-standing persistent atrial fibrillation, which often require more extensive approaches than pulmonary vein isolation alone.
Reinforces tailored ablation beyond PVI in persistent AF; leaves open optimal adjunctive strategies pending prospective trials.
Atrial fibrillation (AF) is currently the most commonly treated cardiac arrhythmia. It is generally a progressive disease, often more difficult to control as electromechanical remodeling alters the underlying substrate. Patients typically evolve from infrequent, self-terminating episodes, to more frequent and sustained events. In addition, atrial remodeling may make sinus rhythm more challenging to achieve. Although an ablation strategy limited to pulmonary vein isolation may be curative in those with paroxysmal AF, a more extensive approach is often required in those with persistent AF. This article discusses the current approaches and most recent advances in the ablation of persistent and long-standing persistent AF.
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Manlucu et al. (2012) conducted a review in Persistent atrial fibrillation. Ablation was evaluated. Ablation of persistent and long-standing persistent atrial fibrillation often requires a more extensive approach than pulmonary vein isolation alone due to progressive electromechanical remodeling.
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