Key result
In a 74-year-old woman with longstanding persistent atrial fibrillation, radiofrequency catheter ablation targeting non-pulmonary vein triggers, followed by a repeat procedure for reconnections, resulted in freedom from arrhythmia recurrence.
Why the study?
Pulmonary vein antral isolation alone is not enough for nonparoxysmal atrial fibrillation, requiring other ablation targets to be sought.
Case Report (n=1)
In a patient with longstanding persistent atrial fibrillation, targeting non-pulmonary vein triggers such as the left atrial appendage and coronary sinus, along with isoproterenol challenge, can achieve long-term arrhythmia freedom despite the potential need for repeat procedures.
May inform non-PV trigger ablation in persistent AF; leaves open efficacy and generalizability pending controlled trials.
Longstanding-persistent atrial fibrillation is one of the most challenging arrhythmias to treat. While radiofrequency catheter ablation is highly effective in paroxysmal atrial fibrillation, pulmonary vein antral isolation (including posterior wall isolation) alone is not enough for nonparoxysmal atrial fibrillation, other targets should be sought in this population. In this case report, we will describe our approach in a typical patient presenting for a first-time ablation procedure for longstanding persistent atrial fibrillation.
No takes yet. Share an insight, caveat, or question.
Gianni et al. (2020) conducted a case report in Longstanding persistent atrial fibrillation (n=1). Radiofrequency catheter ablation targeting non-pulmonary vein triggers was evaluated on Arrhythmia recurrence. In a 74-year-old woman with longstanding persistent atrial fibrillation, radiofrequency catheter ablation targeting non-pulmonary vein triggers, followed by a repeat procedure for reconnections, resulted in freedom from arrhythmia recurrence.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: