Key result
Adjunctive ablation strategies, including left atrial posterior wall, non-pulmonary vein trigger, and rotor ablation, appear to improve outcomes for non-paroxysmal AF when combined with PVAI.
Why the study?
Do adjunctive ablation strategies (LAPW, non-PV trigger, rotor ablation) improve outcomes when performed in conjunction with PVAI in patients with non-paroxysmal atrial fibrillation?
Do adjunctive ablation strategies (LAPW, non-PV trigger, rotor ablation) improve outcomes when performed in conjunction with PVAI in patients with non-paroxysmal atrial fibrillation?
Adjunctive ablation strategies such as LAPW, non-PV trigger, and rotor ablation may improve outcomes in non-paroxysmal AF when added to PVAI, though randomized trials are needed to confirm these findings.
LAPW ablation in nonparoxysmal AF lacks conclusive support; leaves open optimal adjunctive strategies pending dedicated RCTs.
The success rate of pulmonary vein antral isolation (PVAI) for paroxysmal atrial fibrillation (AF) has not been realized for persistent or long-standing AF, collectively termed nonparoxysmal AF. Many investigators have described adjunctive ablation strategies to improve outcomes for catheter ablation in patients with non-paroxysmal AF. In this focused review we aim to describe these therapies and current evidence pertaining to their utilization. At present, left atrial posterior wall (LAPW) ablation, non-pulmonary vein (non-PV) trigger ablation and rotor ablation appear to improve outcomes for patients with non-paroxysmal AF when performed in conjunction with PVAI. Randomized controlled trials are necessary to further elucidate such claims.
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Cohen et al. (2016) conducted a review in Non-paroxysmal atrial fibrillation. Adjunctive ablation strategies (LAPW ablation, non-PV trigger ablation, rotor ablation) was evaluated. Adjunctive ablation strategies, including left atrial posterior wall, non-pulmonary vein trigger, and rotor ablation, appear to improve outcomes for non-paroxysmal AF when combined with PVAI.
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