Key result
A combined endocardial and epicardial ablation approach was required to create an electrically continuous posterior box lesion in 1 patient with persistent atrial fibrillation.
Case Report (n=1)
A combined endocardial and epicardial approach may be required to achieve fully transmural linear atrial lesions for a posterior box lesion set in persistent AF.
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Combined endo-epicardial ablation may be required for transmural posterior box lesions; leaves open hybrid strategy efficacy in AF.
Similar to the surgical mini-maze procedure, the posterior "box" lesion set employs linear ablation lesions along the anterior aspects of both sets of PVs connected by a roof line and an inferior line to electrically isolate the PVs and complete posterior LA wall en masse. However, creating fully transmural linear atrial lesions can be difficult to achieve, even with an irrigated ablation catheter. This report details a case wherein a combined endocardial and epicardial approach was required to create an electrically continuous posterior box lesion in a patient with persistent AF.
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Reddy et al. (2007) conducted a case report in Persistent atrial fibrillation (n=1). Combined endocardial and epicardial ablation was evaluated on Creation of an electrically continuous posterior box lesion. A combined endocardial and epicardial ablation approach was required to create an electrically continuous posterior box lesion in 1 patient with persistent atrial fibrillation.
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