Key result
Circumferential pulmonary vein isolation and new adjunctive ablation strategies have been established as principal procedures with high cure rates for paroxysmal and persistent atrial fibrillation.
This review highlights current advancements in catheter ablation strategies for atrial fibrillation, emphasizing the need for long-term investigation of adjunctive techniques for persistent AF.
Supports PVI-based ablation as AF mainstay; leaves open optimal adjunctive strategies for persistent AF pending long-term data.
Curing atrial fibrillation (AF) by catheter ablation has significantly improved patient morbidity and mortality. The circumferential pulmonary vein isolation technique is established as the principal procedure, with a high cure rate and acceptable safety, for paroxysmal AF, but new adjunctive ablation strategies targeting the AF substrates and sources for long-standing persistent/chronic AF have been developed. These new techniques include linear ablation, complex fractionated atrial electrogram guided ablation, dominant frequency map-guided ablation, ganglionated plexi ablation and disconnection of the coronary sinus and superior vena cava to ablate the AF substrates and sources. The long-term usefulness of the established technique and these innovative adjunctive approaches for the treatment of AF remains to be investigated.
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Iesaka et al. (2007) conducted a review in Atrial fibrillation. Catheter ablation (circumferential pulmonary vein isolation and adjunctive strategies) was evaluated. Circumferential pulmonary vein isolation and new adjunctive ablation strategies have been established as principal procedures with high cure rates for paroxysmal and persistent atrial fibrillation.
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