For repeat catheter ablation in patients with recurrent atrial fibrillation and previously isolated pulmonary veins, the focus should be on substrate homogenization and targeted ablation of arrhythmogenic areas.
Supports targeted substrate ablation in repeat AF after PV isolation; hypothesis-generating and requires randomized validation.
Patients with atrial fibrillation often undergo repeat catheter ablation for the recurrence of tachyarrhythmia. If the pulmonary veins were isolated in prior procedure, the operator should focus on substrate homogenization with identification and ablation of only arrhythmogenic areas.
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Tomaiko et al. (2019) studied this question.
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