Key result
A comprehensive catheter ablation approach including pulmonary vein isolation, posterior wall isolation, and rigorous non-pulmonary vein trigger elimination successfully restored long-term sinus rhythm in a patient with long-standing persistent atrial fibrillation.
Why the study?
Catheter ablation of long-standing persistent AF presents unique challenges, and a lack of large body of evidence creates disagreement and differing treatment approaches.
Case Report (n=1)
No
A comprehensive ablation strategy including pulmonary vein isolation, posterior wall isolation, and rigorous non-pulmonary vein trigger elimination can successfully maintain long-term sinus rhythm in patients with long-standing persistent atrial fibrillation.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for posterior wall and coronary sinus re-isolation in refractory long-standing persistent AF; prospective trials needed before practice change.
Catheter ablation of long-standing persistent atrial fibrillation (LSPAF) presents unique challenges and the lack of large body of evidence surrounding management makes for disagreement and different approaches for treatment. Outlined is a case example that offers a comprehensive approach to ablation in patients with LSPAF that consists of risk factor management, an ablation strategy, a rigorous trigger protocol and follow-up rhythm monitoring. The case presented highlights management of this difficult population as best guided by current evidence and our experience. Ablation treatment and management strategies will continue to evolve with further randomized data and the advent of improved ablation technologies.
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Smietana et al. (2020) conducted a case report in Long-standing persistent atrial fibrillation (n=1). Catheter ablation was evaluated on Maintenance of sinus rhythm. A comprehensive catheter ablation approach including pulmonary vein isolation, posterior wall isolation, and rigorous non-pulmonary vein trigger elimination successfully restored long-term sinus rhythm in a patient with long-standing persistent atrial fibrillation.
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