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Reasons for successful clinical outcome following pulmonary vein isolation despite lack of persistent LA‐PV conduction block
Author(s) -
Pandozi Claudio,
Lavalle Carlo,
Ficili Sabina,
Russo Maurizio,
Galeazzi Marco,
Rio Teresa,
Centurion Aznaran Carlos,
Malacrida Maurizio,
Colivicchi Furio
Publication year - 2019
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.13732
Subject(s) - medicine , pulmonary vein , atrial fibrillation , isolation (microbiology) , ablation , cardiology , catheter ablation , paroxysmal atrial fibrillation , intensive care medicine , bioinformatics , biology
The mechanisms of atrial fibrillation (AF) induction and maintenance, including those involved in paroxysmal atrial fibrillation, are not completely known; this limits our ablation strategies and prevents us from understanding what we are actually doing when performing pulmonary vein isolation. In this report, we focus on the commonly used ablation strategies for AF and question the importance of complete pulmonary vein isolation in achieving lasting success in the ablation of AF. We also discuss in detail the absence of durable pulmonary vein isolation in patients without arrhythmic recurrences after AF ablation and the possibility to cure paroxysmal AF without concomitant pulmonary vein isolation, provocatively questioning the dogma of pulmonary vein isolation as the cornerstone of AF ablation. Finally, a prospective personalized approach in the individual patient is advocated.