Journal article

Persistent atrial fibrillation in the setting of pulmonary vein isolation-Where to next?

Peter M Kistler, David Chieng

Journal of Cardiovascular Electrophysiology | WILEY | Published : 2019

Abstract

Catheter ablation for atrial fibrillation (AF) is indicated in symptomatic patients who are intolerant or refractory to anti-arrhythmic therapy. However, outcomes from catheter ablation remain suboptimal in patients with persistent AF. Pulmonary vein antral isolation (PVAI) is established as the cornerstone of AF ablation strategies. The landmark STAR AF II study demonstrated a lack of incremental benefit with adjunctive linear and complex fractionated electrogram ablation beyond PVAI. Randomised studies thus far have failed to consistently show favourable outcomes from other trigger/ substrate based ablation approaches over PVAI alone. In this issue of the journal we pose an interesting cli..

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