Toward a Uniform Ablation Protocol for Paroxysmal, Persistent, and Permanent Atrial Fibrillation

Domenico Giovanni Della Rocca¹, Carlo Lavalle², Carola Gianni³, Marco Valerio Mariani², Sanghamitra Mohanty³, Chintan Trivedi³, Ugur Canpolat⁴, Bryan MacDonald³, Huseyin Ayhan⁵, Agostino Piro², Mohamed Bassiouny³, Amin Al-Ahmad³, John David Burkhardt³, Joseph G Gallinghouse³, Rodney P Horton³, Javier Sanchez³, Nicola Tarantino⁶, Luigi Di Biase⁷, Andrea Natale⁸

Affiliations

¹ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA. Electronic address: domenicodellarocca@hotmail.it.
² Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy.
³ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA.
⁴ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA; Arrhythmia and Electrophysiology Unit, Department of Cardiology, Hacettepe University, Sihhiye, Ankara 06532, Turkey.
⁵ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA; Department of Cardiology, Ankara Yildirim Beyazit, Ankara, Turkey.
⁶ Montefiore Medical Center, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA.
⁷ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA; Department of Biomedical Engineering, University of Texas, 107 West Dean Keeton Street, Austin, TX 78712, USA; Montefiore Medical Center, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA; Department of Clinical and Experimental Medicine, University of Foggia, Via A. Gramsci, Foggia, Italy.
⁸ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA; Department of Biomedical Engineering, University of Texas, 107 West Dean Keeton Street, Austin, TX 78712, USA; Interventional Electrophysiology, Scripps Clinic, 9898 Genesee Avenue, La Jolla, CA 92037, USA; MetroHealth Medical Center, Case Western Reserve University School of Medicine, 10900 Euclid Avenue, Cleveland, OH 44106, USA; Division of Cardiology, Stanford University, 291 Campus Drive, Stanford, CA 94305, USA.

PMID: 31706479
DOI: 10.1016/j.ccep.2019.08.014

Review

Toward a Uniform Ablation Protocol for Paroxysmal, Persistent, and Permanent Atrial Fibrillation

Domenico Giovanni Della Rocca et al. Card Electrophysiol Clin. 2019 Dec.

. 2019 Dec;11(4):731-738.

doi: 10.1016/j.ccep.2019.08.014.

Authors

Affiliations

¹ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA. Electronic address: domenicodellarocca@hotmail.it.
² Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy.
³ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA.
⁴ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA; Arrhythmia and Electrophysiology Unit, Department of Cardiology, Hacettepe University, Sihhiye, Ankara 06532, Turkey.
⁵ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA; Department of Cardiology, Ankara Yildirim Beyazit, Ankara, Turkey.
⁶ Montefiore Medical Center, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA.
⁷ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA; Department of Biomedical Engineering, University of Texas, 107 West Dean Keeton Street, Austin, TX 78712, USA; Montefiore Medical Center, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA; Department of Clinical and Experimental Medicine, University of Foggia, Via A. Gramsci, Foggia, Italy.
⁸ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA; Department of Biomedical Engineering, University of Texas, 107 West Dean Keeton Street, Austin, TX 78712, USA; Interventional Electrophysiology, Scripps Clinic, 9898 Genesee Avenue, La Jolla, CA 92037, USA; MetroHealth Medical Center, Case Western Reserve University School of Medicine, 10900 Euclid Avenue, Cleveland, OH 44106, USA; Division of Cardiology, Stanford University, 291 Campus Drive, Stanford, CA 94305, USA.

PMID: 31706479
DOI: 10.1016/j.ccep.2019.08.014

Abstract

Atrial fibrillation catheter ablation has emerged as the most effective strategy to restore and maintain sinus rhythm. The cornerstone of atrial fibrillation ablation is elimination of triggers from the pulmonary veins by pulmonary vein isolation. Nevertheless, some patients may experience atrial tachyarrhythmia recurrences even with permanent pulmonary vein antral isolation. Whether and in which patients pulmonary vein antral isolation should be considered as the only ablation strategy remains a matter of debate. This review aims to summarize the rationale and effectiveness of different ablation approaches and identify key points for a uniform atrial fibrillation ablation strategy.

Keywords: Anticoagulation; Atrial fibrillation; Catheter ablation; Outcome; Stroke; Substrate; Trigger.

PubMed Disclaimer

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
- ClinicalKey
- Elsevier Science
Medical
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Toward a Uniform Ablation Protocol for Paroxysmal, Persistent, and Permanent Atrial Fibrillation

Affiliations

Toward a Uniform Ablation Protocol for Paroxysmal, Persistent, and Permanent Atrial Fibrillation

Authors

Affiliations

Abstract

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical