Pedrote A, Acosta J, Jáuregui-Garrido B, Frutos-López M, Arana-Rueda E. Paroxysmal atrial fibrillation ablation: Achieving permanent pulmonary vein isolation by point-by-point radiofrequency lesions. World J Cardiol 2017; 9(3): 230-240 [PMID: 28400919 DOI: 10.4330/wjc.v9.i3.230]
Corresponding Author of This Article
Alonso Pedrote, MD, PhD, Arrhythmia Section, Cardiology Department, Virgen del Rocío University Hospital, C/ Manuel Siurot s/n, 41013 Seville, Spain. pedrote@hotmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Alonso Pedrote, Juan Acosta, Beatriz Jáuregui-Garrido, Manuel Frutos-López, Eduardo Arana-Rueda
Alonso Pedrote, Juan Acosta, Beatriz Jáuregui-Garrido, Manuel Frutos-López, Eduardo Arana-Rueda, Arrhythmia Section, Cardiology Department, Virgen del Rocío University Hospital, 41013 Seville, Spain
Author contributions: Pedrote A and Acosta J performed the majority of the writing; Jáuregui-Garrido B contributed to writing; Frutos-López M and Arana-Rueda E prepared figures and tables, contributed to review of the literature and discussed the manuscript; Pedrote A designed the outline and coordinated the writing of the paper.
Conflict-of-interest statement: There is no conflict of interest associated with any of the authors.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Alonso Pedrote, MD, PhD, Arrhythmia Section, Cardiology Department, Virgen del Rocío University Hospital, C/ Manuel Siurot s/n, 41013 Seville, Spain. pedrote@hotmail.com
Telephone: +34-659-108232
Received: October 27, 2016 Peer-review started: November 2, 2016 First decision: December 1, 2016 Revised: December 14, 2016 Accepted: January 11, 2017 Article in press: January 14, 2017 Published online: March 26, 2017 Processing time: 150 Days and 15.7 Hours
Abstract
Pulmonary vein isolation by point-by-point radiofrequency catheter ablation constitutes the cornerstone of catheter ablation strategies for the treatment of atrial fibrillation. However, despite advances in pulmonary vein isolation ablation strategies, long-term success rates after ablation remain suboptimal, which highlights the need to develop techniques to achieve more durable lesions. Strategies proposed to improve the durability of pulmonary vein isolation can be divided into two groups: Those addressed to improving the quality of the lesion and those that optimize the detection of acute PV reconnection during the ablation procedure. This manuscript reviews the role and potential benefits of these techniques according to current clinical evidence.
Core tip: Results of pulmonary vein isolation remains suboptimal in terms of long-term outcomes. Improving lesion durability could reduce atrial fibrillation recurrence rate after pulmonary vein isolation. This manuscript reviews current techniques proposed in order to achieve more durable pulmonary vein isolation by point-by-point radiofrequency ablation. The role and potential benefits of these techniques are discussed according to current clinical evidence. Furthermore a stepwise approach to achieve permanent pulmonary vein isolation is proposed.
