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Approaches to Catheter Ablation of Nonparoxysmal Atrial Fibrillation

  • Arrhythmia (G Upadhyay, Section Editor)
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Abstract

Purpose of review

We describe the technical aspects and outcomes of several different ablation strategies for nonparoxysmal (persistent and long-standing persistent) atrial fibrillation (AF) and discuss our ablation strategy for these patients.

Recent findings

Catheter ablation is an effective treatment strategy for patients with AF. Outcomes of ablation in patients with nonparoxysmal forms of AF tend to be worse than in patients with paroxysmal AF. Several recent studies have examined the long-term ablation success rates of different ablation approaches in patients with nonparoxysmal AF. While observational studies have suggested benefit of several different ablation strategies for persistent AF, large randomized controlled studies have shown similar success rates with pulmonary vein isolation (PVI) alone as compared versus PVI plus additional ablation.

Summary

The optimal ablation strategy to achieve long-term freedom from recurrent arrhythmias in patients with nonparoxysmal AF remains controversial. Achieving durable PVI should be the cornerstone of AF ablation. Additional large-scale randomized controlled studies are necessary to determine whether additional ablation might result in improved long-term ablation success rates in these patients.

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Authors and Affiliations

  1. Electrophysiology Section, Cardiovascular Division, Hospital of the University of Pennsylvania, 9 Founders Pavilion – Cardiology, 3400 Spruce St, Philadelphia, PA, 19104, USA

    Jackson J. Liang DO, Daniele Muser MD & Pasquale Santangeli MD, PhD

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  1. Jackson J. Liang DO
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  2. Daniele Muser MD
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  3. Pasquale Santangeli MD, PhD
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Correspondence to Pasquale Santangeli MD, PhD.

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Liang, J.J., Muser, D. & Santangeli, P. Approaches to Catheter Ablation of Nonparoxysmal Atrial Fibrillation. Curr Treat Options Cardio Med 20, 39 (2018). https://doi.org/10.1007/s11936-018-0632-0

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