Addition of GP ablation to PVI confers a significantly higher success rate compared with either PVI or GP alone in patients with PAF.

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Recording of Marshall potential is feasible in patients with paroxysmal AF. Combined epicardial and endocardial catheter ablation of ligament of Marshall tissue may reduce the paroxysms of adrenergic AF.

Complex fractionated atrial electrograms at presumed anatomic sites of GP were identified in 68.8% patients with paroxysmal AF. In 11 patients without CFAE at the GP, CFAEs were recorded in the LA wall only in one patient. These findings suggest an association between CFAEs and GP.

Catheter ablation does not eliminate paroxysmal AF in up to 56% of patients in the long term, despite the use of two or three ablation procedures in two-thirds of them. However, it confers symptomatic improvement in 67% of treated patients.