Favorable effect of pulmonic vein isolation by partial circumferential ablation on ostial flow velocity

Transesophageal Echocardiographic Assessment of Pulmonary Veins and Left Atrium in Patients Undergoing Atrial Fibrillation Ablation

“…Although both systolic and diastolic velocities increased after ablation, the increase in the diastolic velocities was relatively larger, so that the systolic to diastolic (S/D) flow velocity ratio decreased compared to the preablation values. Our results are consistent with previous reports describing an increase in peak PV flow velocities with the use of intracardiac echocardiography (ICE) following ostial PV ablation, 15 or partial circumferential PV ablation 16 . We have expanded these results by examining the relationship of the systolic and diastolic velocities in all 4 PVs.…”

Comparison of Cool Tip Versus 8‐mm Tip Catheter in Achieving Electrical Isolation of Pulmonary Veins for Long‐Term Control of Atrial Fibrillation: A Prospective Randomized Pilot Study

“…This would imply that even limited lesions in the posterior LA can result in esophageal injury and care should be applied when ablating in this area. Of note, this has been the only identified LA‐esophageal fistula in our entire AF ablation experience, which includes over 1,000 procedures the majority of which have been done using the 8‐mm tip 6,7,14,21 …”

“…Each participating subject underwent 3 weeks of transtelephonic monitoring (TTM) prior to admission, and during this period, they were instructed to make recordings twice daily as well as for any symptoms. Our ablation protocol has been previously described 6 . Briefly, two decapolar catheters with 5‐mm electrodes and 2‐mm interelectrode spacing were placed in coronary sinus and posterior right atrium (RA).…”

Catheter Ablation for Persistent Atrial Fibrillation

“…Contrary to this practice and regardless of the type of AF, our group at the Hospital of the University of Pennsylvania has consistently used an approach comprising pulmonary vein isolation (PVI) with additional targeting of non-PV trigger sites of AF that are identified by a standard stimulation protocol. [14][15][16][17][18][19][20][21][22][23][24] Using this methodology, we have reported outcomes in patients with persistent and long-standing persistent AF, which are comparable with the results achieved by more extensive ablation strategies, including CFE ablation. The purpose of this review is to offer the readers our perspective on the importance of PVs in more established forms of AF and why targeting them (together with documented non-PV trigger sites) remains our preferred ablation strategy for this group of patients.…”