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How to determine and assess endpoints for left atrial ablation

Published:December 27, 2006DOI:https://doi.org/10.1016/j.hrthm.2006.12.028
      Studies have demonstrated that myocardium surrounding pulmonary vein (PV) ostia plays an important role in the initiation and perpetuation of atrial fibrillation (AF).
      • Haissaguerre M.
      • Jais P.
      • Shah D.C.
      • Takahashi A.
      • Hocini M.
      • Quiniou G.
      • Garrigue S.
      • Le Mouroux A.
      • Le Matayer P.
      • Clementy J.
      Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins.
      • Ouyang F.
      • Bänsch D.
      • Ernst S.
      • Schaumann A.
      • Hachiya H.
      • Chen M.
      • Chun J.
      • Falk P.
      • Khanedani A.
      • Antz M.
      • Kuck K.H.
      Complete isolation of left atrium surrounding the pulmonary veins: new insights from the double-Lasso technique in paroxysmal atrial fibrillation.
      This important finding has led to the development of segmental PV ostial isolation, circumferential ablation, and isolation around the PVs using circular linear lesions guided by three-dimensional (3D) electroanatomic mapping. Substrate modification using limited linear ablation also has been demonstrated to improve the clinical outcome after PV isolation in patients with AF inducibility. However, in the majority of ablation centers the most useful method is PV isolation using either segmental PV isolation or complete PV isolation guided by 3D mapping and Lasso catheters. Here we describe our technique for left atrial (LA) ablation in patients with paroxysmal or persistent AF.

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