Studies have demonstrated that myocardium surrounding pulmonary vein (PV) ostia plays an important role in the initiation and perpetuation of atrial fibrillation (AF).1,2 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.
