Pulmonary vein isolation without reconnection: a decade of trying.

摘要

As the first decade of the 21st century has ended, after reviewing progress in the field of clinical electrophysiology, historians will likely place catheter ablation of atrial fibrillation (AF) as the most important development in this period-ahead of cardiac resynchronization therapy for treatment of congestive heart failure. Interestingly, despite growing acceptance of catheter ablation for supraventricular tachycardia at the beginning of the last decade, physicians had either a lukewarm or even cynical view of AF ablation because this approach was: (1) merely targeting the culprit pulmonary vein (PV) foci triggering AF, (2) quite limited by the long procedure time needed to identify the AF triggers, and (3) associated with a low success rate. Many investigators also believed that most of the AF triggers came from multiple PV sites, which needed to be ablated to stop AF recurrences.