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How to perform posterior wall isolation in catheter ablation for atrial fibrillation |
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| Authors: | Hariharan Sugumar MBBS Stuart P. Thomas MBBS PhD Sandeep Prabhu MBBS Aleksandr Voskoboinik MBBS Peter M. Kistler MBBS PhD |
| Affiliation: | 1. The Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia;2. Heart Centre, The Alfred Hospital, Melbourne, Victoria, Australia;3. Royal Melbourne Hospital, Melbourne, Victoria, Australia;4. University of Melbourne, Melbourne, Victoria, Australia;5. Westmead Hospital, University of Sydney and Macquarie University, Sydney, New South Wales, Australia |
| Abstract: | Catheter ablation has become standard of care in patients with symptomatic atrial fibrillation (AF). Although there have been significant advances in our understanding and technology, a substantial proportion of patients have ongoing AF requiring repeat procedures. Pulmonary vein isolation (PVI) is the cornerstone of AF ablation; however, it is less effective in patients with persistent as opposed to paroxysmal atrial fibrillation. Left atrial posterior wall isolation (PWI) is commonly performed as an adjunct to PVI in patients with persistent AF with nonrandomized studies showing improved outcomes. Anatomical considerations and detailed outline of the various approaches and techniques to performing PWI are detailed, and advantages and pitfalls to assist the clinical electrophysiologist successfully and safely complete PWI are described. |
| Keywords: | ablation techniques atrial fibrillation catheter ablation posterior wall isolation |