Complete pulmonary vein (PV) electrical isolation on the atrial level is the keystone and best-documented target for catheter ablation of patients with drug-refractory symptomatic atrial fibrillation (AF).1
For this reason, current guidelines state that ablation strategies targeting the PVs or PV antra are the cornerstone for most AF ablation procedures and that complete electric isolation and elimination of all PV potentials should be the main goal in overcoming the arrhythmia, with a Class I, Level of Evidence A recommendation.2
This approach is supported by the fact that PVs are not only the area of initiation (sustained PV tachycardia initiated by PV ectopy) but also play a role in the maintenance of AF in a large number of patients.1 The role of PV activity on the pathophysiology of AF is endorsed not only from all randomized clinical trials but also from experimental research.3
CITATION Europace. 2019 Aug 1;21(Supplement_3):iii2-iii4. doi: 10.1093/europace/euz110
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