Long-standing persistent atrial fibrillation ablation

Luigi Di Biase, Pasquale Santangeli, Alessandro Paoletti Perini, Francesco Santoro, Rong Bai, Javier E. Sanchez, Rodney Horton, John David Burkhardt, Andrea Natale

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

This chapter summarizes the ablation strategy approaches described in the literature for the treatment of long-standing persistent AF and more extensively the author's approach that we believe allows a better outcome at the long-term follow-up. Pulmonary vein electrical isolation (PVI) alone has dismal success rate at 2 years follow-up not exceeding 25%. The approach is that the most effective at the long-term follow-up includes in addition to PVI electrical isolation of the posterior wall, the roof, the coronary sinus, the left septum, and the left atrial appendage with or without CFAEs. The chapter presents preliminary data of long-standing persistent AF ablation while on rivaroxaban showing that it is as safe as warfarin. The "BELIEF" study (NCT01362738) randomizing patients with long-standing persistent atrial fibrillation to empirical LAA isolation plus standard approach versus standard approach without LAA isolation will clarify the relevance of the LAA isolation in patients with LSP.

Original languageEnglish (US)
Title of host publicationPractical Guide to Catheter Ablation of Atrial Fibrillation
Subtitle of host publicationSecond Edition
PublisherWiley-Blackwell
Pages315-322
Number of pages8
ISBN (Electronic)9781118658369
ISBN (Print)9781118658505
DOIs
StatePublished - Dec 5 2015

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Keywords

  • Cathetar ablation
  • Long-standing persistent atrial fibrillation
  • Pulmonary vein electrical isolation
  • Rivaroxaban

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Di Biase, L., Santangeli, P., Perini, A. P., Santoro, F., Bai, R., Sanchez, J. E., Horton, R., Burkhardt, J. D., & Natale, A. (2015). Long-standing persistent atrial fibrillation ablation. In Practical Guide to Catheter Ablation of Atrial Fibrillation: Second Edition (pp. 315-322). Wiley-Blackwell. https://doi.org/10.1002/9781118658369.ch22