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Current perspectives on curative catheter ablation of atrial fibrillation

Hôpital Cardiologique du Haut-Lévêque, Avenue de Magellan, 33604 Pessac Cedex, France

Correspondence to:
Correspondence to:
Dr Dipen C Shah, Hôpital Cardiologique du Haut-Lévêque, Avenue de Magellan, 33604 Pessac Cedex, France;
jacques.clementy@pu.u-bordeaux2.fr

Keywords: catheter ablations; atrial fibrillation; pulmonary veins

Following the remarkable success of catheter based ablation techniques in curing regular supraventricular tachycardias, the attention of the electrophysiological community has turned upon atrial fibrillation based on the assumption that if surgical incisions with a knife can be duplicated by point by point lesions, a catheter based technique should provide results equivalent to the Maze procedure. Considering that transmurality is an inherent accompaniment of each knife incision, that a surgical atriotomy is much narrower than anything that catheters can currently achieve, and that lesion continuity and placement is assured under direct vision in the surgical field, it is not surprising to note the difficulty encountered in reproducing surgical results by catheter based techniques.

INITIAL ATTEMPTS AT LINEAR ABLATION
Two early studies attempted to intervene in both atria^1,2: one in a progressive incremental fashion and the other more directly imitating the surgical Maze with a biatrial approach. The essential lessons learned from these studies (and . . . [Full text of this article]

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