Abstract

ESPINOSA ANGUIANO, José Saul  and  INZUNZA-CERVANTES, Gustavo. Recurrent atrial fibrillation after ablation of pulmonary veins. Case series. Rev.Urug.Cardiol. [online]. 2023, vol.38, n.1, e405.  Epub Dec 01, 2023. ISSN 0797-0048.  https://doi.org/10.29277/cardio.38.1.8.

Pulmonary vein ablation has become a key treatment for atrial fibrillation (AF). However, recurrences can occur.

The ideal strategy for ablation after AF recurrence is controversial, complex, and challenging, with limited data available.

By presenting a series of cases, we summarize and discuss key elements in the understanding and treatment of patients with symptomatic recurrent AF after an initial pulmonary vein ablation procedure who are subjected to a new ablation procedure.

In recent decades, there has been a better understanding of the pathophysiological mechanisms involved in recurrent AF after pulmonary vein ablation, making it possible to identify associated factors, create predictive scores and implement optimization techniques or additional strategies to improve the durability and efficacy of pulmonary veins isolation. Because pulmonary vein reconnection is a typical finding during repeat procedures, it should be considered the primary goal for a repeat ablation procedure. Additional ablation strategies (extrapulmonary triggers or arrhythmogenic substrates) are controversial and require further investigation.

Keywords : atrial fibrillation; catheter ablation; pulmonary vein isolation; recurrences.

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