The Yin and Yang of the persistent atrial fibrillation catheter ablation: Posterior wall isolation and novel pulsed field ablation technology

Journal of Cardiovascular ElectrophysiologyEarly View INVITED EDITORIAL The Yin and Yang of the persistent atrial fibrillation catheter ablation: Posterior wall isolation and novel pulsed field ablation technology Ugur Canpolat MD, Corresponding Author Ugur Canpolat MD [email protected] orcid.org/0000-0002-4250-1706 Department of Cardiology, Arrhythmia, and Electrophysiology Unit, Hacettepe University Faculty of Medicine, Ankara, Turkey Correspondence Ugur Canpolat, MD, Department of Cardiology, Arrhythmia and Electrophysiology Unit, Hacettepe University Faculty of Medicine, Altindag 06100, Ankara, Turkey. Email: [email protected]Search for more papers by this author Ugur Canpolat MD, Corresponding Author Ugur Canpolat MD [email protected] orcid.org/0000-0002-4250-1706 Department of Cardiology, Arrhythmia, and Electrophysiology Unit, Hacettepe University Faculty of Medicine, Ankara, Turkey Correspondence Ugur Canpolat, MD, Department of Cardiology, Arrhythmia and Electrophysiology Unit, Hacettepe University Faculty of Medicine, Altindag 06100, Ankara, Turkey. Email: [email protected]Search for more papers by this author First published: 03 April 2024 https://doi.org/10.1111/jce.16273 Disclosures: None. 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Effect of catheter ablation using pulmonary vein isolation with vs without posterior left atrial wall isolation on atrial arrhythmia recurrence in patients with persistent atrial fibrillation: the CAPLA randomized clinical trial. JAMA. 2023; 329(2): 127-135. 10.1001/jama.2022.23722 PubMedWeb of Science®Google Scholar 3Kanitsoraphan C, Rattanawong P, Techorueangwiwat C, et al. The efficacy of posterior wall isolation in atrial fibrillation ablation: a systematic review and meta-analysis of randomized controlled trials. J Arrhythm. 2022; 38(3): 275-286. 10.1002/joa3.12698 PubMedWeb of Science®Google Scholar 4Shrestha DB, Pathak BD, Thapa N, et al. Catheter ablation using pulmonary vein isolation with versus without left atrial posterior wall isolation for persistent atrial fibrillation: an updated systematic review and meta-analysis. J Interv Card Electrophysiol. 2023. In press. doi:10.1007/s10840-023-01656-z 10.1007/s10840-023-01656-z Web of Science®Google Scholar 5Bai R, Di Biase L, Mohanty P, et al. Proven isolation of the pulmonary vein antrum with or without left atrial posterior wall isolation in patients with persistent atrial fibrillation. Heart Rhythm. 2016; 13(1): 132-140. 10.1016/j.hrthm.2015.08.019 PubMedWeb of Science®Google Scholar 6Aryana A, Baker JH, Espinosa Ginic MA, et al. Posterior wall isolation using the cryoballoon in conjunction with pulmonary vein ablation is superior to pulmonary vein isolation alone in patients with persistent atrial fibrillation: a multicenter experience. Heart Rhythm. 2018; 15(8): 1121-1129. 10.1016/j.hrthm.2018.05.014 PubMedWeb of Science®Google Scholar 7Clarke JRD, Piccini JP, Friedman DJ. The role of posterior wall isolation in catheter ablation of persistent atrial fibrillation. J Cardiovasc Electrophysiol. 2021; 32(9): 2567-2576. 10.1111/jce.15164 PubMedWeb of Science®Google Scholar 8Bradley CJ, Haines DE. Pulsed field ablation for pulmonary vein isolation in the treatment of atrial fibrillation. J Cardiovasc Electrophysiol. 2020; 31(8): 2136-2147. 10.1111/jce.14414 PubMedWeb of Science®Google Scholar 9Reddy VY, Neuzil P, Koruth JS, et al. Pulsed field ablation for pulmonary vein isolation in atrial fibrillation. J Am Coll Cardiol. 2019; 74(3): 315-326. 10.1016/j.jacc.2019.04.021 PubMedWeb of Science®Google Scholar 10Ekanem E, Reddy VY, Schmidt B, et al. Multi-national survey on the methods, efficacy, and safety on the post-approval clinical use of pulsed field ablation (MANIFEST-PF). EP Europace. 2022; 24(8): 1256-1266. 10.1093/europace/euac050 PubMedWeb of Science®Google Scholar 11Schmidt B, Bordignon S, Neven K, et al. EUropean real-world outcomes with pulsed field ablation in patients with symptomatic atRIAl fibrillation: lessons from the multi-centre EU-PORIA registry. Europace. 2023; 25(7):euad185. doi:10.1093/europace/euad185 10.1093/europace/euad185 PubMedWeb of Science®Google Scholar 12Reddy VY, Dukkipati SR, Neuzil P, et al. Pulsed field ablation of paroxysmal atrial fibrillation. JACC Clin Electrophysiol. 2021; 7(5): 614-627. 10.1016/j.jacep.2021.02.014 PubMedGoogle Scholar 13Reddy VY, Gerstenfeld EP, Natale A, et al. Pulsed field or conventional thermal ablation for paroxysmal atrial fibrillation. N Engl J Med. 2023; 389(18): 1660-1671. 10.1056/NEJMoa2307291 CASPubMedGoogle Scholar 14Reddy VY, Anic A, Koruth J, et al. Pulsed field ablation in patients with persistent atrial fibrillation. J Am Coll Cardiol. 2020; 76(9): 1068-1080. 10.1016/j.jacc.2020.07.007 PubMedWeb of Science®Google Scholar 15Liang Z, Liu L, Cheng L, et al. New method and electrophysiological characteristics of LA posterior wall isolation in persistent atrial fibrillation. Pacing Clin Electrophysiol. 2021; 44(10): 1691-1700. 10.1111/pace.14220 PubMedWeb of Science®Google Scholar 16Gunawardene MA, Frommeyer G, Ellermann C, et al. Left atrial posterior wall isolation with pulsed field ablation in persistent atrial fibrillation. J Clin Med. 2023; 12(19): 6304. 10.3390/jcm12196304 PubMedWeb of Science®Google Scholar 17Turagam MK, Neuzil P, Schmidt B, et al. Impact of left atrial posterior wall ablation during Pulsed-Field ablation for persistent atrial fibrillation. JACC Clin Electrophysiol. 2024:S2405-500X(24)00030-6. doi:10.1016/j.jacep.2024.01.017 PubMedGoogle Scholar 18Badertscher P, Mannhart D, Weidlich S, et al. Left atrial posterior wall isolation using pulsed-field ablation: procedural characteristics, safety, and mid-term outcomes. J Interv Card Electrophysiol. 2024. In press. doi:10.1007/s10840-023-01728-0 10.1007/s10840-023-01728-0 Web of Science®Google Scholar 19Kueffer T, Tanner H, Madaffari A, et al. Posterior wall ablation by pulsed-field ablation: procedural safety, efficacy, and findings on redo procedures. Europace. 2023; 26(1):euae006. doi:10.1093/europace/euae006 10.1093/europace/euae006 PubMedWeb of Science®Google Scholar 20Lee JM, Shim J, Park J, et al. The electrical isolation of the left atrial posterior wall in catheter ablation of persistent atrial fibrillation. JACC Clin Electrophysiol. 2019; 5(11): 1253-1261. 10.1016/j.jacep.2019.08.021 PubMedGoogle Scholar Early ViewOnline Version of Record before inclusion in an issue ReferencesRelatedInformation