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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Atrial fibrillation ablation: evolution of the curative approach

Leonardo Arrantes1, Fiorenzo Gaita2, Kang-teng Lim1, Marco Scaglione2, Pierre Jais1, Mélèze Hocini1, Seiichiro Matsuo1, Sebastien Knecht1 and Michel Haïssaguerre1,*

1 Service de Rythmologie, Hôpital Cardiologique du Haut-Lévêque and the Université Victor Segalen Bordeaux II, Avenue de Magellan, Bordeaux-Pessac 33604, France
2 Ospedale Civile Cardinal Massaia, Asti, Italy

* Corresponding author. Fax: +33 5 57 65 65 09. E-mail address: jacques.clementy{at}pu.u-bordeaux2.fr

The morbidity and mortality of atrial fibrillation (AF) makes the search for a curative approach one of the main quests in modern electrophysiology. After the ground-breaking steps of surgery for AF, recognition of the pulmonary veins’ (PVs) role in triggering AF, followed by the PV isolation (PVI) technique brought new hope for catheter ablation for AF. Safety and success were progressively improved in parallel with improvements in technological tools. The mechanistic heterogeneity of AF, enhanced in the chronic form, may explain the limited success of PVI alone in long-standing AF. This complex environment needs multiple approaches to extend the success rate to the whole spectrum of AF. Increase in mechanistic knowledge and technology may result in broader indications.

Key Words: Atrial fibrillation • Catheter ablation • Surgery


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