Meta-analyses
Meta-analyses of studies employing LVA ablation in addition to PVI do demonstrate improved freedom from AF and reduced rates of post-ablation atrial tachycardia with VGA when compared to conventional ablation approaches (31,32). However, as evident in Table 1, most data are from observational studies with relatively small cohorts of patients, a mixed history of AF duration, and many utilizing historical outcomes as controls. Moreover, the strategies employed in delineating and ablating LVAs are highly heterogeneous with respect to catheter properties, mapping rhythm and voltage thresholds making detailed comparisons challenging.