4 | DISCUSSION
Thermal ablation methods have the potential for adjacent tissue
damage.1 New energy sources have been developed to
address these issues. Despite the promising results in terms of efficacy
and safety of PVI with PFA in paroxysmal AF,7,8 the
PVI-only strategy may be insufficient for PeAF. Only a few studies have
demonstrated that PFA was a feasible and safe ablation approach for part
linear ablation in addition to PVI in PeAF
patients.11,12 Our study sought to evaluate a
comprehensive ablation strategy involving PVI, LAPW isolation, CTI
block, and MI block, with rigorous follow-up monitoring. The key finding
of the present study is that PFA, under the guidance of a 3-dimensional
mapping system, is effective and safe for PVI, linear block, and
posterior wall isolation, but the long-term durability of PFA lesions is
unsatisfying.