Ablation strategies for repeat ablation in patients with
durably isolated PVs
Figure 3 provides an overview of distribution of individual strategies
and number of strategies performed. In 12.0% of the 274 patients with
durably isolated PVs no additional ablation was performed. A single
ablation strategy was performed most often (41.2%), followed by two
(32.1%), three (12.8%), and four (1.8%) strategies.
Posterior box ablation was the most frequently applied (58.4%) ablation
strategy, followed by antralization of the PVs (26.3%). Roof line
ablation alone was performed in 17 (6.2%) patients, while creation of
an inferior line alone was performed in 1 (0.4%) patient. Posterior box
creation through combined roof and inferior lines was performed in
34.3% of patients (58.8% of all posterior wall ablation cases). A
mitral isthmus line was applied in 48 (17.6%) patients and CTI ablation
in 72 (26.3%) patients. Trigger ablation was performed in 33 (12.0%)
patients with the following triggers: superior vena cava in 14 (5.1%)
patients, LAA in 4 (1.5%) patients, coronary sinus in 8 (2.9%)
patients, other triggers in 10 (3.7%) patients. Low voltage area
ablation was performed in 36 (13.1%) patients and CFAE ablation was
performed in 43 (15.7%) patients. When comparing patients with
paroxysmal AF to those with persistent AF, posterior box ablation was
more commonly performed in the persistent AF group (p<0.05, see
Appendix Table 1A). Additionally, persistent AF patients received more
often a higher number of ablation strategies compared to patients with
paroxysmal AF (p<0.05).