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).