Interesting Article on AF

Search for https: // www.ncbi.nlm.nih.gov/pubmed / 30459630...if the number at the end wont take when you paste you can search for it after you access the site.

It's not the numbers at the end that's the problem. It's the spaces. URLs can't have spaces in them. Try this:

https://www.ncbi.nlm.nih.gov/pubmed/30459630

Quote

No ablation strategy consistently demonstrated superiority to pulmonary vein isolation in preventing long term recurrences of atrial arrhythmias.

I think Dr. Natale would disagree with this statement. He and his group successfully ablate persistent afib regularly.

Here's the entire article:

https://www.frontiersin.org/articles/10.3389/fphys.2018.01458/full

"Later, wide area circumferential ablation that disconnects the PV two by two became the strategy of choice. This technique is thought to have better results (Lo et al., 2007) by targeting the trigger sources and the ostial drivers and also by autonomic denervation (Redfearn et al., 2007)."

Given how many folks who've had a PVI that has been successful in terms of preventing AF still get a lot of ectopics (many or most of which are from the PVs via reconnection - and I have seen a lot of research that confirms that almost all folks with one ablation under their belt invariably get some degree of reconnection), I've always suspected/thought that a successful PVI is way more than 'just' preventing errant signals from the PVs entering the atria. So its interesting to read that PVI is as much about targeting ostial drivers and autonomic denervation as it is about isolating the PVs per se.

Really good article in my opinion. Thanks for posting it guys.

(Explains why when ablating me as a PAFr Pierre Jais - a co-author of the article - at Bordeaux was in no rush to go exploring elsewhere in the atria when in his view a good thorough PVI ought to be enough.)

I put the spaces in Carey because for some unknown reason it wouldn't copy across in my message so I just spaced it and it worked.. Maybe it's because I'm from a land down under