Catheter ablation for the treatment of atrial fibrillation – development of various technical modalities

Abstract

Treatment of atrial fibrillation (AF) remains a rapidly developing field of cardiology characterized by continuous technological improvements and a multidisciplinary approach to problem solving. In addition to searching for improved ablation methods for effective and safe pulmonary vein isolation, the efforts are also dedicated to upgrade the understanding of apparently chaotic mechanisms of action potential propagation during AF. The mechanisms of clinical AF can be explained by the hypothesis of triggers and drivers. According to this hypothesis, AF is triggered by premature beats originating mostly from the pulmonary veins and is maintained (driven) by local regions with slow action potential propagation located predominantly in the atrial wall where pulmonary veins enter the left atrium. Pulmonary vein isolation thus remains a corner stone of invasive treatment of AF.