Dreaming of a 'Swiss Army Knife' for atrial fibrillation ablation ...

Abstract

This editorial refers to ‘Pulmonary vein anatomy and long-term outcome after multielectrode pulmonary vein isolation with phased radiofrequency energy for paroxysmal atrial fibrillation’ by A.A.W. Mulder et al ., on page 1557 One of the most challenging issues in atrial fibrillation (AF) ablation is the reproducibility and standardization of the procedure. Since the beginning, radiofrequency catheter ablation has had a relatively wide ‘uncertainty’ regarding its success rates in all kinds of arrhythmias. In the AF setting, at least three factors may be considered: the learning curve, individual patient's cardiac anatomy, and the adequacy of the tools used. The learning curve will always be necessary to tame a new technique,1 but may be significantly shortened in the setting of experienced teams, especially if specific fellowship programmes are provided in such tertiary centres. Patients' anatomical variability is inevitable, but we can better control its impact by improving knowledge of anatomy, via learning sessions and better …