“This recommendation was based on observational studies, not on a prospective randomized trial. But some electrophysiologists (EPs) continue to believe that it’s sufficient to create incomplete linear lesions where conduction sites still exist between the pulmonary veins and left atrium,” explained Professor Karl Kuck, from Asklepios Klinik St George, Hamburg ,Germany, presenter of the GAP-AF study.
“The study shows us for the first time that complete isolation of the pulmonary veins is more effective than incomplete isolation. It suggests that the level of evidence for complete ablation should be upgraded from class Ic to class Ia, where it is supported by a multicentre randomized trial,” said Prof. Kuck.
“Our study shows that, if proper selection criteria are applied, ablation can achieve good results for patients with persistent AF,” said Mont. “It’s likely to have an impact on guidelines and may contribute to an upgrade of ablation in persistent AF to category 1B.” Results would not apply to patients with very dilated atrium and long standing persistent AF.
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