Fibrilación auricular recurrente posterior a ablación de venas pulmonares. Serie de casos

Abstract

Pulmonary vein ablation has become a key treatment for atrial fibrillation (AF). However, recurrences can occur. The ideal strategy for ablation after AF recurrence is controversial, complex, and challenging, with limited data available. By presenting a series of cases, we summarize and discuss key elements in the understanding and treatment of patients with symptomatic recurrent AF after an initial pulmonary vein ablation procedure who are sub - jected to a new ablation procedure. In recent decades, there has been a better understanding of the pathophysiological mechanisms involved in recurrent AF after pulmonary vein ablation, making it possible to identify associated factors, create predicti - ve scores and implement optimization techniques or additional strategies to improve the durability and effica - cy of pulmonary veins isolation. Because pulmonary vein reconnection is a typical finding during repeat proce - dures, it should be considered the primary goal for a repeat ablation procedure. Additional ablation strategies (extrapulmonary triggers or arrhythmogenic substrates) are controversial and require further investigation