Catheter ablation is widely used to
treat drug-refractory, symptomatic atrial fibrillation (AF). However, beyond
pulmonary vein isolation, there remains little consensus on the recommended
approach to ablation both in paroxysmal or persistent AF patients. Although
ancillary ablation strategies are often used, the lack of a clear endpoint for
AF ablation makes it challenging to evaluating their importance.
Non-inducibility of AF and termination of AF during AF ablation have been
advocated as potential endpoints. Several studies have attempted to assess
their role in an AF ablation protocol. However,
the data for non-inducibility and termination as endpoints are mixed. Moreover,
there are a number of limitations in the studies reported and limitations of
the endpoints themselves. It is likely that non-inducibility of AF or
termination of AF during AF ablation may be markers of less structural
remodeling rather than true endpoints for ablation. Herein, we review the
relevant literature on the topic of inducibility and termination with respect
to AF ablation and attempt to draw conclusions with guidance to further
investigation.
Credits: Matthew Baker; Prabhat Kumar; James Hummel; Anil Gehi