One of the greatest discoveries in cardiac electrophysiology was the
recognition of the crucial role of pulmonary vein (PV) myocardial sleeves for atrial
fibrillation (AF) initiation. Based on this concept, catheter ablation of paroxysmal
AF by pulmonary vein isolation (PVI) has become a routine approach for this
arrhythmia.
An attractive concept implies the selective isolation of the
arrhythmogenic PVs only. Based on the most important studies regarding this
approach, we describe pros and cons of a selective PVI compared to a complete PVI
and try to illustrate why selective PVI did not find widespread acceptance in
the electrophysiologic community.
Credits: Sonia Ammar, MD; Tilko Reents, MD; Stephanie Fichtner, MD; Gabriele Hessling, MD; Isabel Deisenhofer, MD