Catheter Ablation for Atrial Fibrillation: Improving Durability of Pulmonary Vein Isolation and Patient Selection

This thesis focuses on improving the outcomes of catheter ablation of atrial fibrillation (AF), which has emerged as an important treatment option in symptomatic AF patients. Pulmonary vein isolation (PVI) is the cornerstone of AF ablation procedures and focal radiofrequency (RF) ablation currently remains the most commonly employed method for PVI. However, despite advancing of ablation technologies and the increased number of AF ablation procedures performed worldwide, recurrence of AF is frequently observed after PVI. For a significant part, this is due to reconnection of pulmonary veins (PVs) after the initial isolation procedure. Apart from failing to durably isolate the PVs, the inability to reliably discriminate between patients who will or will not benefit from AF ablation may also impact outcomes of PVI. The first part of this thesis focused on ablation techniques and mechanisms that are associated with AF ablation outcomes. The second part of this thesis focused on improving patient selection for AF ablation.