Claudio Tondo, M.D., Ph.D., FESC, FHRS
Heart Rhythm Center, Department of Clinical Electrophysiology and Cardiac Pacing, Monzino Cardiology Center, Department of Biochemical, Surgical and Dentist Sciences, University of Milan, Milan, Italy
“ Funding: None”
“ Conflict of interest: None”
Correspondence:
Prof. Claudio Tondo, M.D., Ph.D., FESC, FHRS
Heart Rhythm Center, Department of Clinical Electrophysiology and Cardiac Pacing,
Monzino Cardiology Center,
Department of Biochemical, Surgical and Dentist Sciences, University of Milan, Milan, Italy
Via Carlo Parea, 4 – 20128 Milano, Italy
Email address: claudio.tondo@cardiologicomonzino.it; claudio.tondo@unimi.it n
In this issue of the Journal of Cardiovascular Electrophysiology, Sayuri et al discuss the role of isolation of left atrial posterior wall (PWI) in addition to pulmonary vein isolation (PVI) in the treatment of persistent AF patients and, in particular with regards to recurrent atrial arrhythmias (1)
More in detail, the authors compared PVI only strategy to PVI plus PWI and PWI was achieved through the creation of roof line between the two superior PVs and bottom line between the two inferior PVs (the so-called “box lesion”). They found that PWI for persistent AF was more effective in reducing episodes of recurrent persistent AF with no increase in recurrent atrial tachycardias (AT). The authors have touched a very controversial issue and whether the isolation of LPW is required or promotes additional advantages over PVI alone in patients with persistent AF is still unclear and debatable argument