Not Safe at Any Velocity: Left Atrial Appendage Emptying and Cessation of Anticoagulation After Appendage Electrical Isolation.

Abstract

Catheter-based ablation targeting pulmonary vein isolation has become a widely used first-line therapy for patients with paroxysmal atrial fibrillation (AF) with excellent safety and efficacy. In patients with persistent and longstanding persistent AF, ablation outcomes remain suboptimal due to a more complex substrate and more advanced left atrial adverse remodeling. Multiple strategies which target left atrial substrate modification have been proposed over the past decade to improve clinical outcomes in nonparoxysmal AF patients without clear benefit.