Journal of Clinical Medicine
Evaluation of Intraprocedural Strategies to Assess Acute Pulmonary Vein Isolation After First-Pass Wide Antral Circumferential Ablation
By Lyuboslav Katov, Julian Ballweg, Yannick Teumer and 5 others.
Abstract
Background
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. While pulmonary vein isolation (PVI) remains the cornerstone of AF ablation, the optimal method for confirming complete acute isolation remains uncertain. This study evaluated the diagnostic value of pulmonary vein (PV) pacing compared with repeat three-dimensional (3D) electroanatomical mapping following wide antral circumferential ablation (WACA).
Methods
In this prospective observational study, 58 patients with paroxysmal or persistent AF undergoing bilateral WACA at the University Heart Center Ulm between November 2023 and April 2025 were included. Following successful PVI, pacing was performed from each PV and the corresponding carina region using a maximal stimulation output of 20 mA. Subsequently, comprehensive 3D re-mapping was performed to reassess electrical conduction. Results obtained from pacing maneuvers were compared with repeat mapping findings.