Risk Assessment and Treatment of Atrial Fibrillation: Focus on Catheter Ablation

Dear Colleagues,

We are launching a Special Issue titled “Risk Assessment and Treatment of Atrial Fibrillation: Focus on Catheter Ablation”.

Catheter ablation of atrial fibrillation with pulmonary vein isolation (PVI) as the cornerstone has evolved as superior to antiarrhythmic drugs (AADs) as initial therapy for patients with paroxysmal atrial fibrillation (AF).

Despite its remarkable success and expansion, many questions and challenges remain.

Can first-line ablation be propagated as initial therapy? For the moment it is not clear whether first-line ablation is superior to drug therapy in persistent AF. Data on the prognostic impact of ablation are still lacking, making it essential to consider ablation in asymptomatic patients. Can ablation have an impact on hard CV endpoints?

What is the ideal timing of ablation given the impact of diagnosis-to-ablation time on the risk for AF recurrence? Controversy exists at the present time as to whether it is as early as possible or if a certain period of time between diagnosis and ablation can be accepted.

Beyond the known clinical and procedural predictors, how can we further improve patient selection to maximize the likelihood of a positive response to ablation?

How to assess the patient with an early versus late recurrence after ablation?

We need further advantages in optimizing the ablation strategy beyond PVI in non-paroxysmal AF patients and in redo-procedures after failed PVI with persistent PVI.

The optimal ablation strategy beyond PVI has not been clarified in the non-paroxysmal AF population.

How will the new kid on the block, pulsed field ablation, further evolve? How does this technique relate to its predecessors, point-by-point RF ablation and cryoballoon ablation? Will mapping become essential in PVI by PFA? Will PFA result in acceptable PVI durability and clinical success rates? What could be the advantages of PFA in more difficult substrates, such as persistent AF?

As you see, there is a lot to investigate further. We invite you to submit your high-quality research on any of these topics. We will accept original research articles and reviews that highlight new advancements in the field of catheter ablation of atrial fibrillation.

Prof. Dr. Yves De Greef
Guest Editor

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