Advances in Ablation Therapy for Atrial Fibrillation: Innovations and Clinical Applications

Dear Colleagues,

Atrial fibrillation (AF) represents the most frequent sustained cardiac arrhythmia and imposes a significant burden on patients and healthcare systems. Management strategies encompass a broad spectrum of both pharmacological therapies and interventional approaches tailored to patient-specific needs. Recent advances in ablation therapy have revolutionized AF treatment, with catheter ablation emerging as the most efficacious intervention for sustaining a normal sinus rhythm, surpassing other therapeutic modalities in long-term rhythm control.

Over the past two decades, significant progress has been made in ablation technology and strategy development, focusing on enhancing efficacy and safety. The evolution of radiofrequency (RF) ablation has progressed from traditional 4 mm tip catheters to advanced systems incorporating irrigated catheters and contact force sensing technology. The novel very-high-power short-duration (vHPSD) mode (90 W for ≤ 4 seconds) represents a significant advancement, offering theoretical advantages, including greater procedure efficiency and reduced collateral damage.

Among single-shot devices, the cryoballoon (CB) has demonstrated high procedural efficiency and favorable outcomes. Recent evidence has established CB-PVI as a superior first-line therapy compared to antiarrhythmic drugs, not only improving efficacy but also reducing AF progression. While pulmonary vein isolation remains fundamental, emerging non-thermal energy modalities, such as pulsed-field ablation (PFA), have gained significant interest due to their selective action and reduced thermal risks.

This Special Issue aims to highlight the latest advancements in AF ablation therapy, and we encourage submissions of original research, reviews, and meta-analyses focusing on novel interventional techniques and therapeutic strategies for AF management.

Dr. Ioanna Koniari
Guest Editor

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