A limited ablation approach does as well as empiric isolation of all pulmonary veins in achieving sustained control of atrial fibrillation (AF), researchers report in the February issue of Heart Rhythm. A limited ablation approach does as well as empiric isolation of all pulmonary veins in achieving sustained control of atrial fibrillation (AF), researchers report in the February issue of Heart Rhythm.

"The study," lead investigator Dr. Sanjay Dixit told Reuters Health, "showed that a limited ablation approach targeting only the 'arrhythmogenic' pulmonary veins identified using our stimulation protocol is as efficacious as ablating all pulmonary veins for achieving long term control of AF."

Dr. Dixit and colleagues at the University of Pennsylvania in Philadelphia note that although their limited approach may have advantages, it has not gained wide acceptance.

In their current study, the researchers followed 103 patients with AF who had been randomized to ablation of either arrhythmogenic pulmonary veins or all pulmonary veins. Antiarrhythmic drugs were discontinued at six weeks.

After one year, freedom from AF or a greater than 90 per cent reduction in AF burden had been achieved in 75 per cent of all-vein patients and 71 per cent of arrhythmogenic vein patients.

In addition to its effectiveness, concludes Dr. Dixit, "the implications of a limited ablation strategy include less x-ray exposure, fewer ablation lesions, shorter procedure time, and potentially less complications.