Atrial fibrillation ablation beyond pulmonary veins: The role of left atrial appendage

Jorge Romero, Andrea Natale, Luigi Di Biase

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


The role of pulmonary vein isolation in patients with non-paroxysmal atrial fibrillation (AF) is only modest. Several studies have demonstrated the role of the left atrial appendage (LAA) in initiating and maintaining of this arrhythmia. We review in this article the incremental benefit in free-arrhythmia recurrence of LAA electrical isolation in patients undergoing procedures for persistent AF or long standing persistent AF either using radiofrequency ablation, cryoablation or Lariat device implantation. Likewise, acute complications, anticoagulation and the risk of ischemic stroke after LAA electrical isolation (LAAEI) are analyzed. LAAEI in addition to standard ablation appears to have a substantial incremental benefit to achieve freedom from all atrial arrhythmias in patients with persistent AF and long standing persistent atrial fibrillation (LSPAF) without increasing acute procedural complications and without raising the risk of ischemic stroke.

Original languageEnglish (US)
Pages (from-to)31-41
Number of pages11
JournalRevista Portuguesa de Cardiologia
StatePublished - Nov 2017


  • Cryoablation
  • LARIAT device
  • Left atrial appendage
  • Long standing persistent atrial fibrillation
  • Persistent atrial fibrillation
  • Radiofrequency ablation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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