This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Callahan, T. D. Articles by Natale, A. Search for Related Content PubMed PubMed Citation Articles by Callahan, T. D. Articles by Natale, A. Pubmed/NCBI databases Medline Plus Health Information Arrhythmia Related Collections Ablation/ICD/surgery Arrhythmias, clinical electrophysiology, drugs

(Circulation. 2008;117:131-133.)
© 2008 American Heart Association, Inc.

Editorial

Procedural End Points in Pulmonary Vein Antrum Isolation

Are We There Yet?

Thomas D. Callahan, MD; Andrea Natale, MD

From Cardiac Electrophysiology and Pacing, Cleveland Clinic, Cleveland, Ohio (T.D.C.), and Electrophysiology Section, Department of Cardiology, Stanford University, Stanford, Calif (A.N.).

Correspondence to Andrea Natale, MD, Adjunct Professor, Section of Electrophysiology, Department of Cardiology, Stanford University Hospital, 300 Pasteur Dr, Stanford, CA 94305. E-mail nataleam@roadrunner.com

Key Words: Editorials • arrhythmia • catheter ablation • fibrillation • tachyarrhythmias

An extract of the first 250 words of the full text is provided, because this article has no abstract.

If you have ever been on a long car trip with a small child, you have almost certainly encountered the age-old question, "Are we there yet?" Although a careful review of the literature reveals surprisingly little in the way of rigorous studies on this matter, strong anecdotal evidence suggests that the longer or more arduous the journey and the more desirable the destination, the more likely it is this question will be asked. In our quest to develop a cure for atrial fibrillation (AF) with our catheters, electrophysiologists have found ourselves asking the very same question. This is no surprise, because the journey has been difficult, with long, technically demanding procedures, and the destination, the cure of a disease with often profound symptoms and morbidity that affects millions, is coveted. In the world of pulmonary vein antrum isolation (PVAI), what we are really asking is whether our lesions will provide our patients with a lasting cure of their AF: "Are we there yet?"

Article p 136

Unfortunately, the answer to this question has not come easily. AF is notoriously sporadic. Just because a patient’s AF is gone one moment does not mean it will not return the next. No imaging or serological testing can yet identify or rule out the heart’s propensity to develop this arrhythmia. Instead, we must hunt for surrogates to tell us whether or not we have adequately diminished the ability of a patient’s heart to develop AF. Here again, though, the questions and their answers are . . . [Full Text of this Article]

This article has been cited by other articles:

				E. Buch and K. Shivkumar Exploring the potential of pulmonary vein recordings: can they help elucidate mechanisms of paroxysmal atrial fibrillation? Europace, June 1, 2008; 10(6): 690 - 691. [Full Text] [PDF]