Recent Advances in Lesion Formation for Catheter Ablation of Atrial Fibrillation

Despite advances in ablation technology, many patients experience recurrent atrial fibrillation (AF) after radiofrequency ablation. Although estimates vary, the overall 1-year drug-free success for AF ablation is estimated at 40% to 60% for a single procedure and 70% for multiple procedures. 1 The cornerstone of conventional AF ablation is pulmonary vein isolation (PVI), and in clinical practice, the most common PVI technique involves creating circular radiofrequency lesions in a point-by-point fashion around the PV ostia/ antra. 2 However, conventional radiofrequency ablation can be difficult and time-consuming, has less than outstanding efficacy, and can be associated with potentially serious complications, such as steam pops, perforation, tamponade, and thrombus formation, which can lead to thromboembolic events. Given the limitations of conventional radiofrequency ablation, there has been ongoing development of new technologies to facilitate the safety and efficacy of lesion formation and durability. This review will summarize several recent advancements in catheter technology for AF ablation aimed at improving lesion formation (Figure 1).