Anatomical analysis of recurrent conduction after circumferential ablation

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Abstract
There is general agreement on the importance of electrical isolation of antral (including pulmonary vein) myocardium for effective atrial fibrillation (AF) ablation. However, isolation is often impermanent, and return of conduction (RoC) is associated with recrudescent AF. It is generally assumed that the mechanism of RoC is recovery of ablated myocardium, but this is based almost solely on experience after ablation at the venoatrial junctions. Our objective was to perform an anatomical analysis as a means to gain further insight into RoC risk factors and mechanism(s) after wide-area circumferential ablation.

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