Meta-analyses
Meta-analyses of studies employing LVA ablation in addition to PVI do
demonstrate improved freedom from AF and reduced rates of post-ablation
atrial tachycardia with VGA when compared to conventional ablation
approaches (31,32). However, as evident in Table 1, most data are from
observational studies with relatively small cohorts of patients, a mixed
history of AF duration, and many utilizing historical outcomes as
controls. Moreover, the strategies employed in delineating and ablating
LVAs are highly heterogeneous with respect to catheter properties,
mapping rhythm and voltage thresholds making detailed comparisons
challenging.