Radiofrequency ablation of atrial fibrillation using a single catheter approach: time to lose the halo

Excerpt

Pulmonary vein isolation (PVI) is the cornerstone of catheter ablation for atrial fibrillation (AF), and radiofrequency (RF) continues to be the most commonly used ablation modality. For over two decades, the standard approach has been to use two catheters in the left atrium: an ablation catheter and a multipolar mapping catheter. Several recent studies have challenged that dogma, showing that both mapping and ablation can be performed successfully with the ablation catheter alone, rendering the second catheter redundant. In this edition of the Journal of Interventional Cardiac Electrophysiology, Badertscher et al. add to this evidence base, utilising a single catheter approach to compare high power short duration (HPSD) ablation against standard RF ablation [1]. They found that the single catheter approach was successful with both strategies, with HPSD ablation improving procedural and ablation times. In this editorial, we will argue for the benefits of the single catheter approach in the context of this study. …