The study will compare two ablation strategies in patients with paroxysmal or persistent atrial fibrillation undergoing repeat ablation using pulsed-field ablation: redo pulmonary vein isolation only versus redo pulmonary vein isolation with added posterior wall ablation.
Documented recurrence of paroxysmal or persistent AF following single prior catheter ablation with PVI, confirmed by 12-lead ECG, Holter monitoring, or ICM within the last 2 years.
Candidate for repeat catheter ablation according to current European Society of Cardiology (ESC) AF management guidelines.
Continuous oral anticoagulation with a vitamin K antagonist or non-vitamin K oral anticoagulant (NOAC) for ≥ 4 weeks prior to the ablation, or transoesophageal echocardiography (TEE) and/or cardiac computed tomography (CT) within 48 hours before the procedure excluding LA thrombus.
Age ≥ 18 years at the time of informed consent.
Previous LA surgery
> 1 prior LA ablation
LA ablation outside of the PVs in the first LA ablation
LA diameter >60 mm in the parasternal long axis
University Hospital, Basel, Switzerland
Lead sponsor
Swiss Heart Foundation
Collaborator
Boston Scientific Corporation
Collaborator