EDITORIAL Delayed Activation of the Left Atrial Appendage Following Catheter Ablation of Persistent Atrial Fibrillation: A Cause for Concern?

ablation, atrial fibrillation Despite advances in catheter ablation of pa-tients with persistent atrial fibrillation (AF), the ideal ablation strategy still is in evolution. It is known, however, that these patients fare poorly with pulmonary vein (PV) isolation alone.1 In an effort to improve outcomes, potential mechanisms of AF beyond the PVs have been targeted by left atrial linear ablation,2,3 ablation of complex frac-tionated atrial electrograms (CFAEs),4 ablation of ganglionated plexi, and a combination thereof. Re-cently, “stepwise ablation, ” consisting of PV iso-lation, ablation of CFAEs, and linear ablation in an effort to terminate AF, has been reported to be highly effective in patients with persistent AF.