Durable Pulmonary Vein Isolation: The Holy Grail of Atrial Fibrillation Ablation

The inability to achieve durable pulmonary vein isolation remains a major limitation to catheter ablation for the treatment of atrial fibrillation (AF). In this review, we discuss the research performed over the past decade investigating methods to improve lesion permanence for the goal of durable pulmonary vein isolation (PVI). Investigations evaluating procedural techniques, adjunctive pharmacologic therapy, and newer energy sources designed to improve ablation lesion permanence are discussed.