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Original Articles: Adult Cardiac

Invited Commentary

Division of Cardiothoracic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602 Japan

(Email: nitta@nms.ac.jp).

The first 20% of the full text of this article appears below.

Although the majority of the patients with paroxysmal atrial fibrillation (AF) can be successfully treated by surgical or catheter-based pulmonary vein (PV) isolation, the success rate of the PV isolation alone for persistent or longstanding persistent AF has been unsatisfactory. It has been demonstrated that the repetitive activations arising from the PV or other regions act as a trigger, and a substrate in the atrium is required for the perpetuation of AF [1]. The substrate may include slow conduction, dispersion of refractoriness, or non-PV abnormal activations. The multiple atrial incisions of the maze procedure may disrupt the substrate, resulting in . . . [Full Text of this Article]

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