Context

Pulmonary vein isolation (PVI) is a well-established treatment for patients with paroxysmal atrial fibrillation (AF).1 ,2 Ablation of persistent AF (beyond 7 days) or longstanding persistent AF (>12 months) is less likely to result in permanent sinus rhythm.1 ,2 For this reason, additional ablation methods subsumed as ‘substrate modification’ are often combined with PVI. These methods include ablation of complex fractionated atrial electrograms (CFAEs) and/or creation of linear lesions within the left atrium.