Another sobering study in AF ablation. Melbourne group reports on 121 patients who have recurrent AF despite durable PVI. All have posterior wall isolation. [Because we can.] The results are similar to the trials. Not good. doi.org/10.1016/j.jacep.2026… @peterkistler3

Credit to the EP team in Bern for this excellent remapping study after either RF or PFA. Mandated remapping is much better than remapping for symptoms jacc.org/doi/10.1016/j.jacep… A) PFA no better than RF for durable PVI B) Recapitulates GAP study showing that AF still occurs in one-third of durably isolated PVs and 72% of those with reconnected veins DID NOT have AF at one year This is the crux of our problem in EP: we don't understand the pathophysiology of the condition. PVs get isolated because we can. @TobiasReichlin