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Acute pulmonary vein isolation is achieved by a combination of reversible and irreversible atrial injury after catheter ablation : evidence from magnetic resonance imaging

Atrial fibrillation (AF) treated with catheter ablation technique of isolating the pulmonary veins (site of the initiation of arrhythmia) from the left atrium recurs in about half of the treated patients. In this paper, we used state-of-the-art MRI techniques to elucidate the mechanism. We showed that the initial isolation of the veins is achieved by a combination of permanent injury and reversible edema. Although both mechanisms cause electrical isolation initially, at 3-months the edema resolves and reconnects the pulmonary veins to the left atrium and this is seen much more in the patients who have a recurrence of their AF.