A 71-Year-Old Man With Recurrent AFib After Prior Ablation
A 71-year-old male with a history of hypertension, mild-moderate LVH, non-obstructive CAD, and paroxysmal atrial fibrillation (AF) refractory to pharmacologic suppression with Dofetalide underwent radiofrequency (RF) catheter ablation 9 months ago. Ablation consisted of wide-antral circumferential pulmonary vein isolation (PVI). He did well post-procedure without recurrent AF.
He was taken back to the EP laboratory for assessment of pulmonary vein isolation and repeat catheter ablation. A circular mapping catheter was placed in each of the four pulmonary veins. All pulmonary veins appeared isolated with evidence of entrance block (Figure 1):
With documentation of vein isolation, what is the best next step?