Conclusion
A stepwise percutaneous endo-/epicardial stepwise approach for CA of
persistent and longstanding persistent AF resulted in restoration and
maintenance of sinus rhythm in the majority of patients at 9-month
follow-up. BB ablation appeared to be a pivotal component of such an
approach, and was feasible in all patients, with low risk of serious
procedural complications. Further studies are highly needed to confirm
our promising results, which could represent an important step forward
in the management of AF in patients with persistent or longstanding
persistent forms of the arrhythmia after a failed endocardial AF CA.