4.2 Clinical utility of the CST ablation technique
There can be an alternative to adding more CB applications to the present PV or shifting the CB to the ipsilateral PV in expectation of a CST phenomenon in cases with electrical connections remaining between the LA and PV despite rigorous CB applications to the superior PV. The success rate of PV isolation using the CST ablation technique was reported by Miyazaki et al.14 to be 41.9% (13/31 cases) and was 48.4% (15/31 patients) in our study, which is relatively high. Therefore, once the predictors postulated in this study could be introduced into the CB ablation setting, superior PV isolation would be expected to be more efficiently achieved, which would enable a reduction in the ablation application time and freezing damage to the myocardium and collateral tissues, including the esophagus and phrenic nerve. To the best of our knowledge, there has been no systematic study on how often the CST ablation technique can be applied in actual CB ablation. Nevertheless, the occurrence rate of successful CST cases among all CB ablation cases was 2.9% (16/541 patients) in our study and was reported to be 2.9% (15/511 patients) and 4.7% (32/676 patients) in previous studies, respectively.2,14