Ablation of Atrial Fibrillation: Are We Still “Learning While Burning”?

  • J. A. Salerno-Uriarte
  • R. De Ponti
  • M. Tritto
  • M. E. Lanzotti
  • R. Marazzi
  • G. Spadacini
  • P. Moretti
Conference paper


During the 1990s, the concept of “learning while burning” was introduced and developed by Callans et al. in a series of articles [1–3]. In these papers, the authors expressed the idea that catheter ablation (burning), far from marking the end of pathophysiological investigation, may be viewed as a tool to provide unique and new information (learning) about arrhythmia substrates. Earlier, since with the introduction of catheter ablation electrophysiology had focused more and more on procedural efficacy and case volume, Smith and Cain [4] showed the possible detrimental development from electrophysiology to “electrotechnology,” with loss of research, investigation, and learning-teaching, which has always surrounded the field of cardiac electrophysiology. Recently, the “learning while burning” concept has been revisited and applied [5] to the pathophysiology of atrial fibrillation, where, although the experience of pulmonary vein ablation contributes to the increase of our knowledge day by day, much still remains to be understood of the ultimate mechanism of the arrhythmia. On the other hand, it has been pointed out that trying to elucidate the mechanism of human atrial fibrillation appears as frustrating as being the translator at the Tower of Babel [6], meaning that the pathophysiology of this arrhythmia may present multiple aspects in different clinical and electrophysiological settings, difficult to investigate in humans. In the present paper, we attempt to revisit some aspects of the experience in catheter ablation of atrial fibrillation, trying to point out what we have learnt and what we still have to learn to improve our knowledge and, hopefully, results. For reasons of brevity, only catheter ablation for electrical isolation of the pulmonary veins with an electrophysiological end-point [7] is considered.


Atrial Fibrillation Pulmonary Vein Catheter Ablation Pulmonary Vein Isolation Radiofrequency Catheter Ablation 
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Copyright information

© Springer-Verlag Italia 2004

Authors and Affiliations

  • J. A. Salerno-Uriarte
    • 1
  • R. De Ponti
    • 1
  • M. Tritto
    • 2
  • M. E. Lanzotti
    • 1
  • R. Marazzi
    • 1
  • G. Spadacini
    • 2
  • P. Moretti
    • 2
  1. 1.Department of Cardiovascular Sciences, Ospedale di Circolo e Fondazione MacchiUniversity of Insubria-VareseVareseItaly
  2. 2.Department of Cardiology“Mater Domini”CastellanzaItaly

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