LAUSR

The tachyarrhythmia induction test with atrial burst pacing is a simple and feasible technique to evaluate therapeutic efficacy and/or endpoint of catheter ablation. However, its role in atrial fibrillation (AF) ablation is controversial.1 Induced AF in response to atrial burst pacing may reflect residual arrhythmogenic substrates in the atria that could maintain AF. At the same time, a response to atrial burst pacing may be a nonspecific phenomenon with relatively poor reproducibility. In the current issue, Tachibana et al reported that AF induction test with atrial burst pacing has no predictive value for long-term recurrence in their whole-studied population, but has a significant predictive value when tested in shorter cycle length of pacing in persistent AF patients. 2 Previous reports have shown that predictive value of AF induction test with atrial burst pacing has, if any, an only limited value, as Tachibana et al well summarized in their discussion section and a table.2 The positive predictive value (PPV) of atrial burst pacing for clinical recurrence is very low. This means that an induction positive is “false positive” in most of the cases. On the other hand, negative predictive value (NPV) of atrial burst pacing is relatively high in the series of study.