Conclusion
Contributions from non-PV triggers have a significant influence on the progression of PersAF and LSPAF, making it imperative to execute other strategies beyond PVI. With the development of novel approaches, more RCTs are needed to compare each strategy in a head-to-head fashion and to evaluate their efficacy and safety. Importantly, current evidence seems to demonstrate that the use of scar, CFAE and FIRM ablation have no role in the current management of non-PAF, as there is no evidence demonstrating improved outcomes but they are associated with significantly higher risk of procedure related complications. Other strategies, including PWI and LAAEI, are currently being studied and may play a significant role in reducing AF recurrence. Further randomized controlled trials are needed to guide the most appropriate therapy in this group of patients.