![]() Pulmonary vein isolation is the cornerstone of current ablation techniques to treat AF both radiofrequency ablation and cryoballoon ablation have similar efficacy.Īdjunctive ablation strategies that target sites beyond the pulmonary veins can be performed in patients with persistent AF but the best approach and additive benefit remain uncertain.Ĭontinued advances in catheter ablation technology aim to improve the outcomes and procedural safety and to reduce the duration of the procedure. We also discuss lifestyle modification strategies to improve ablation outcomes.Ĭatheter ablation for atrial fibrillation (AF) is a safe and effective rhythm-control strategy for symptomatic patients who do not benefit from or prefer not to take medical therapy.Ĭatheter ablation is currently indicated only for symptom relief but evidence suggests that it might be indicated for mortality reduction in patients with comorbid AF and heart failure, as well as in selected asymptomatic patients after appropriate discussion and evaluation. In this Review, we discuss the relevant data to support the recommended and evolving indications for catheter ablation of AF, describe the different ablation techniques, and highlight the latest advances in technology that aim to improve its safety and efficacy. Numerous exciting new technologies are in various stages of development. Technological advances in the past decade have focused on achieving durable vein isolation, reducing procedure duration and improving safety. Additional atrial ablation can be performed in patients with persistent AF, but its benefits are largely unproven. Pulmonary vein isolation using point-by-point radiofrequency or with the cryoballoon remains the cornerstone technique in AF ablation. Data from large registries indicate that AF ablation might reduce mortality and the risk of heart failure and stroke, but evidence from randomized controlled trials is mixed. The procedure might also be considered as a first-line approach in selected asymptomatic patients. ![]() Current guidelines recommend the procedure in symptomatic patients with paroxysmal or persistent AF who are refractory or intolerant to antiarrhythmic drugs. Catheter ablation for atrial fibrillation (AF) has emerged as an important rhythm-control strategy and is by far the most common cardiac ablation procedure performed worldwide.
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