[Catheter ablation as first-line therapy for atrial fibrillation: an analysis of available evidence].

In patients with symptomatic atrial fibrillation refractory to antiarrhythmic therapy, catheter ablation is effective in restoring and maintaining sinus rhythm, in reducing hospitalization and improving quality of life. On the other hand, the role of catheter ablation as first-line therapy for atrial fibrillation is still controversial and has been recently evaluated by two randomized controlled trials and two consecutive case series. These studies showed the superiority of catheter ablation over antiarrhythmic therapy for the rhythm control of atrial fibrillation, with similar rates of complications between the two groups. According to these results, catheter ablation could be considered as first-line therapy for patients with symptomatic paroxysmal atrial fibrillation without significant heart disease.