Catheter ablation of atrial fibrillation: for whom and how?

Catheter ablation is the treatment of choice for certain patients with drug-refractory paroxysmal or even persistent atrial fibrillation. Several techniques are used with a similar success rate of approximately 70% over 6 to 12 months of follow-up. Pulmonary vein isolation by conventional antral or electroanatomic circumferential ablation is mainly used in patients with paroxysmal atrial fibrillation. Electrogram-guided and combined approaches are also used, particularly in patients with persistent atrial fibrillation, whereas new methods such as autonomic denervation are under investigation.