Catheter Ablation for Atrial Fibrillation

Abstract

Atrial fibrillation (AF) is an arrhythmia associated with increased morbidity and mortality. The pulmonary veins (PVs) play an important role not only in the onset but also the maintenance of AF. Therefore, the goal of present AF ablation is to electrically disconnect the PVs from the rest of the atrium by ablating around the origin of the PVs. Several groups using ablation of all 4 PVs outside the tubular portion have reported that the success rate without antiarrhythmic drugs is much more consistent, at 75 to 95%. A further 10% to 20% of patients may become responsive to previously ineffective antiarrhythmic drugs. Although the success rate of AF ablation appears high, a very low incidence of complications has been reported including cardiac tamponade, embolism, esophageal injury, PV stenosis, and proarrhythmia resulting from reentrant tachycardias. However, the complication rates can be decreased by more recent modifications to the technique and presently available technologies. Thus, AF ablation is an effective, safe, and established treatment for AF that offers an excellent chance for a lasting cure.