Catheter ablation is established as a treatment option for atrial fibrillation--is catheter ablation established as a treatment option of atrial fibrillation? (Pro)

Abstract

Atrial fibrillation (AF) is the most common arrhythmia in clinical practice and it has a significant impact on morbidity and mortality. Large randomized trials have failed to demonstrate a benefit for mortality of the pharmacological rhythm control strategy as compared with the rate control strategy, indicating that rate control may be an adequate treatment for AF. However, further study determined that the presence of AF at the time of study termination was a more potent predictor of mortality than the treatment strategy, suggesting the importance of sinus rhythm. On the other hand, catheter ablation recently has emerged as an alternative treatment option to pharmacological therapy for AF. Although AF ablation is an invasive strategy, over the past decade its efficacy has increased and the complication rate has decreased with the growing experience of operators and evolving technology. Moreover, the ablation methodology, such as pulmonary vein isolation based ablation, is consistent worldwide and the success rate of AF ablation, especially in paroxysmal AF, is similar. Therefore, catheter ablation is established as a treatment option for AF.