Curative catheter ablation for atrial fibrillation.

With the recent advances in the understanding of the mechanisms of atrial fibrillation, radiofrequency catheter ablation has emerged as an effective therapeutic modality for patients with atrial fibrillation. Techniques for catheter ablation evolved from elimination of triggers that often originate within the pulmonary veins and initiate atrial fibrillation, to additional left atrial ablation using a variety of approaches to also eliminate the mechanisms that play a role in perpetuation of atrial fibrillation. With the current ablation strategies, atrial fibrillation can be eliminated in approximately 85% of patients with paroxysmal, and in approximately 70% of patients with chronic, atrial fibrillation with a low incidence of significant complications. In symptomatic patients with paroxysmal or chronic atrial fibrillation who have failed antiarrhythmic drug therapy, catheter ablation is an effective treatment strategy for maintenance of sinus rhythm.