Can We Consider Catheter Ablation as First-Line Therapy for all Our Atrial Fibrillation Patients Yet?

Abstract

The prevalence of atrial fibrillation is increasing. Despite the well known prognostic benefits of maintaining sinus rhythm, pharmacological strategies have not provided satisfactory results showing limited efficacy, proarrhythmic effects, systemic toxicity and in some studies even increased mortality. AF ablation has undergone a great evolution with an increasing number of procedures performed all over the world. AF ablation is currently a topic of intense research. The results of recent research have raised catheter ablation indication as first-line therapy in patients with symptomatic paroxysmal AF in the 2012 focused update of the European Society of Cardiology guidelines. Although much effort remains to be done, we believe that technical evolution and the increasing expertise of teams performing ablation are allowing us to treat our patients with safer and more effective procedures. That is why AF ablation as first-line therapy is here to stay and probably we will be witness of a further extension of the indications.