Long-term success after catheter ablation of atrial fibrillation

Abstract

Ablation is an established treatment option for atrial fibrillation (AF) and is associated with convincing success rates and areasonable safety profile. Ablation strategies going beyond pulmonary vein isolation in patients with chronic forms of AF are less well established and reproducible. Especially in patients with progressed AF forms multiple ablation procedures might be mandatory to achieve reasonable clinical success. An early ablation strategy might stop or prolong the progress from paroxysmal to persistent AF. In addition, ablation is more effective than drug-based treatment and comparably safe. Long-term success rates after asingle and after multiple ablation procedures in paroxysmal AF are reported with 60-70% and up to 80%, while success rates in persistent or long-standing persistent AF are less favorable (single procedure 40-50%, multiple procedures 70%). However, currently non-recurrence of AF is the most established but potentially not the best endpoint. The burden of AF after ablation as assessed by novel monitoring modalities might gain further clinical importance.