Indications for atrial fibrillation ablation

Since the method was first proposed in the late 1990s, endocavitary ablation of atrial fibrillation (AF) has become a reference treatment whose indications are constantly expanding. Initially proposed mainly for patients with healthy hearts, it is now also indicated for patients with severe heart disease and heart failure, and even for those awaiting transplantation. After outlining the pathophysiological basis of endocavitary AF ablation and the technological developments that have made this method safer and more effective, we will detail its current indications. Particular emphasis will be placed on the role of AF ablation as a first -line treatment, prior to any trial of antiarrhythmic therapy. More recent evidence of the prognostic value of AF ablation in heart failure patients, including end -stage patients, will also be discussed. (c) 2024 Published by Elsevier Masson SAS on behalf of l'Acad & eacute;mie nationale de m & eacute;decine.