Role of Catheter Ablation as a First-Line Treatment for Atrial Fibrillation

Purpose of reviewCatheter ablation has emerged as the most effective long-term rhythm controlling strategy in patients with symptomatic atrial fibrillation (AF). Over the last few years, the role of ablation has shifted from a last-resort strategy toward a first-line approach in AF management. The purpose of this review is to highlight the rationale behind an early ablation strategy and to summarize recent data regarding its effectiveness.Recent findingsPulmonary vein isolation (PVI), the cornerstone of catheter ablation of AF, is superior to antiarrhythmic drugs (AADs) in preventing recurrence of AF. PVI is most effective when performed early in the disease process. Recent studies have shown significant long-term benefit in patients treated with PVI early after AF diagnosis and/or prior to use of AADs.SummaryPVI is emerging as a highly appropriate first-line therapy for patients with symptomatic AF. As ablation technologies continue to improve, offering PVI to patients with recently diagnosed atrial fibrillation may become standard of care.