Long-Term Benefits Following Catheter Ablation of Atrial Fibrillation

Catheter ablation has acquired a prominent role in the management of symptomatic atrial fibrillation (AF). Attempting to accurately assess the benefit of ablation can be quite challenging and is influenced by many variables, including the type of AF, procedural technique, operator experience, and duration and method of follow-up. Equally elusive is the proper definition of a successful ablation outcome. Should a "successful" ablation necessitate complete resolution of AF and AF symptoms documented by long-term monitoring, or does a more clinical approach evaluating for symptomatic improvement constitute a favorable outcome? Furthermore, at what point following an ablation should a recurrence be an acceptable, if not an expected, occurrence and should a significant decrease in AF burden warrant consideration as success? Our goal here will be to explore the current data evaluating outcomes for ablation of AF. We will examine electrophysiologic and other clinical endpoints, and hope to provide long-term expectations following ablation of paroxysmal and persistent AF. (Circ J 2013; 77: 1091-1096)