Catheter ablation in atrial fibrillation: a state-of-the-art review

Abstract

Antonio Sorgente,1 Riccardo Cappato2 1Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates; 2Arrhythmia and Electrophysiology Research Center, IRCCS Humanitas Clinical and Research Center, Rozzano, Milan, Italy Abstract: There are no doubts that paroxysmal atrial fibrillation is driven by triggers located at the ostia of pulmonary veins. Cardiac electrophysiologists have to thank the seminal work of Dr Haissaguerre in demonstrating for the first time this finding in human hearts in 1998. On this premise, atrial fibrillation ablation performed through pulmonary vein electrical isolation has become a mainstay of the non-pharmacological treatment of this arrhythmia. The scope of this brief and concise review is to provide a state-of-the-art of catheter ablation of atrial fibrillation, considering the obvious different outcomes in different varieties of atrial fibrillation. If the results in the treatment of paroxysmal atrial fibrillation are really promising, it is clear that more research and more clinical trials are warranted for the cure of non-paroxysmal atrial fibrillation, which cause seems to be more multifactorial and less dependent on electrical triggers. Keywords: atrial fibrillation, arrhythmia, sinus rhythm, pulmonary veins, anticoagulation, catheter ablation