Atrial fibrillation ablation: contemporary practice and future potential

Recurrence of paroxysmal AF after pulmonary vein isolation is almost invariably associated with electrical reconnection of one or more pulmonary veins although a small proportion also require ablation of non-pulmonary vein foci. 7 In 2010, success rates in excess of 90%, defined as freedom from atrial tachyarrhythmias off all antiarrhythmic agents after a 3-month blanking period, can be achieved in most patients presenting with paroxysmal AF after an average of less than two procedures per patient. 8 Success rates following ablation of paroxysmal AF remain excellent even in cohorts thought to have a greater degree of atrial myopathy including those with congestive heart failure, cardiomyopathies, valvular heart disease, sarcoidosis, previous cardiac surgery and the elderly.