[Ablative methods for atrial fibrillation]

Surgery and catheter-based ablation are the only curative approaches of atrial fibrillation. Since 1994, several ablative techniques based on 2 different concepts have been developed: modification of the substrate with long linear lesions to prevent fibrillation maintenance; and foci ablation to prevent fibrillation initiations. The latter is more frequently used now as the clustering of foci in pulmonary veins allows their isolation. The presence of numerous foci in some patients is responsible for more complex procedures and limits the success rate to 70%. In spite of this limit and because of a reasonable complication rate, this procedure compares favourably to His bundle ablation in young patients with symptomatic and drug-resistant paroxysmal atrial fibrillation.