State of the art: catheter ablation of atrial fibrillation

Curative treatment of atrial fibrillation with catheter ablation is now a legitimate option for a large number of patients. In the last decade a tremendous amount has been discovered about this fascinating arrhythmia, yet there is still much that is understood. A number of different ablation strategies have been used including pulmonary vein isolation, targeting of fractionated electrograms, compartmentalising the atria with linear lesions and various combinations and modifications of these lesion sets. The optimal ablation strategy for both paroxysmal and long-lasting persistent atrial fibrillation is unknown. In this review the possible mechanisms underlying atrial fibrillation are examined along with the current catheter ablation techniques used in the treatment atrial fibrillation.