Improving ablation strategies for the treatment of atrial fibrillation

Atrial fibrillation (AF) is the most common sustained arrhythmia encountered in clinical practice. The contemporary management of AF is centered on symptomatic improvement, as well as reduction in the AF associated morbidity and mortality. For many highly symptomatic patients catheter ablation offers an efficacious means to maintaining sinus rhythm when antiarrhythmic drugs have been ineffective, are contraindicated or cannot be tolerated. Over the past 15 years, catheter ablation has moved from an 'experimental therapy' to the standard of care for the maintenance of sinus rhythm. Unfortunately, while the results of ablation are unequivocally superior to medical therapy, recognized limitations of the contemporary AF ablation procedures have spurred several developments designed to improve the efficacy of the index ablation procedure, while limiting adverse events. The purpose of this review is to discuss the procedural refinements, and technological innovations proposed to outcomes of patients undergoing a percutaneous catheter ablation procedure for AF.