[Atrial fibrillation in 2025: catheter ablation for everyone?]

By 2025, catheter ablation has become a cornerstone treatment option for atrial fibrillation, particularly in symptomatic patients or those with heart failure. It significantly reduces recurrences, improves quality of life, and restores cardiac function in cases of arrhythmia-mediated cardiomyopathy. Among recent advances, pulsed field ablation stands out for its enhanced safety and efficacy, thanks to its cellular selectivity, thereby minimizing complications. While the use of ablation is becoming more widespread, rigorous patient selection, especially in asymptomatic individuals, remains essential to balance the benefits against potential risks. A patient-tailored approach therefore remains mandatory for this complex arrhythmia.