When to consider catheter ablation

The ESC/EHRA guidelines suggest catheter ablation of paroxysmal AF in patients who have symptomatic recurrences while taking AADs and who need further rhythm control. Catheter or surgical ablation is also an option for to improve symptoms in persistent or long-standing persistent AF that is refractory to AADs.5

Catheter ablation (Figure 17) is an option for people with symptomatic AF, CHF and suspected tachycardiomyopathy with reduced ejection fraction to improve symptoms and cardiac function. Catheter ablation can also prevent recurrence of common (typical) atrial flutter if documented or observed during the procedure and may avoid pacemaker implantation in patients with AF-related bradycardia.5

Catheter ablation offers a potential treatment for some symptomatic atrial fibrillation patients

Figure 17. Catheter ablation offers a potential treatment for some symptomatic atrial fibrillation patients.5

Oral anticoagulation should continue for at least 8 weeks after catheter or surgical ablation and indefinitely in high-risk patients, even if the procedure appears to have restored sinus rhythm. Patients can continue warfarin or direct oral anticoagulants (DOAC) during catheter ablation to maintain effective anticoagulation.5

Review details about surgical ablation in the next section


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