Atrial fibrillation ablation: the outcomes of AF ablation study and sedation versus general anaesthesia study

Atrial fibrillation (AF) is the most common sustained atrial arrhythmia, and its epidemic is increasingly recognized as a growing health problem worldwide [1-3]. Pulmonary vein isolation (PVI), with either Radiofrequency ablation (RF) or Cryoballoon (CB) ablation (Figure 1.1), has been an effective option for treating patients with symptomatic drug refractory atrial fibrillation (AF), and as a first-line therapy in selected patients to improve their quality of life and potentially long-term prognosis in selected patients with symptomatic AF and heart failure [4-7]. In the randomised clinical trials of AF ablation versus anti-arrhythmic medications there is a strong benefit shown in the direction of ablation in terms of reducing recurrence of AF and symptoms from atrial fibrillation [9-14]. Several randomised trials also show improvements in left ventricular ejection fraction, heart failure hospitalization and/or mortality following AF ablation in patients with systolic heart failure [15-18].