Atrial Fibrillation Ablation: First-Line Therapy?

Background: Ablation for atrial fibrillation (AF) is a widely-accepted treatment for this arrhythmia. Ablation is traditionally reserved for second-line therapy in patients who have failed drug therapy, but it may be ready for first-line treatment. Objective: This article outlines the rationale for using ablation as first-line therapy for AF. Findings: AF increases both morbidity and mortality. Unfortunately, drug-based therapy for AF is very ineffective and may contribute adversely to both patient morbidity and mortality. Ablation addresses the root causes of AF and thus may be curative. The technique for ablation has become quite consistent and the outcomes better than those with drug therapy. The complication risk is also acceptably low. There is even preliminary evidence to suggest that AF ablation is superior as first-line treatment compared to drugs. Conclusion: AF ablation is rapidly evolving towards becoming first-line therapy for some patients with this debilitating arrhythmia.