Catheter ablation of atrial fibrillation: an update for 2011

Catheter ablation of atrial fibrillation has undergone significant refinements since its first description more than a decade ago. Recently, several centers have published 5-year follow-up data on the outcome of circumferential pulmonary vein isolation, demonstrating an acceptable long-term benefit. New technologies such as contact force assessment or in-tissue temperature measurement thrive to improve lesion formation, since inadequate lesion transmurality results in arrhythmia recurrence. Clinical research is currently underway to assess their role in clinical practice. Owing to the complex nature of point-by-point ablation, balloon-based techniques and specially designed catheters have been developed, promising a simplified approach to catheter ablation of atrial fibrillation. Randomized controlled trials comparing these new technologies to conventional radiofrequency current ablation are underway. Remote-controlled ablation is another area of development that allows completion of ablation from the con...