Current status and future catheter ablation strategies in atrial fibrillation

Catheter ablation of atrial fibrillation (AF) is a highly effective therapy to achieve freedom of recurrent arrhythmia and relief from symptomatic AF. Transmural ablation of atrial tissue is crucial for success. Thus steerable sheaths and catheter design with contact measurement as an additional feature have been developed to increase success rates. New 3 dimentional (3D) mapping technologies engage clinical routine to reduce fluoroscopy time and radiation dose for patients and medical staff to a minimum. To unmask dormant pulmonary vein reconduction and to avoid early pulmonary vein reconduction administration of adenosine is useful. Future approaches aim at individualized ablation strategies taking clinical and electrophysiologic characteristics of the individual patient into account.