Indications for catheter and surgical ablation of atrial fibrillation

The indications for catheter ablation of atrial fibrillation (AF) have been defined by three major documents. The first is the 2012 HRS Consensus Document on Catheter and Surgical Ablation of Atrial Fibrillation, the second is the European Society of Cardiology 2010 Guidelines for the Management of Atrial Fibrillation, and the third are the ACC/AHA/HRS Guideline for the Management of the Patients with Atrial Fibrillation. This chapter reviews and compares the indications for AF ablation, as defined in each of these three documents. Catheter and surgical ablation of AF are highly complex procedures, and a careful assessment of benefit and risk must be considered for each patient. It is well recognized that symptomatic and/or asymptomatic AF may recur during long-term follow-up after an AF ablation procedure. Either aspirin or warfarin is appropriate for patients who do not have a high stroke risk.