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Preventing complications following catheter ablation of atrial fibrillation: is intracardiac echocardiography the answer we are seeking?

This editorial refers to ‘Complications of catheter ablation for atrial fibrillation in a high-volume centre with the use of intracardiac echocardiography’ by B. Aldhoon et al. , on page 24 

Catheter ablation of atrial fibrillation (AF) is now a commonly performed procedure throughout the world.1 Although there are many theoretical benefits of eliminating AF, improvement in quality of life remains the only proven benefit of this complex procedure. One of the fundamental principles of medicine is primum non nocere according to which the physician should not cause harm to the patient. It is this light that we must consider the very important issue of complications which occur in patients undergoing catheter ablation of AF. This is particularly true because the only proven benefit of AF ablation is to improve quality of life. While theoretic reasons exist to allow hypothesizing that elimination of AF may prevent heart failure, reduce dementia, lower stroke risk, and prolong survival, definitive proof is lacking.

In the present issue of the journal, Aldhoon et al. 2 report the complications which occurred at a single centre in 959 consecutive patients who underwent 1192 AF ablation between March 2006 and …