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[Primary catheter ablation in atrial fibrillation].

BACKGROUND
Primary catheter ablation of atrial fibrillation is a new and curative option for the treatment of patients with drug-refractory atrial fibrillation. It is aiming at a long-term restoration of sinus rhythm and thereby causing a coordinated atrial contraction.


ABLATION METHODS
Two different ablation strategies have been established: The "trigger elimination" tries to identify triggering atrial extrasystoles (mostly within the pulmonary veins), followed by focal ablation or isolation within the pulmonary veins. The "substrate modification" changes by long linear radiofrequency-induced lesions the ability of the atrial myocardium to sustain atrial fibrillation.


VALUATION
Both treatment options still have to prove their effectiveness in carefully monitored follow-up, before they can be offered to the general patient population with atrial fibrillation.