There is limited evidence to suggest which ablation method was the best .
There is limited evidence to suggest that CA may be a better treatment option compared to medical therapies in the management of persistent AF .
This review was also unable to recommend the best CA method
BACKGROUND Atrial fibrillation ( AF ) is the most common cardiac arrhythmia seen in cardiovascular departments .
Treatments include medical interventions and catheter ablation .
Due to uncertainties in medical therapies for AF , and the need to continue sinus rhythm , ablation has been recently considered as a viable alternative .
Many new ablation methods based on pulmonary vein isolation ( PVI ) have been developed .
OBJECTIVES The primary objective of this review was to assess the beneficial and harmful effects of  catheter ablation ( CA ) in comparison with medical treatment in patients with paroxysmal and persistent AF .
The secondary objective was to determine the best regimen of CA .
A randomized trial to compare atrial fibrillation ablation using a steerable vs. a non-steerable sheath.
AIMS Catheter positioning and stability are recognized challenges in catheter ablation of atrial fibrillation ( AF ) . This prospect i ve r and omized study assessed whether routinely using a steerable sheath affects procedure outcomes . METHODS AND RESULTS Fifty-six AF patients were r and omized to  ablation using either an Agilis NXT ( St Jude Medical , St Paul , MN , USA ) steerable sheath or a fixed-curve Mullins sheath ( Cook Medical Inc. , Bloomington , IN , USA ) for the ablation catheter . A mapping system with CT integration was used to isolate the pulmonary veins ( PVs ) in pairs and further ablation performed if AF persisted . There was no significant difference in time to gain trans-septal access , CT registration time , time to isolate PVs , fluoroscopy time for PV isolation , total procedure time , or total fluoroscopy time . A learning curve was seen for the steerable sheath , and after correcting for this , CT registration time and right PV isolation were quicker in this group . One patient crossed over from fixed-curve to steerable . Acute , 3- , and 6-month single procedure success were similar in both groups . CONCLUSION Allowing for the usage learning curve , a steerable sheath reduced time for some elements of AF ablation . Although this did not result in improved success , it may be useful for inexperienced operators , but at increased procedure cost
There is limited evidence to suggest which ablation method was the best .
There is limited evidence to suggest that CA may be a better treatment option compared to medical therapies in the management of persistent AF .
This review was also unable to recommend the best CA method
BACKGROUND Atrial fibrillation ( AF ) is the most common cardiac arrhythmia seen in cardiovascular departments .
Treatments include medical interventions and catheter ablation .
Due to uncertainties in medical therapies for AF , and the need to continue sinus rhythm , ablation has been recently considered as a viable alternative .
Many new ablation methods based on pulmonary vein isolation ( PVI ) have been developed .
OBJECTIVES The primary objective of this review was to assess the beneficial and harmful effects of  catheter ablation ( CA ) in comparison with medical treatment in patients with paroxysmal and persistent AF .
The secondary objective was to determine the best regimen of CA .