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 .
Transvenous cryoablation reduces platelet activation during pulmonary vein ablation compared with radiofrequency energy in patients with atrial fibrillation.
BACKGROUND Radiofrequency ( RF ) ablation procedures for atrial fibrillation ( AF ) are associated with potential risks of thromboembolism , which may be minimized by the use of cryoablation that preserves the integrity of endocardium . The objective of this study was to compare the thrombogenic potential of transvenous cryoablation versus RF ablation during pulmonary vein ( PV ) isolation . METHODS AND RESULTS Thirty consecutive patients with paroxysmal AF were r and omized to undergo segmental PV isolation procedure using 4-mm tip RF ablation ( n = 15 ) or cryoablation ( CryoCor , San Diego , CA , USA ) ( n = 15 ) . Blood sample s were drawn after sheath insertion ( baseline ) , after transseptal puncture , before ablation ( after heparin administration ) , and after isolation of a superior PV . Activation of coagulation was measured with plasma levels of prothrombin fragment 1 + 2 ( F1 + 2 ) and thrombin-antithrombin III complex ( TAT ) , and platelets by plasma level of beta-thromboglobulin ( beta-TG ) and flow cytometric enumerating of P-selectin (CD62)-positive platelets . In both groups , the plasma level of beta-TG , F1 + 2 , and TAT were elevated after sheath insertion . The percentage changes in plasma level of beta-TG , F1 + 2 , and TAT and CD41/62-positive platelets from baseline after transseptal puncture and before ablation were similar ( P > 0.05 ) . However , the percentage changes in CD62-positive platelets from baseline were significantly higher in patients treated with RF ablation ( 82 + /- 20 % ) than with cryoablation ( 22 + /- 14 % , P = 0.02 ) , although their plasma levels of beta-TG , F1 + 2 , and TAT were not different ( P > 0.05 ) . CONCLUSIONS Significant platelet and coagulation activations were observed during PV ablation procedures , and heparin administration only prevented activation of coagulation but not platelets . Persistent platelets activation was observed during RF energy application , but not during cryoablation
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 .