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 .
Prophylactic catheter ablation for the prevention of defibrillator therapy.
BACKGROUND For patients who have a ventricular tachyarrhythmic event , implantable cardioverter-defibrillators ( ICDs ) are a mainstay of therapy to prevent sudden death . However , ICD shocks are painful , can result in clinical depression , and do not offer complete protection against death from arrhythmia . We design ed this r and omized trial to examine whether prophylactic radiofrequency catheter ablation of arrhythmogenic ventricular tissue would reduce the incidence of ICD therapy . METHODS Eligible patients with a history of a myocardial infa rct ion underwent defibrillator implantation for spontaneous ventricular tachycardia or fibrillation . The patients did not receive  antiarrhythmic drugs .  Patients were r and omly assigned to  defibrillator implantation alone or defibrillator implantation with adjunctive catheter ablation  ( 64 patients in each group ) . Ablation was performed with the use of a substrate-based approach in which the myocardial scar is mapped and ablated while the heart remains predominantly in sinus rhythm . The primary end point was survival free from any appropriate ICD therapy . RESULTS The mortality rate 30 days after ablation was zero , and there were no significant changes in ventricular function or functional class during the mean ( + /-SD ) follow-up period of 22.5+/-5.5 months . Twenty-one patients assigned to defibrillator implantation alone ( 33 % ) and eight patients assigned to defibrillator implantation plus ablation ( 12 % ) received appropriate ICD therapy ( antitachycardia pacing or shocks ) ( hazard ratio in the ablation group , 0.35 ; 95 % confidence interval , 0.15 to 0.78 , P=0.007 ) . Among these patients , 20 in the control group ( 31 % ) and 6 in the ablation group ( 9 % ) received shocks ( P=0.003 ) . Mortality was not increased in the group assigned to ablation as compared with the control group ( 9 % vs. 17 % , P=0.29 ) . CONCLUSIONS In this r and omized trial , prophylactic substrate-based catheter ablation reduced the incidence of ICD therapy in patients with a history of myocardial infa rct ion who received ICDs for the secondary prevention of sudden death . ( Current Controlled Trials number , IS RCT N62488166 [ controlled-trials.com ] . )
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 .