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 .
Pulmonary Vein Isolation for Paroxysmal and Persistent Atrial Fibrillation
Background —The pulmonary veins ( PVs ) have been demonstrated to often play an important role in generating atrial fibrillation ( AF ) . The purpose of this study was to determine the safety and efficacy of segmental PV isolation in patients with paroxysmal or persistent AF . Methods and Results —In 70 consecutive patients ( mean age , 53±11 years ) with paroxysmal ( 58 ) or persistent ( 12 ) AF , segmental PV isolation guided by ostial PV potentials was performed . The left superior , left inferior , and right superior PVs were targeted for isolation in all patients , and the right inferior PV was isolated in 20 patients . Among the 230 targeted PVs , 217 ( 94 % ) were completely isolated , with a mean of 6.5±4.2 minutes of radiofrequency energy applied at a maximum power setting of 35 W. A second PV isolation procedure was performed in 6 patients ( 9 % ) . At 5 months of follow-up , 70 % of patients with paroxysmal and 22 % of patients with persistent AF were free from recurrent AF ( P < 0.001 ) , and 83 % of patients with paroxysmal AF were either free of symptomatic AF or had significant improvement . Among various clinical characteristics , only paroxysmal AF was an independent predictor of freedom from recurrence of AF ( P < 0.05 ) . One patient developed unilateral quadrantopsia after the procedure . There were no other complications . Conclusions —With a segmental isolation approach that targets at least 3 PVs , a clinical ly satisfactory result can be achieved in > 80 % of patients with paroxysmal AF . The clinical efficacy of pulmonary vein isolation is much lower when AF is persistent than when it is paroxysmal
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 .