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 .
Randomized comparison between open irrigation technology and intracardiac-echo-guided energy delivery for pulmonary vein antrum isolation: procedural parameters, outcomes, and the effect on esophageal injury.
INTRODUCTION We performed a prospect i ve study to compare efficacy and safety of both open irrigation tip ( OIT ) technology with intracardiac echo (ICE)-guided energy delivery in patients presenting for PVAI . METHODS AND RESULTS Fifty-three patients presenting for PVAI were r and omized to ablation using an OIT catheter ( Group 1 , 26 patients ; temperature and power were set at 50 degrees and 50 W , respectively , with a saline pump flow rate of 30 mL/min ) or radiofrequency ( RF ) energy delivery under ICE guidance ( Group 2 , 27 patients ; energy was titrated based on microbubbles formation ) . The mean procedure time and fluoroscopy exposure were lower in Group 1 ( 164 + /- 42 min and 7,560 + /- 2,298 microGray m2 vs 204 + /- 47 min and 12,240 + /- 4,356 microGray m2 ; P = 0.005 and 0.008 , respectively ) . Moreover , the duration s of RF lesions applied per PV antrum was lower in Group 1 compared with Group 2 ( 5.1 + /- 2.2 min vs 9.2 + /- 3.2 min , P = 0.03 , respectively ) . Within 24 hours after PVAI in 35.7 % ( all erythema ) of Group 1 and 57.1 % ( 21.4 % erythema and 35.7 % necrosis ) of Group 2 , patients ' esophageal wall changes were documented . After 14 + /- 2 months of follow up , recurrences were documented in 19.2 % of Group 1 and 22.2 % of Group 2 patients . CONCLUSION Although both OIT and ICE-guided energy delivery possess a similar effect in treating AF , OIT seems to be superior in terms of achieving isolation and shortening fluoroscopy exposure . Moreover , a lower incidence of esophageal wall injury was observed utilizing OIT for PVAI
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 .