Toward radiofrequency catheter ablation of atrial fibrillation

Curative treatments of supraventricular arrhythmias—that is, aiming at the elimination of arrhythmic substrate—were initially performed in the 1970s during cardiac surgery as a last resort. A tandem team of surgeons and electrophysiologists intervened, as the individual location of substrate required mapping guidance of the electrical anomaly. In the early 1980s, catheter ablation began using direct current (DC) shocks, with most procedures being palliative as they aimed at interrupting atrioventricular (AV) conduction in patients with uncontrolled ventricular rate associated with atrial fibrillation (AF) or AV nodal reentrant tachycardia (AVNRT).