First-Line Catheter Ablation for Paroxysmal Atrial Fibrillation — Have We Reached the Tipping Point?

Atrial fibrillation is a heterogeneous disorder with a variable course. Approximately one third of cases of atrial fibrillation that start out as short, self-terminating paroxysmal episodes progress to longer-lasting persistent attacks over time.1,2 Once the transition from paroxysmal to persistent atrial fibrillation occurs, the likelihood of treatment success decreases and the risks of adverse clinical outcomes increase.3,4 Therefore, treatment strategies to prevent progression to persistent forms of atrial fibrillation are needed. However, what strategies are successful and how early do we need to intervene? Randomized trials have consistently shown that a treatment strategy that includes ablation results in lower rates . . .