[Atrial fibrillation: practical questions. Who are the best candidates for atrial fibrillation ablation?]

Ablation of paroxysmal AF in symptomatic patients is a clear indication after failure of anti-arrhythmic therapy (class IIa according to the recommendations). Ablation of persistent AF is feasible, as second line after failure of medical treatment, although there is no real consensus on ablative techniques : this procedure is long and complex, exposure to ionizing radiation is important. Regarding ablation of persistent AF, a careful selection of patients and multiple interventions are often necessary to increase the success rate. Standardization of the procedure and better reproducibility of results are essential to increase the indications for ablation in patients with persistent AF. Improvements are expected concerning the operative strategy, the targets of ablation and available tools.