1. AF: Catheter Ablation Isolation of the 4 pulmonary veins Linear lesions to create additional lines of block 1

2. AF Catheter Ablation: Current status Candidates: Severely symptomatic patients who failed at least one AAD Results are better for Paroxysmal and persistent AF than for permanent AF Success rate is around 60-70% Over 30% may require a second procedure left atrial flutter and tachycardia are not uncommon post ablation and can be challenge to treat Serious complications: Rare but can be life threatening (Esophageal fistula, tamponad, PV stenosis, CVA) 2

3. AF: Summary Proper work-up should be done to identify reversible causes and to help guide drug therapy Anticoagulation is based on the degree of risk for strokes Anticoagulation should be continued even when SR seems to have been established and maintained The strategy of rhythm control was not better than rate control due to ineffective AAD and pro-arrhythmic effects Ablation of AF can be considered for pts. Who can not tolerate AF and have failed at least one AAD. 3

4. Thank you

5. No heart disease HypertensionCADHF Flecainide Propafenone Sotalol Substantial LVH Dofetilide Sotalol Amiodarone Dofetilide NoYesAmioda rone Cathete r ablation Amiodar one Dofetilid e Catheter ablation Flecainide Propafenone Sotalol Amiodarone Dofet ilide Cath eter ablati on 5

6. AF: Ablation at KFAFH Candidates for catheter ablation at KFAFH: Paroxysmal or persistent AF Severely symptomatic and have failed at least one AAD LA size ≤ 48mm LVEF > 35% No significant co-morbidities 6