title: Ablation as First-Line Therapy for Atrial Fibrillation: Yes.
abstract: This article addresses the use of catheter ablation (CA) as first-line therapy for atrial fibrillation (AF). CA increases long-term freedom from AF, reduces hospitalizations, and improves quality of life compared with antiarrhythmic drug (AAD) therapy in patients with symptomatic AF who have already failed one AAD. The role of CA as first-line therapy for AF, however, is still controversial. Evidence from randomized controlled trials shows that CA is definitely superior to AADs as first-line therapy for relatively young patients with paroxysmal AF, with comparable complication rates and results consistently reproducible across different institutions, operators, and types of ablation approaches.
authors.affiliation: Texas Cardiac Arrhythmia Institute, St David's Medical Center, 3000 North I-35, Suite 720, Austin, TX 78705, USA; University of Foggia, Foggia, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Santangeli
authors.affiliation: Texas Cardiac Arrhythmia Institute, St David's Medical Center, 3000 North I-35, Suite 720, Austin, TX 78705, USA; University of Foggia, Foggia, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Biase
authors.affiliation: Division of Cardiology, Stanford University, 300 Pasteur Drive, MC 5319 A260, Stanford, CA, USA.
authors.forename: Amin
authors.initials: A
authors.lastname: Al-Ahmad
authors.affiliation: Texas Cardiac Arrhythmia Institute, St David's Medical Center, 3000 North I-35, Suite 720, Austin, TX 78705, USA.
authors.forename: Rodney
authors.initials: R
authors.lastname: Horton
authors.affiliation: Texas Cardiac Arrhythmia Institute, St David's Medical Center, 3000 North I-35, Suite 720, Austin, TX 78705, USA.
authors.forename: J David
authors.initials: JD
authors.lastname: Burkhardt
authors.affiliation: Texas Cardiac Arrhythmia Institute, St David's Medical Center, 3000 North I-35, Suite 720, Austin, TX 78705, USA.
authors.forename: Javier E
authors.initials: JE
authors.lastname: Sanchez
authors.affiliation: Texas Cardiac Arrhythmia Institute, St David's Medical Center, 3000 North I-35, Suite 720, Austin, TX 78705, USA.
authors.forename: G Joseph
authors.initials: GJ
authors.lastname: Gallinghouse
authors.affiliation: Texas Cardiac Arrhythmia Institute, St David's Medical Center, 3000 North I-35, Suite 720, Austin, TX 78705, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Zagrodzky
authors.affiliation: Texas Cardiac Arrhythmia Institute, St David's Medical Center, 3000 North I-35, Suite 720, Austin, TX 78705, USA; Department of Internal Medicine, Tong-Ji Hospital, Tong-Ji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Bai
authors.affiliation: Texas Cardiac Arrhythmia Institute, St David's Medical Center, 3000 North I-35, Suite 720, Austin, TX 78705, USA; Heart Institute, Faculty of Medicine, University of Pecs, Pecs, Hungary.
authors.forename: Agnes
authors.initials: A
authors.lastname: Pump
authors.affiliation: Texas Cardiac Arrhythmia Institute, St David's Medical Center, 3000 North I-35, Suite 720, Austin, TX 78705, USA.
authors.forename: Sanghamitra
authors.initials: S
authors.lastname: Mohanty
authors.affiliation: Heart and Vascular Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA.
authors.forename: William R
authors.initials: WR
authors.lastname: Lewis
authors.affiliation: Texas Cardiac Arrhythmia Institute, St David's Medical Center, 3000 North I-35, Suite 720, Austin, TX 78705, USA; Division of Cardiology, Stanford University, 300 Pasteur Drive, MC 5319 A260, Stanford, CA, USA; Heart and Vascular Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA; Interventional Electrophysiology, Scripps Clinic, San Diego, CA, USA; EP Services, California Pacific Medical Center, San Francisco, CA, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Natale