MEDICAL PROFESSIONALS

Patient Selection

Patient selection criteria

Catheter ablation is indicated for an ever-growing population of patients with atrial fibrillation. In general, patients that are referred for catheter ablation include those with paroxysmal or persistent Afib, have a left atrium size less than 5.0 cm, and have no structural heart disease. Another criterion that is under consideration is that patients referred for catheter ablation are normally refractory to pharmacological therapy. However, at present, there are no internationally established criteria as to the exact definition of this or how many different medical therapies should be attempted before ablation is considered. As already noted, it is likely that patients should be considered for ablative treatment after one pharmacological failure, also in light of the fact that multiple drug failures, and consequent cardiac remodeling, might render patients less refractory to ablative therapy. Lastly, younger patients are also more likely to benefit more from catheter ablation, due to more their active lifestyle (ref. 30).
 

In contrast, patients with prior heart surgery, an upper limit of left atrial size between 5.5 and 6.0 cm, and a lower limit of LVEF between 30% and 35% are generally contraindicated for catheter ablation as are older patients with permanent Afib.