Catheter ablation of an arrhythmogenic focus may be beneficial in a patient with atrial fibrillation.
Usual indications for catheter ablation in a patient with atrial fibrillation:
(1) failure of drug therapy (adequate trial of one or more Class I or III antiarrhythmic agents) in a patient who is symptomatic
(2) intolerance to drug therapy in a patient who is symptomatic
(3) presence of reduced left ventricular ejection fraction or heart failure if clinically indicated
Rarely a patient with atrial fibrillation may undergo catheter ablation as first line therapy without attempting control using drug therapy.
Contraindications:
(1) left atrial thrombus (absolute)
(2) inability to anticoagulate the patient (relative)