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Catheter ablation of atrial fibrillation (AF), a procedure now widely performed in major electrophysiology laboratories, has been studied most carefully in patients with paroxysmal AF. In this study, researchers randomized 146 patients with symptomatic, drug-refractory chronic AF to circumferential pulmonary-vein catheter ablation or control treatment. Patients were a select group: Their maximum age was 70 (mean, 57); all had left-atrial diameters ≤5.5 cm and LV ejection fractions (LVEFs) ≥30%; and only 8% had structural heart disease.
Both groups started amiodarone (200 mg daily) 6 weeks before the ablation group underwent their procedures. The ablation group continued the amiodarone for 3 months postablation and were permitted one cardiove…