Dear Colleagues,

 

Prevalence of atrial fibrillation is increasing worldwide and its management poses challenges that prompted the recent update of the European Society of Cardiology/European Association of Cardio-Thoracic Surgery guidelines. Catheter ablation of atrial fibrillation improved significantly over the past decade, but many patients still experience recurrent atrial fibrillation after the procedure leading to the need for repeat ablation.

In current guidelines, surgical ablation of atrial fibrillation is not recommended as first-line therapy due to the limited, though promising, available evidence, but it may be considered as initial therapy in selected patients. In particular, by comparing guideline recommendations of 2016 vs 2020, catheter or surgical ablation should be considered in patients with symptomatic persistent or long-standing persistent atrial fibrillation (Class IIb in 2016), but only atrial fibrillation catheter ablation for pulmonary vein isolation is recommended for rhythm control after one failed or intolerant drug therapy (Class I in 2020). Thoracoscopic or hybrid surgical ablation for patients refractory to drug therapy or after failed percutaneous AF ablation stays as a Class IIa recommendation. In other words, the best treatment for atrial fibrillation, in particular the long-standing persistent atrial fibrillation, is still open.

Hence, this special issue “New insight in Treatment of Atrial Fibrillation” aims to provide a comprehensive overview of atrial fibrillation and discuss the contribution of novel approaches to advances in the treatment of patients with atrial fibrillation. Full papers and communications, as well as comprehensive reviews, are welcome. Please feel free to contact me, the guest editor, in case of further questions.

Dr. Giuseppe Nasso and Prof. Dr. Giuseppe Santarpino

Guest Editors