**Abstract**

Atrial fibrillation is a very frequent arrhythmia in our daily clinical practice, either isolated or associated with other heart diseases. It has high relevance as it can act as a decompensating agent of other heart diseases or damage the myocardium itself. Traditionally, the treatment of atrial fibrillation has been based on rhythm and rate control and also the treatment of its complications. To rhythm control, electrical or pharmacological cardioversion has been used, and different groups of bradycardizing drugs have been used for rate control. Anticoagulation is the most relevant treatment to prevent thromboembolic phenomena secondary to atrial fibrillation. However, with the recent development of endovascular procedures, the use of ablation to maintain sinus rhythm in this kind of patients has been increased displacing the use of other treatment strategies. Therefore, in this chapter, we would review the present evidence in the use of ablation techniques as atrial fibrillation treatment.

**Keywords:** atrial fibrillation, ablation, rhythm control

## **1. Introduction**

Atrial fibrillation is the most frequent sustained cardiac arrhythmia in adults. It has two differential characteristics, one electrocardiographic and another clinical. Clinically it is characterized by an irregularly irregular pulse, due to a supraventricular tachycardia producing a chaotic atrial activity. In addition, the electrocardiogram (ECG) shows the following defining characteristics [1]:

• Irregular R-R interval


Nowadays, the prevalence of this arrhythmia is rising due to, among to other causes, the increase in life expectancy and the effort to diagnose it [2]. In addition to the importance of this fact, AF has a special relevance resulting from its treatments and its complications, existing multiple pharmacologic treatments to control the harmful effects of this arrhythmia on patients. However, there are alternatives to pharmacological treatments that we would like to summarize in this chapter.
