CACAF2 Study: Catheter Ablation for Cure of Atrial Fibrillation (CACAF-2)

Inclusion Criteria: 18-70 years Written informed consent One documented relapse of atrial fibrillation (AF) during antiarrhythmic drug therapy after an electrical cardioversion Exclusion Criteria: Permanent atrial fibrillation Patients who had tried >1 antiarrhythmic drug (Class I or Class III). AF was the sole rhythm for >6 months before the enrollment. Previous ablation for AF. AF is deemed secondary to a transient or correctable abnormality including electrolyte imbalance, trauma, recent surgery, infection, toxic ingestion, and endocrinopathy. Patients who have fibrillation episodes triggered by another uniform arrhythmia (eg, atrial flutter or atrial tachycardia). Patients with intra-atrial thrombus, tumor, or another abnormality that precludes catheter introduction. Patients with Wolf-Parkinson-White syndrome. Patients awaiting cardiac transplantation. Congestive heart failure (CHF) New York Heart Association (NYHA) Class II-III-IV or ejection fraction (EF) <40%. Patients with unstable angina or acute myocardial infarction within 3 months. Patients with cardiac revascularization or other cardiac surgery within 6 months. Patients with heart disease in which corrective surgery is anticipated. Patients in whom appropriate vascular access is precluded. Pregnant women. A separate requirement for antiarrhythmic drug treatment, which will require an antiarrhythmic drug not previously tried for AF suppression. Prior atrial surgery. Contraindication to treatment with warfarin or other bleeding diathesis. Renal failure requiring dialysis. Hepatic failure. Participant in investigational clinical or device trial. Unwilling or unable to give informed consent. Inaccessible for follow-up. Psychological problem that might limit compliance. Active abuse of alcohol or other drugs which may be causative of AF. An implanted device (pacemaker or cardioverter-defibrillator). Left atrial diameter (anteroposterior) >50 mm.