Persistent atrial fibrillation (AF) represents a major public health and medical challenge. The progressive nature of the disease, high morbidity and increasing health-economic costs ensure it remains at the forefront of novel research into mechanisms and potential therapies. These are largely divided into pharmacological (drugs) and electrical (ablation), with patients often going from former to latter. AF ablation has improved sufficiently to be offered as first line for paroxysmal AF, but there is uncertainty on whether drug therapy will improve from its current role or be relegated to niche status. In this review we shall outline the progress in mechanistic understanding of AF that may allow results from ablation to diverge dramatically from drug therapy, to identify populations in whom drug therapy may become less relevant. We end by looking ahead to future developments which we hope will spur on therapeutic efficacy in both fields.
View details for DOI 10.1097/FJC.0000000000000270
View details for PubMedID 25923323