Efficacy of Catheter Ablation for Atrial Fibrillation: Comparison of Techniques, Populations, and Predictors of Success

Introduction: Atrial fibrillation (AF) is the most common cardiac arrhythmia, associated with cardiovascular complications and a significant impact on quality of life. Catheter ablation is an effective alternative to pharmacological treatment; however, the optimal technique and predictors of recurrence remain subjects of debate. Objective: To evaluate the efficacy and safety of ablation strategies for AF, considering different techniques, recurrence predictors, and clinical impact. Methods: A systematic review based on 11 studies published between 2020 and 2024, selected from PubMed, Scopus, and Cochrane databases, including randomized clinical trials and observational studies. Inclusion criteria encompassed studies comparing ablation strategies and analyzing biomarkers and clinical outcomes. Results: Hybrid ablation (epicardial + endocardial) demonstrated greater efficacy in maintaining sinus rhythm compared to endocardial ablation alone. Patients undergoing ablation reported improved quality of life compared to those using antiarrhythmic drugs. Biomarkers such as TSH, FT4, and BNP were associated with AF recurrence. Additionally, ablation proved effective in elderly patients and those with heart failure, reducing hospitalizations and cardiovascular mortality. Conclusion: Catheter ablation is an effective strategy for AF, providing significant clinical benefits. The choice of technique should be individualized, considering clinical factors and biomarkers. Further studies are necessary to standardize approaches and optimize outcomes.