Intracranial emboli associated with catheter ablation of atrial fibrillation: has the silence finally been broken?

Catheter ablation has become an accepted treatment approach for drug-refractory, symptomatic atrial fibrillation (AF). The technical aspects of the procedure have evolved, but to a remarkable degree, the objective of the procedure is nearly the same as when it was first introduced: the electrical isolation of the principal trigger sites of AF, the pulmonary veins (PVI). The procedure has an excellent success rate and acceptable safety profile, although AF may not be permanently eliminated even if response is initially complete (1).