5
Table 2b. Indications for Atrial Fibrillation Ablation in
Populations of Patients Not Well Represented in
Clinical Trials
Recommendations COR LOE
Congestive heart
failure
It is reasonable to use similar indications
for AF ablation in selected patients with
heart failure as in patients without heart
failure.
2A B-R
Older patients
(>75 years of age)
It is reasonable to use similar indications
for AF ablation in selected older patients
with AF as in younger patients.
2A B-NR
Hypertrophic
cardiomyopathy
It is reasonable to use similar indications
for AF ablation in selected patients with
HCM as in patients without HCM.
2A B-NR
Young patients
(<45 years of age)
It is reasonable to use similar indications
for AF ablation in young patients
with AF (<45 years of age) as in older
patients.
2A B-NR
Tachy-brady
syndrome
It is reasonable to offer AF ablation as an
alternative to pacemaker implantation in
patients with tachy-brady syndrome.
2A B-NR
Athletes with AF It is reasonable to offer high-level
athletes AF ablation as first-line
therapy due to the negative effects of
medications on athletic performance.
2A C-LD
Asymptomatic AF
a
Paroxysmal: Catheter ablation may be
considered in select patients.
a
2B C-EO
Persistent: Catheter ablation may be
considered in select patients.
2B C-EO
a
A decision to perform AF ablation in an asymptomatic patient requires additional discussion
with the patient as the potential benefits of the procedure for the patient without symptoms
are uncertain.
