Perspective:

Catheter ablation has emerged as an important intervention for patients with atrial fibrillation, both after a failure of antiarrhythmic drug(s) and as a first-line approach. Given that there is relatively limited evidence of decreased mortality and morbidity with rhythm-control strategy, interventions aiming to restore and maintain sinus rhythm, including catheter ablation, have been offered to patients who, physicians believe, have enough symptoms to warrant an intervention. The current study shows the limitations of physician interview in the assessment of AF symptom severity and impact on quality of life. Almost a third of patients who reported significant symptoms through the AFEQT survey were thought to be asymptomatic by their physicians. If these findings are confirmed, future studies should address the utility of validated questionnaires to help in patient-centered decision making regarding rhythm control, and how such measures could potentially facilitate the treatment of patients and improve clinical outcomes in patients with AF.