1. Catheter ablation effect: paroxysmal AF is stronger than persistent AF In the 2012 HRS/EHRA/ECAS guidelines for atrial fibrillation ablation, the indications for catheter ablation of atrial fibrillation include paroxysmal AF as a Class I indication and Class A evidence. The 2014 AHA/ACC/HRS published guidelines for atrial fibrillation also adopted the same recommendation, and catheter ablation is feasible for symptomatic paroxysmal atrial fibrillation (Class I recommendation) and symptomatic persistent atrial fibrillation (Class IIa recommendation) that are not treated with Class I or Class III antiarrhythmic drugs or are intolerant. In other words, catheter ablation is considered as “first-line treatment” only for patients with paroxysmal atrial fibrillation. 2. First-line treatment of paroxysmal atrial fibrillation: catheter ablation is superior to drugs Randomized controlled clinical studies have demonstrated that catheter ablation is superior to drug therapy in young patients with paroxysmal atrial fibrillation without left atrial enlargement. In June 2015, the latest issue of HeartRhythm published online the latest controlled study of catheter ablation versus drug therapy for paroxysmal atrial fibrillation. RESULTS: At 3 months, the lowest atrial fibrillation load was observed in the drug-only group; at 18 months, the atrial fibrillation load in the ablation-only group was already lower than in the other two groups; at 2 years of follow-up, the atrial fibrillation load was significantly lower in the ablation group than in the other two groups. At the end of the 2-year follow-up period, the incidence of clinical events was consistently lower in the ablation group than in the drug treatment group. Catheter ablation of paroxysmal atrial fibrillation: most of the mechanisms are clear, and the procedure is mature. In 1950, the mechanism of atrial fibrillation was gradually studied in depth, and several theories emerged one after another, and each theory was almost accompanied by a corresponding procedure. In 1998, Haissaguerre’s research published in the New England Journal of Medicine attracted worldwide attention. This study identified foci of AF triggers in each pulmonary vein separately and determined the focal triggering mechanism of AF, showing that ectopic foci within the pulmonary veins triggered 80% to 95% of cases. In the late 1990s, based on the pulmonary vein triggering mechanism of paroxysmal AF, Italian scholar Pappone started to perform pulmonary vein isolation in AF using a three-dimensional technique, which significantly improved the efficacy and is still the mainstream of AF ablation. Catheter ablation of paroxysmal atrial fibrillation: the earlier the better A study published in Circulation in 2010 on the effects and risks of catheter ablation in patients younger than 45 years of age with atrial fibrillation showed the lowest complication rate in the young patient group younger than 45 years of age among the four age groups. The young patients with atrial fibrillation younger than 45 years of age had the highest rate of postoperative maintenance of sinus rhythm without the need for antiarrhythmic drugs. Conclusion: Catheter ablation should be considered as first-line treatment in the young AF patient group. 5. What is the safety of catheter ablation of atrial fibrillation? The 2014 guidelines used the largest clinical data available on the complications of atrial fibrillation ablation, with 16,309 patients included and 20,825 procedures performed. The results: the incidence of serious complications such as death and pericardial tamponade was very low. It can be concluded that the safety of catheter ablation of atrial fibrillation is very positive. Each patient faces such challenges regarding the benefits and risks of the procedure, and physicians need to weigh the pros and cons of both. Catheter ablation for paroxysmal atrial fibrillation is an opportunity for the patient; for the physician, if more patients can be cured as a result, it is also an opportunity for the physician. Paroxysmal atrial fibrillation, such a God-given opportunity, do you still need to wait?