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Purpose of Review Atrial fibrillation (AF), the most common sustained arrhythmia, is associated with high rates of morbidity and mortality. Maintenance of stable sinus rhythm (SR) is the intended treatment target in symptomatic patients, and catheter ablation aimed at isolating the pulmonary veins provides the most effective treatment option, supported by encouraging clinical outcome data. A variety of energy sources and devices have been developed and evaluated. In this review, we summarize the current state of the art of catheter ablation of AF and describe future perspectives. Recent Findings Catheter ablation is a well-established treatment option for patients with symptomatic AF and is more successful at maintaining SR than antiarrhythmic drugs. Antral pulmonary vein isolation (PVI) as a stand-alone ablation strategy results in beneficial clinical outcomes and is therefore recommended as first-line strategy for both paroxysmal and persistent AF. While radiofrequency-based PVI in conjunction with a three-dimensional mapping system was for many years considered to be the “gold standard”, the cryoballoon has emerged as the most commonly used alternative AF ablation tool, especially in patients with paroxysmal AF. Patients with persistent or long-standing persistent AF and with arrhythmia recurrence after previous PVI may benefit from additional ablation strategies, such as substrate modification of various forms or left atrial appendage isolation. New technologies and techniques, such as identification of the AF sources and magnetic resonance imaging-guided substrate modification, are on the way to further improve the success rates of catheter ablation for selected patients and might help to further reduce arrhythmia recurrence. Conclusions Pulmonary vein isolation is the treatment of choice for symptomatic patients with paroxysmal and persistent drug-refractory AF. The reconnection of previously isolated pulmonary veins remains the major cause of AF recurrence. Novel ablation tools, such as balloon technologies or alternative energy sources, might help to overcome this limitation. Patients with non-paroxysmal AF and with AF recurrence might benefit from alternative ablation strategies. However, further studies are warranted to further improve our knowledge of the underlying mechanisms of AF and to obtain long-term clinical outcomes on new ablation techniques.

Das Hauptanliegen meines Forschungsprojektes war die erneute Untersuchung der aus dem späten 3. bis 7. Jahrhundert n. Chr. stammenden griechischen medizinischen Papyri, die zwischen 1913 und 1914 hauptsächlich an einem Ort in der ägyptischen Stätte von Antinoopolis gefunden wurden. Antinoopolis bietet die Gelegenheit, diesen Dokumenten einen archäologischen Kontext zu geben, zumal die vorliegende geographische und chronologische Kontinuität einen detaillierten Vergleich der durch diese Quellen konservierten Daten begünstigt. Das Interesse an Antinoopolis aus medizinhistorischer Perspektive ist durch die diversen Heilpraktiken begründet, die von den dokumentarischen, literarischen und archäologischen Beweisstücken bezeugt werden, und deren Quantität und Bandbreite für ein ägyptisches Dorf außergewöhnlich sind. Das Ziel meiner Forschung an den Papyri ist sowohl philologischer als auch kulturhistorischer Natur. Erstens habe ich versucht, die Manuskripte wissenschaftlich zu präsentieren und ihre Eigentümlichkeiten, Charakteristika und Funktionen zu diskutieren. Ich wollte unser Verständnis dieser Fragmente durch die Identifizierung neuer Textabschnitte, die Integrierung von Textzusätzen und eine genauere Untersuchung ihrer formellen Struktur verbessern, was zu einer überarbeiteten Edition einiger ausgewählter Papyri führte. Darüber hinaus habe ich versucht, zum besseren Verständnis des allgemeinen Umfeldes dieser ägyptischen Gemeinschaft, besonders in Bezug auf religiöse Heilpraktiken im Zusammenhang mit der heiligen Stätte des Collouthus beizutragen, und die historischen und kulturellen Gegebenheiten zu untersuchen, in denen diese Texte genutzt wurden. Schlussendlich untersucht meine Forschung die Entwicklung des Kodex im Allgemeinen über den Zeitraum der späten Antike, die an verschiedenen Aspekten beobachtet werden kann. Eine der interessantesten Fragen dabei ist, wie die Texte gesammelt und präsentiert wurden, d.h. der Zusammenhang von Aufbewahrung der Papyri und ihrem Textinhalt. The main aim of my research project was to re-examine the Greek medical papyri from the Egyptian site of Antinoopolis dating between late 3rd up to 7th century AD, discovered mostly in a single area between 1913 and 1914. Antinoopolis offers the potential for putting documents into an archaeological context, and this geographical and chronological consistency facilitates a close comparison between the data preserved in these sources. The interest in Antinoopolis, as far as the medical tradition is concerned, lies in the diverse healing practices attested by documentary, literary and archaeological evidence whose quantity and range is altogether exceptional among Egyptian villages. The objective of my research is both papyrological-philological and cultural-historical. Firstly, I have tried to present the manuscripts and discuss their peculiarities, characteristics and functions. I have sought to improve our understanding of these fragments through the identification of new portions of text, the integration of supplements and a better assessment of their formal arrangement, which resulted in the revised edition of a few outstanding papyri. In addition to this, I have tried to contribute to the evaluation of the general context of this Egyptian community, particularly as regards religious healing practices connected to the sanctuary of Collouthus, and to explore the historical and cultural circumstances in which these texts were used. Finally, my research investigates the development of the codex throughout late Antiquity, which can be observed in a number of respects. One of the most significant concerns how the texts were assembled and presented, namely the interplay between container and content.