[2006] Left atrial ablation 1.7.19 If drug treatment is unsuccessful, unsuitable or not tolerated in people with symptomatic paroxysmal or persistent atrial fibrillation: consider radiofrequency point-by-point ablation or if radiofrequency point-by-point ablation is assessed as being unsuitable, consider cryoballoon ablation or laser balloon ablation. [2021] 1.7.20 When considering left atrial ablation, discuss the risks and benefits and take into account the person's preferences. In particular, explain that the procedure is not always effective and that the resolution of symptoms may not be long-lasting. [2021] 1.7.21 Consider left atrial surgical ablation at the same time as other cardiothoracic surgery for people with symptomatic atrial fibrillation. For NICE interventional procedures guidance on left atrial ablation for atrial fibrillation, see the NICE interventional procedures guidance on our topic page on heart rhythm conditions. For a short explanation of why the committee made the 2021 recommendations and how they might affect practice, see the rationale and impact section on left atrial ablation. Full details of the evidence and the committee's discussion are in evidence review J1: ablation, evidence review J2: ablation network meta-analysis and evidence review J3: ablation cost-effectiveness analysis. Preventing recurrence after ablation 1.7.22 Consider antiarrhythmic drug treatment for 3 months after left atrial ablation to prevent recurrence of atrial fibrillation, taking into account the person's preferences, and the risks and potential benefits. [2021] 1.7.23 Reassess the need for antiarrhythmic drug treatment at 3 months after left atrial ablation. [2021] For a short explanation of why the committee made these recommendations and how they might affect practice, see the rationale and impact section on preventing recurrence after ablation. Full details of the evidence and the committee's discussion are in evidence review K: antiarrhythmic drugs after ablation. 