What next?
As shown in the table, published data to date do not support ICANS modulation as an alternative to PV isolation. This is especially as ablation technologies have made the latter a streamlined, safe procedure with unequivocal objective end-points and excellent clinical results. Whether ICANS modulation would have a role in carefully selected subgroups, such as those with AF recurrence in spite of documented isolated PVs, remains to be proven. As of now, we believe that when it comes to the ablating the autonomic nervous system in AF, it may be preferable to take flight rather than to fight.