Severe aortic stenosis is a quite common clinical condition, particularly among individuals older than 70 years. It is usually accompanied by symptoms such as chest pain, easy fatigue, dyspnea and fainting attacks. However due to the timing of clinical presentation, symptoms are often attributed to other co-morbidities or simply the age of patient.

Physical examination is sometimes misleading in guiding diagnostic thinking, since the most expected physical findings are not always present. Diagnosis is easily made with echocardiography, a simple, convenient and non-invasive diagnostic procedure. With the use of ultrasound the physician is able to accurately determine the severity of aortic valve stenosis and also evaluate the function of other valves and the contractility of the heart. This echocardiographic evaluation is of paramount importance for the final decision regarding any therapeutic intervention.

Several medications have been used in order to regress or even delay the worsening of this condition, but none was found to be successful. The only way to manage this form of valvulopathy is surgical replacement of the pathologic valve. Each patient needs to be evaluated thoroughly in order to assess the surgical risk and the expected benefit from such intervention.

In general, a patient should be referred for surgery when the severity of aortic valve stenosis is documented (aortic valve area < 1cm2) and also when symptoms are present. For patients who are considered to be at high risk for a traditional surgical operation there is now the option of a transcutaneous procedure (TAVI).

After a successful replacement of the aortic valve the patient will be able to resume back to the normal daily activities without any restrictions, and most importantly without symptoms.

Catheter ablation of atrial fibrillation is an invasive therapeutic option for individuals with AF. It was first introduced in the late 1980s and has now emerged as a quite common procedure in many hospitals. Accumulated clinical experience as well as data from several prospective randomized trials confirm that catheter ablation of AF is superior to antiarrhythmic drug therapy in controlling AF.

AF ablation is suggested to be particularly beneficial for patients with the paroxysmal form of AF without other severe comorbidities. Catheter ablation is indicated for treatment of patients with symptomatic AF in whom one or more attempts with antiarrhythmic drug (class I or III) therapy have failed.

In the recent guidelines for management of AF, catheter ablation is reasonable to be implemented as a first-line therapy in selected patients; however it is more practical in clinical practice to initiate a non-invasive pharmaceutical intervention first.

This procedure has made a remarkable progress in the last years mostly due to novel technological improvements and packed clinical experience and skills. Finally it should be noted that catheter ablation is very rarely associated with potentially life-threatening complications, such as an atriooesophageal fistula, stroke, and cardiac tamponade.