Data presented at the recent 2011 Heart Rhythm Society meeting in San Francisco regarding the effectiveness of catheter ablation for treatment of persistent atrial fibrillation suggests that multiple procedures may be needed. Dr. Thomas Rostock presented data on 395 patients (261 with persistent atrial fibrillation and 134 with longstanding persistent afib) who had stepwise ablation at his center in Hamburg, Germany. After about 2.5 years, 27% of patients were free of atrial fibrillation after a single procedure. When patients had multiple procedures, the success rate improved to 79%. In both cases, some patients were still on antiarrhythmic drugs.