International Circulation: You have a presentation about catheter ablation for atrial fibrillation at this meeting. Can you talk about where you see the direction of the treatment of atrial fibrillation head? Do you think the indications for catheter ablation will be much broader in future than now?

Win-Kuang Shen: To highlight some very active areas， there is no question that ablation will continue to evolve since there are many upcoming trials to investigate this.  We will learn which patient population will enjoy a higher success rate， what the patient population may not be suitable for ablative therapy.  The techniques and technology for atrial fibrillation will continue to improve.  There will always be a role for anti-arrhythmic drug therapy and actually drug therapy targeting upstream prevention of atrial fibrillation， whether it is anti-inflammatory drug therapy， modification of risk factors like hypertension， sleep apnea， obesity， which is a critical issue for society， and diabetes.  Drug therapy will remain and there are new drugs coming as well.  This patient population is really a difficult one.  We have heard discussions that in the very old group perhaps ablation can be considered and feasible.  There is another approach that hasn’t been discussed much in China， which is the ablate and pace approach.  For older patients we are going to be examining the question whether we can ablate and pace earlier.  In fact we have a rather large ongoing trial looking at this question.  The there is stroke prevention.  We will see new drugs as well as other non-pharmacological treatments like appendage closure or removal tools.

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