Using the SF-36, both the physical and mental QoL scores improved in patients after ablation. Surprisingly, QoL improvement did not seem to differ for the ablation efficacy subgroups, with patients who had no AF recurrences having results similar to those not controlled even with drugs. A difference was noted using the Mayo AF-Specific Symptom Inventory, and here the ablation outcomes influenced the symptom results, and patients with elimination of AF fared better than those with recurrent AF. Although this seems to make sense, caution is advised with this analysis because it was only used in a smaller subgroup of patients and will require testing in a larger and broader population of post-ablation patients. Specific factors that negatively affected QoL after ablation were obesity, continued warfarin use, and higher baseline SF-36 scores. The authors opine that the limited QoL improvement in obese patients relates to diminished underlying functional capacity, which may be correct, but this is an important issue that requires more investigation. If such patients are not likely to have a better QoL after ablation, even with no AF recurrence, then why should they undergo the risks of the procedure? We caution any such conclusions along these lines, but suggest that investigators look into this issue. The negative effect on QoL with continued warfarin use is no surprise; in fact, many patients request an ablation merely to “get off warfarin.” That said, until more safety data are obtained, patients at high risk of stroke should continue warfarin therapy post-ablation even with no obvious AF recurrence (2- 3). Perhaps newer anticoagulants will be better tolerated by patients (5). Last, it seems obvious that patients who had more favorable SF-36 scores at baseline would derive less benefit after ablation.