Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2012 Apr 18;2012(4):CD007101.
doi: 10.1002/14651858.CD007101.pub2.

Catheter ablation for paroxysmal and persistent atrial fibrillation

Huai Sheng Chen  1 , Jun Min Wen, Sheng Nan Wu, Jian Ping Liu
Affiliations
Meta-Analysis

Catheter ablation for paroxysmal and persistent atrial fibrillation

Huai Sheng Chen et al. Cochrane Database Syst Rev. .

Abstract

Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia seen in cardiovascular departments. Treatments include medical interventions and catheter ablation. Due to uncertainties in medical therapies for AF, and the need to continue sinus rhythm, ablation has been recently considered as a viable alternative. Many new ablation methods based on pulmonary vein isolation (PVI) have been developed.

Objectives: The primary objective of this review was to assess the beneficial and harmful effects of catheter ablation (CA) in comparison with medical treatment in patients with paroxysmal and persistent AF. The secondary objective was to determine the best regimen of CA.

Search methods: Searches were run on The Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library Issue 3 2009, MEDLINE (1950 to August 2009), EMBASE (1980 to August 2009), the Chinese Biomedical Literature Database (1978 to August 2009) and the CKNI Chinese Paper Database (1994 to 2009) . Several journals published in Chinese were also handsearched.

Selection criteria: Randomised controlled trials (RCTs) in people with paroxysmal and persistent AF treated by any type of CA method. Two reviewers independently selected the trials for inclusion.

Data collection and analysis: Assessments of risk of bias were performed by two reviewers, and relative risk (RR) and 95% confidence intervals (CI) were used for dichotomous variables. Meta-analysis were performed where appropriate.

Main results: A total of 32 RCTs (3,560 patients) were included. RCTs were small in size and of poor quality.CA compared with medical therapies: seven RCTs indicated that CA had a better effect in inhibiting recurrence of AF [RR 0.27; 95% CI 0.18, 0.41)] but there was significant heterogeneity. There was limited evidence to suggest that sinus rhythm was restored during CA (one small trial: RR 0.28, 95% CI 0.20-0.40), and at the end of follow-up (RR 1.87, 95% CI 1.31-2.67; I(2)=83%). There were no differences in mortality (RR, 0.50, 95% CI 0.04 to 5.65), fatal and non-fatal embolic complication (RR 1.01, 95% CI 0.18 to 5.68) or death from thrombo-embolic events (RR 3.04, 95% CI 0.13 to 73.43).Comparisons of different CAs; 25 RCTs compared CA of various kinds. Circumferential pulmonary vein ablation was better than segmental pulmonary vein ablation in improving symptoms of AF (p<=0.01) and in reducing the recurrence of AF (p<0.01). There is limited evidence to suggest which ablation method was the best.

Authors' conclusions: There is limited evidence to suggest that CA may be a better treatment option compared to medical therapies in the management of persistent AF. This review was also unable to recommend the best CA method.

PubMed Disclaimer

Conflict of interest statement

None known.

Figures

1
1
Flow diagram.
2
2
Funnel plot of comparison: 5 Recurrence of AF in comparing CA with Medicines, outcome: 5.1 recurrence of AF.
3
3
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
4
4
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1 Recurrence of AF in comparing CA with Medicines (rhythm control), Outcome 1 recurrence of AF.
2.1
2.1. Analysis
Comparison 2 Fatal or non‐fatal embolic complications in comparing CA with Medicines (rhythm control), Outcome 1 fatal or non‐fatal embolic complications.
3.1
3.1. Analysis
Comparison 3 mortality in comparing CA with Medicines (rhythm control), Outcome 1 mortality.
4.1
4.1. Analysis
Comparison 4 Death of thrombo‐embolic events in comparing CA with Medicines (rhythm control), Outcome 1 death of thrombo‐embolic events.
5.1
5.1. Analysis
Comparison 5 SR restored during the procedure in comparing CA with Medicines (rhythm control), Outcome 1 SR restored during the procedure.
6.1
6.1. Analysis
Comparison 6 SR restored at last follow up in comparing CA with Medicines (rhythm control), Outcome 1 SR restored at last follow up.
7.1
7.1. Analysis
Comparison 7 Recurrence of AF in comparing SPVA with CPVA, Outcome 1 Recurrence of AF.
8.1
8.1. Analysis
Comparison 8 Recurrence of AF between CPVA plus CTIB and CPVA alone, Outcome 1 Recurrence of AF at 12 months follow‐up.
9.1
9.1. Analysis
Comparison 9 Recurrence of AF between small and large area PVI, Outcome 1 recurrence of AF.
10.1
10.1. Analysis
Comparison 10 Comparison of recurrence of AF between CFAE plus PVAI and PVAI alone, Outcome 1 Recurrence of AF.
10.2
10.2. Analysis
Comparison 10 Comparison of recurrence of AF between CFAE plus PVAI and PVAI alone, Outcome 2 Recurrence of AF in persistent AF patients.
11.1
11.1. Analysis
Comparison 11 Embolic complications in comparing PVI with PVI plus additional atrium ablation, Outcome 1 embolic complication.
12.1
12.1. Analysis
Comparison 12 sinus rhythm restored during the ablation procedure, Outcome 1 Sinus rhythm restored during the ablation procedure.
13.1
13.1. Analysis
Comparison 13 Sinus rhythm restored at the end of follow‐up, Outcome 1 PVI compared to PVI plus left atrium linear ablation.
13.2
13.2. Analysis
Comparison 13 Sinus rhythm restored at the end of follow‐up, Outcome 2 CPVA compared to modified CPVA.
14.1
14.1. Analysis
Comparison 14 Comparison of superior PVs and four‐PVs ablation in free of AF in one year follow‐up, Outcome 1 Free of atrial fibrillation.
15.1
15.1. Analysis
Comparison 15 Comparision of sinus rhythm between CFAE+PV(A)I and PV(A)I, Outcome 1 Sinus rhythm remaining.
16.1
16.1. Analysis
Comparison 16 Insidence of cardiac tamponade, Outcome 1 Cardiac tamponade.
17.1
17.1. Analysis
Comparison 17 Comparison of complication of superior PVs and four‐PV ablation, Outcome 1 Asymptomatic PV stenosis.
18.1
18.1. Analysis
Comparison 18 Comparison of complication of PV‐AJ ablation plus or not cavo‐tricuspid isthmus ablation, Outcome 1 Asymptomatic PV stenosis.
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD007101

References

References to studies included in this review

Arentz 2007 {published data only}
    1. Thomas Arentz, Reinhold Weber, Gerd Bürkle, Claudia Herrera, Thomas Blum, Jochem Stockinger, et al. Small or Large Isolation Areas Around the Pulmonary Veins for the Treatment of Atrial Fibrillation? Results From a Prospective Randomized Study. Circulation 2007;115:3057‐3063. - PubMed
Calo 2006 {published data only}
    1. Leonardo Calò, Filippo Lamberti, Maria Luisa Loricchio, Ermenegildo De Ruvo, Furio Colivicchi, Leopoldo Bianconi, et al. Left Atrial Ablation Versus Biatrial Ablation for Persistent and Permanent Atrial Fibrillation: A Prospective and Randomized Study. Journal of the American College of Cardiology 2006;47(12):2504‐2512. [PUBMED: 16781381] - PubMed
Deisenhofer 2009 {published data only}
    1. Isabel Deisenhofer, Heidi Estner, Tilko Reents, Stephanie Fichtner, Axel Bauer, Jinjin Wu, et al. Does Electrogram Guided Substrate Ablation Add to the Success of Pulmonary Vein Isolation in Patients with Paroxysmal Atrial Fibrillation?A Prospective, Randomized Study. Journal of Cardiovascular Electrophysiology 2009;20(5):514‐521. - PubMed
Dixit 2008 {published data only}
    1. Sanjay Dixit, Edward P. Gerstenfeld, Sarah J. Ratcliffe, Joshua M. Cooper, Andrea M. Russo, Stephen E. Kimmel, et al. Single procedure efficacy of isolating all versus arrhythmogenic pulmonary veins on long‐term control of atrial fibrillation: A prospective randomized study. Heart rhythm 2008;5(2):174‐181. - PubMed
Fassini 2005 {published data only}
    1. Gaetano Fassini, Stefania Riva, Roberta Chiodelli, Nicola Trevisi, Marco Berti, Corrado Carbucicchio, et al. Left Mitral Isthmus Ablation Associated with PV Isolation: Long‐Term Results of a Prospective Randomized Study. J Cardiovasc Electrophysiol 2005;16(11):1150‐1156. [PUBMED: 16302895] - PubMed
Forleo 2009 {published data only}
    1. Giovannib Forleo, Massimo Mantica, Lucia De Luca, Roberto Leo, Luca Santini, Stefania Panigada, et al. Catheter ablation of atrial fibrillation in patients with diabetes mellitus type 2: results from a randomized study comparing pulmonary vein isolation versus antiarrhythmic drug therapy. Journal of cardiovascular electrophysiology 2009;20(1):22‐28. - PubMed
Haïssaguerre 2004 {published data only}
    1. Michel Haïssaguerre, Prashanthan Sanders, Mélèze Hocini, Li‐Fern Hsu, Dipen C. Shah, Christophe Scavée, et al. Changes in Atrial Fibrillation Cycle Length and Inducibility During Catheter Ablation and Their Relation to Outcome. Circulation 2004;109(24):3007‐3013. [PUBMED: 15184286] - PubMed
Hocini 2005 {published data only}
    1. Mélèze Hocini, Pierre Jaïs, Prashanthan Sanders, Yoshihide Takahashi, Martin Rotter, Thomas Rostock, et al. Techniques, Evaluation, and Consequences of Linear Block at the Left Atrial Roof in Paroxysmal Atrial Fibrillation: A Prospective Randomized Study. Circulation 2005;112(24):3688‐3696. [PUBMED: 16344401] - PubMed
Jaïs 2008 {published data only}
    1. Pierre Jaïs, Bruno Cauchemez, Laurent Macle, Emile Daoud, Paul Khairy, Rajesh Subbiah, et al. Catheter Ablation Versus Antiarrhythmic Drugsfor Atrial Fibrillation: the A4 Study. Circulation 2008;118(24):2498‐2505. - PubMed
Karch 2005 {published data only}
    1. Axel Bauer, Isabel Deisenhofer, Raphael Schneider, Bernhard Zrenner, Petra Barthel, MD, * Martin Karch, et al. Effects of circumferential or segmental pulmonary vein ablation for paroxysmal atrial fibrillation on cardiac autonomic function. Heart Rhythm 2005;3:1428 –1435. - PubMed
    1. Martin R. Karch, Bernhard Zrenner, Isabel Deisenhofer, Jürgen Schreieck, Gjin Ndrepepa, Jun Dong, et al. Freedom From Atrial Tachyarrhythmias After Catheter Ablation of Atrial FibrillationA Randomized Comparison Between 2 Current Ablation Strategies. Circulation 2005;111(22):2875‐80. [PUBMED: 15927974] - PubMed
Katritsis 2004 {published data only}
    1. Katritsis DG, Ellenbogen KA, Panagiotakos DB, Giazitzoglou E, Karabinos I, Papadopoulos A, et al. ablation of superior pulmonary vein compared to ablation of all four pulmonary veins: a randomized clinical trial. J Cardiovasc Electrophysiol 2004;15(6):641‐645. [PUBMED: 15175057] - PubMed
Krittayaphong 2003 {published data only}
    1. Krittayaphong R. Raungrattanaamporn O. Bhuripanyo K. Sriratanasathavorn C. Pooranawattanakul S. Punlee K, et al. A randomized clinical trial of the efficacy of radiofrequency catheter ablation and amiodarone in the treatment of symptomatic atrial fibrillation. Journal of the Medical Association of Thailand 2003;86(Suppl 1):S8‐16. - PubMed
Liu02 2006 {published data only}
    1. Xingpeng Liu, Jianzeng Dong, Hercules E. mavakis, Fuli Hu, Deyong Long, Dongping Fang, et al. Achievement of Pulmonary Vein Isolation in Patients Undergoing Circumferential Pulmonary Vein Ablation: A Randomized Comparison Between Two Different Isolation Approaches. J Cardiovasc Electrophysiol 2006;17(12):1263‐1270. [PUBMED: 17239094] - PubMed
Liu 2006 {published data only}
    1. Xingpeng Liu, Deyong Long, Jianzeng Dong, Fuli Hu, Ronghui Yu, Ribo Tang, et al. Is Circumferential Pulmonary Vein Isolation Preferable to Stepwise Segmental Pulmonary Vein Isolation for Patients With Paroxysmal Atrial Fibrillation? A Randomized Study. Circulation Journal 2006;70(11):1392‐1397. [PUBMED: 17062959] - PubMed
Marrouche 2007 {published data only}
    1. Nassir F. Marrouche, Jens Guenther, Nathan M. Segerson, Marcos Daccarett, Harald Rittger, Harald Marschang, et al. Randomized Comparison Between Open Irrigation Technology and Intracardiac‐Echo‐Guided Energy Delivery for Pulmonary Vein Antrum Isolation: Procedural Parameters, Outcomes, and the Effect on Esophageal Injury. J Cardiovasc Electrophysiol 2007;18(6):583‐588. [PUBMED: 17490437] - PubMed
Nilsson 2006 {published data only}
    1. Brian Nilsson, Xu Chen, Steen Pehrson, Lars Køber, Jørgen Hilden, Jesper H. Svendsen. Recurrence of pulmonary vein conduction and atrial fibrillation after pulmonary vein isolation for atrial fibrillation: A randomized trial of the ostial versus the extraostial ablation strategy. American Heart Journal 2006;152:537.e1‐e8. - PubMed
Oral 2003 {published data only}
    1. Hakan Oral, Christoph Scharf, Aman Chugh, Burr Hall, Peter Cheung, Eric Good, et al. Catheter Ablation for Paroxysmal Atrial Fibrillation Segmental Pulmonary Vein Ostial Ablation Versus Left Atrial Ablation. Circulation 2003;108(19):2355‐2360. [PUBMED: 14557355] - PubMed
Oral 2004 {published data only}
    1. Hakan Oral, Aman Chugh, Kristina Lemola, Peter Cheung, Burr Hall, Eric Good, et al. Noninducibility of Atrial Fibrillation as an End Point of Left Atrial Circumferential Ablation for Paroxysmal Atrial Fibrillation: A Randomized Study. Circulation 2004;110(18):2797‐2801. [PUBMED: 15505091 ] - PubMed
Oral 2006 {published data only}
    1. Oral H, Pappone C, Chugh A, Good E, Bogun F, Pelosi F, et al. Circumferential Pulmonary‐Vein Ablation for Chronic Atrial Fibrillation. New England Journal of Medicine 2006;354(9):934‐41. - PubMed
Oral 2009 {published data only}
    1. Hakan Oral, Aman Chugh, Kentaro Yoshida, Jean F. Sarrazin, Michael Kuhne, Thomas Crawford, et al. A randomized assessment of the incremental role of ablation of complex fractionated atrial electrograms after antral pulmonary vein isolation for long‐lasting persistent atrial fibrillation. Journal of the American College of Cardiology 2009;53(9):782‐789. - PubMed
Pappone 2004 {published data only}
    1. Carlo Pappone, Francesco Manguso, Gabriele Vicedomini, Filippo Gugliotta, Ornella Santinelli, Amedeo Ferro, et al. Prevention of Iatrogenic Atrial Tachycardia After Ablation of Atrial Fibrillation A Prospective Randomized Study Comparing Circumferential Pulmonary Vein Ablation With a Modified Approach. Circulation 2004;110(19):3036‐3042. [PUBMED: 15520310] - PubMed
Pappone 2006 {published data only}
    1. Pappone C. Augello G. Sala S. Gugliotta F. Vicedomini G. Gulletta S, et al. A randomized trial of circumferential pulmonary vein ablation versus antiarrhythmic drug therapy in paroxysmal atrial fibrillation: the APAF Study. Journal of the American College of Cardiology 2006;48(11):2340‐7. - PubMed
Pontoppidan 2009 {published data only}
    1. Pontoppidan J, Nielsen JC, Poulsen SH, Jensen HK, Walfridsson H, Pedersen AK, et al. Prophylactic cavotricuspid isthmus block during atrial fibrillation ablation in patients without atrial flutter: a randomised controlled trial. Heart 2009;95(12):994‐999. - PubMed
Rajappan 2009 {published data only}
    1. Kim Rajappan, Victoria Baker, Laura Richmond, Peter M. Kistler, Glyn Thomas, Calum Redpath, et al. A randomized trial to compare atrial fibrillation ablation using a steerable vs. a non‐steerable sheath. Europace 2009;11(5):571‐575. - PubMed
Sheikh 2006 {published data only}
    1. Imran Sheikh, David Krum, Ryan Cooley, Anwer Dhala, Zalmen Blanck, Atul Bhatia, et al. Pulmonary vein isolation and linear lesions in atrial fibrillation ablation. J Interv Card Electrophysiol 2006;17(2):103‐109. [PUBMED: 17318445] - PubMed
Stabile 2006 {published data only}
    1. Stabile G. Bertaglia E. Senatore G. De Simone A. Zoppo F. Donnici G, et al. Catheter ablation treatment in patients with drug‐refractory atrial fibrillation: a prospective, multi‐centre, randomized, controlled study (Catheter Ablation For The Cure Of Atrial Fibrillation Study). European Heart Journal 2006;27(2):216‐21. - PubMed
Verma 2007 {published data only}
    1. Atul Verma, Dimpi Patel, Tamer Famy, David O. Martin, J. David Burkhardt, S. Claude Elayi, et al. Efficacy of Adjuvant Anterior Left Atrial Ablation During Intracardiac Echocardiography‐Guided Pulmonary Vein Antrum Isolation for Atrial Fibrillation. J Cardiovasc Electrophysiol 2007;18(2):151‐156. [PUBMED: 17338763] - PubMed
Wang 2008 {published data only}
    1. Wang Xin‐Hua, Liu Xu, Sun Yu‐Min, Shi Hai‐Feng, Zhou Li, Gu Jia‐Ning. Pulmonary vein isolation combined with superior vena cava isolation for atrial fibrillation ablation: a prospective randomized study. Europace 2008;10(5):600‐605. - PubMed
Wazni 2003 {published data only}
    1. Oussama Wazni, Nassir F. Marrouche, David O. Martin, A. Marc Gillinov, Walid Saliba, Eduardo Saad, et al. Randomized Study Comparing Combined PulmonaryVein–Left Atrial Junction Disconnection and Cavotricuspid Isthmus Ablation Versus Pulmonary Vein–Left Atrial Junction Disconnection Alone in Patients Presenting With Typical Atrial Flutter and Atrial Fibrillation. Circulation 2003;108(20):2479‐2483. - PubMed
Wazni 2005 {published data only}
    1. Wazni OM. Marrouche NF. Martin DO. Verma A. Bhargava M. Saliba W, et al. Radiofrequency ablation vs antiarrhythmic drugs as first‐line treatment of symptomatic atrial fibrillation: a randomized trial. JAMA 2005;293(21):2634‐40. [PUBMED: 14610012] - PubMed
Willems 2006 {published data only}
    1. Stephan Willems, Hanno Klemm, Thomas Rostock, Benedikt Brandstrup, Rodolfo Ventura, Daniel Steven, et al. Substrate modification combined with pulmonary vein isolation improves outcome of catheter ablation in patients with persistent atrial fibrillation: a prospective randomized comparison. European Heart Journal 2006;27(23):2871‐2878. [PUBMED: 16782716] - PubMed
Zhang 2007 {published data only}
    1. Zhang Jinlin, Xu Yawei, Xu Jiangang, Zhou Ke, Yu Xuejing. Necessity of pulmonary vein isolation as an end point for circumferential pulmonary vein ablation in patient with paroxysmal atrial fibrillation. Journal of Clinical Cardiology (China) 2007;23(7):516‐518.

References to studies excluded from this review

Bauer 2006 {published data only}
    1. Axel Bauer, Isabel Deisenhofer, Raphael Schneider, Bernhard Zrenner, Petra Barthel, Martin Karch, et al. Effects of circumferential or segmental pulmonary vein ablation for paroxysmal atrial fibrillation on cardiac autonomic function. Heart Rhythm 2006;3(12):1428‐1435. [PUBMED: 17161785 ] - PubMed
Brignole 1994 {published data only}
    1. Michele Brignole, Lorella Gianfranchi, Carlo Menozzi, Nicola Bottoni, Roberto Bollini, Gino Lolli, et al. Influence of Atrioventricular Junction Radiofrequency Ablation in Patients with Chronic Atrial Fibrillation and Flutter on Quality of life and Cardiac Performance. American Journal of Cardiology 1994;74(3):242‐246. - PubMed
Fiala 2008 {published data only}
    1. Martin Fiala, Jan Chovančík, Renáta Nevřalová, Radek Neuwirth, Otakar Jiravský, Igor Nykl, et al. Pulmonary vein isolation using segmental versus electroanatomical circumferential ablation for paroxysmal atrial fibrillation: over 3‐year results of a prospective randomized study. Journal of interventional cardiac electrophysiology 2008;22(1):13‐21. - PubMed
Ito 2007 {published data only}
    1. Sachiko Ito, Hiroshi Tada, Shigeto Naito, Yasunori Kutsumi, Isamu Miyamori, Akihiko Nogami, et al. Randomized Comparison of Bipolar vs Unipolar Plus Bipolar Recordings During Atrioventricular Junction Ablation: Importance and Efficacy of Unipolar Recording. Circ J 2007;71(6):874‐879. [PUBMED: 17526983] - PubMed
Kirkutis 2004 {published data only}
    1. Algimantas Kirkutis, Aušrius Poviliūnas, Pasaka Gricienė, Sotir Polena, Stephen Yang, Geeta Yalamanchi, et al. Cardiac Rate Normalization in Chronic Atrial Fibrillation: Comparison of Long‐term Efficacy of Treatment with Amiodarone versus AV Node Ablation and Permanent His‐bundle Pacing. Proc. West. Pharmacol. Soc 2004;47:69‐70. - PubMed
Padeletti 2003 {published data only}
    1. Luigi Padeletti, Gianluca Botto, Andrea Spampinato, Antonio Michelucci, Andrea Colella, Maria Cristina Porciani, et al. Prevention of Paroxysmal Atrial Fibrillation in Patients with Sinus Bradycardia: Role of Right Atrial Linear Ablation and Pacing Site. Journal of Cardiovascular Electrophysiology 2003;14:733‐738. - PubMed
Reddy 2007 {published data only}
    1. Vivek Y. Reddy, Matthew R. Reynolds, Petr Neuzil, Allison W. Richardson, Milos Taborsky, Krit Jongnarangsin, et al. Prophylactic Catheter Ablation for the Prevention of Defibrillator Therapy. New England Journal of Medicine 2007;357(26):2657–2665. - PMC - PubMed
Tse 2005 {published data only}
    1. Hung Fat Tse, Yok Lam Kwong, Chu Pak Lau. Transvenous cryoablation reduces platelet activation during pulmonary vein ablation compared with radiofrequency energy in patients with atrial fibrillation. Journal of Cardiovascular Electrophysiology 2005;16(10):1064‐1070. - PubMed

Additional references

Aguilar 2005
    1. MI Aguilar, R Hart. Oral anticoagulants for preventing stroke in patients with non‐valvular atrial fibrillation and no previous history of stroke or transient ischemic attacks. Cochrane Database of Systematic Reviews 2005, Issue 3. [DOI: 10.1002/14651858.CD001927.pub2] - DOI - PMC - PubMed
Andrikopoulos 2009
    1. George Andrikopoulos, Stylianos Tzeis, Nikos Maniadakis, Hercules E. Mavrakis, Panos E. Vardas. Cost‐effectiveness of atrial fibrillation catheter ablation. Europace 2009;11:147‐151. - PubMed
Bechtel 2011
    1. Bechtel BF, Nunez TC, Lyon JA, Cotton BA, Barrett TW. Treatments for reversing warfarin anticoagulation in patients with acute intracranial hemorrhage: a structured literature review. Int J Emerg Med 2011;4(1):40. - PMC - PubMed
Bernhardt 2006
    1. Bernhardt P, Schmidt H, Sommer T, Luderitz B, Omran H. Atrial fibrillation ‐ patients at high risk for cerebral embolism. Clinical Research in Cardiology 2006;95(3):148‐53. - PubMed
Bertaglia 2007
    1. Emanuele Bertaglia, Franco Zoppo, Claudio Tondo, Andrea Colella, Roberto Mantovan, Gaetano Senatore, et al. Early complications of pulmonary vein catheter ablation for atrial fibrillation: A multicenter prospective registry on procedural safety. Heart Rhythm 2007;4(10):1265–1271. - PubMed
Bonanno 2010
    1. Bonanno C, Paccanaro M, Vecchia LL, Ometto R, Fontanelli A. Efficacy and safety of catheter ablation versus antiarrhythmic drugs for atrial fibrillation: a meta‐analysis of randomized trials. Journal of Cardiovascular Medicine 2010;11(6):408‐418. - PubMed
Bordin 2003
    1. Bordin P, Mazzone C, Pandullo C, Goldstein D, Scardi S. Morbility and mortality in 229 elderly patients with nonrheumatic atrial fibrillation. A five year follow‐up. Italian Heart Journal 2003;4(8):537‐43. - PubMed
Cappato 2009
    1. Riccardo Cappato, Hugh Calkins, Shih‐Ann Chen, Wyn Davies, Yoshito Iesaka, Jonathan Kalman, et al. Prevalence and causes of fatal outcomes in catheter ablation of atrial fibrillation. Journal of the American College of Cardiology 2009;53(19):1798‐1804. - PubMed
Cha 2004
    1. Cha TJ, Ehrlich JR, Zhang L, Shi YF, Tardif JC, Leung TK, et al. Dissociation between ionic remodeling and ability to sustain atrial fibrillation during recovery from experimental congestive heart failure. Circulation 2004;109(3):412‐418. - PubMed
Crandall 2009
    1. Crandall MA, Horne BD, Day JD, Anderson JL, Muhlestein JB, Crandall BG, et al. Atrial fibrillation significantly increases total mortality and stroke risk beyond that conveyed by the CHADS2 risk factors. Pacing Clin Electrophysiol 2009;32(8):981‐986. - PubMed
Egger 1997
    1. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta‐analysis detected by a simple graphical test. British Medical Journal 1997;315:629‐34. - PMC - PubMed
Garnier 2004
    1. Garnier LF, Rouesnel P, Espitalier F. Atrial fibrillation and anticoagulation. Arch Mal Coeur Vaiss 2004;97(10):1001‐1005. - PubMed
Gelder 2002
    1. Gelder IC, Hagens VE, Bosker HA, Kingma JH, Kamp O, Kingma T, et al. A Comparison of rate control and rhythm control in patients with recurrent persistent atrial fibrillation. New England Journal of Medicine 2002;347:1834‐40. - PubMed
Gluud 2001
    1. Gluud C. Alcoholic hepatitis: no glucocorticosteroids?. In: Leuschner OFW, Dancygier J, Dancygier H editor(s). Steatohepatitis : NASH and ASH proceedings of Falk Symposium 121. London: Kluwer Academic, 2001:322‐42.
Hashimoto 2007
    1. Hashimoto T, Tada H, Naito S, Miyaji K, Yamada M, Tadokoro K, et al. Prevalence and characteristics of left atrial tachycardia following left atrial catheter ablation. Pacing & Clinical Electrophysiology 2007;30(Suppl 1):S94‐7. - PubMed
Hassantash 2008
    1. Hassantash SA, Kalantarian S, Bikdeli B, Sadeghian M, Kasraii F, Haghdoost A. Surgical ablation for atrial fibrillation (Protocol). Cochrane Database of Systematic Reviews 2008, Issue 3. [DOI: 10.1002/14651858.CD007318] - DOI
Haïssaguerre 1998
    1. Haïssaguerre M, Jaïs P, Shah DC, Takahashi A, Hocini M, Quiniou G, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med 1998;339(10):659‐666. - PubMed
Higgins 2011
    1. Higgins J, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org..
Hoppe 2006
    1. Hoppe UC, Casares JM, Eiskjaer H, Hagemann A, Cleland JG, Freemantle N, et al. Effect of cardiac resynchronization on the incidence of atrial fibrillation in patients with severe heart failure. Circulation 2006;114(1):18‐25. - PubMed
Kannel 1982
    1. Kannel WB, Abbott RD, Savage DD, McNamara PM. Epidemiologic features of chronic atrial fibrillation: the Framingham study. New England Journal of Medicine 1982;306:1018‐22. - PubMed
Karin 2004
    1. Humphries KH, Kerr CR, Steinbuch M, Dorian P. Limitations to antiarrhythmic drug use in patients with atrial fibrillation. Canadian Medical Association Journal 2004;171(7):741‐5. - PMC - PubMed
Lemola 2008
    1. Kristina Lemola, Denis Chartier, yung‐Hsin Yeh, Marc Dubuc, Raymond Cartier, Andrew Armour, et al. Pulmonary vein region ablation in experimental vagal atrial fibrillation, role of pulmonary veins versus autonomic ganglia. Circulation 2008;117:470‐477. - PubMed
Li 2008
    1. Li Yi‐gang, Wang Qun‐shan, Yu Jie‐fei, Sun Jian. Advances in catheter ablation of chronic atrial fibrillation. Journal of Shanghai Jiaotong University (Medical Science) 2008;10(28):1211‐1218.
Li 2011
    1. Li WJ, Bai YY, Zhang HY, Tang RB, Miao CL, Sang CH, et al. Additional ablation of complex fractionated atrial electrograms after pulmonary vein isolation in patients with atrial fibrillation: a meta‐analysis. Circ Arrhythm Electrophysiol 2011;4(2):143‐148. - PubMed
Lip 2011
    1. Lip GY. The role of aspirin for stroke prevention in atrial fibrillation. Nat Rev Cardiol 2011;8(10):602‐606. [DOI: 10.1038/nrcardio.2011.112] - DOI - PubMed
Lu 2009
    1. Lu YM, Zhang Y, Wu XH, Li YG, Han B, Huang DM, et al. The impact of radiofrequency of catheter ablation on quality of life in the patients of persistent atrial fibrillation. J Clin Cardiol (China) 2009;25(1):39‐41.
Lutomsky 2008
    1. Lutomsky BA, Rostock T, Koops A, Steven D, Müllerleile K, Servatius H, et al. Catheter ablation of paroxysmal atrial fibrillation improves cardiac function: a prospective study on the impact of atrial fibrillation ablation on left ventricular function assessed by magnetic resonance imaging. Europace 2008;10(5):593‐599. - PubMed
Ma 2006
    1. Ma ChangSheng, Meng Xu, Zhu XueShi. Management of atrial fibrillation: surgical or internal catheter ablation, which one is better?. Chinese Journal of Cardiovascular Review 2006;4(11):801‐805.
McKenna 2009
    1. C McKenna, S palmer, M Rodgers, D Chambers, N Hawkins, S Golder, et al. Cost‐effectiveness of radiofrequency catheter ablation for the treatment of atrial fibrillation in the United Kingdom. Heart 2009;95:542‐549. - PubMed
Mead 2005
    1. GE Mead, AT Elder, AD Flapan, A Kelman. Electrical cardioversion for atrial fibrillation and flutter. Cochrane Database of Systematic Reviews 2005, Issue 3. [DOI: 10.1002/14651858.CD002903.pub2] - DOI - PubMed
Meinertz 2011
    1. Meinertz T, Kirch W, Rosin L, Pittrow D, Willich SN, Kirchhof P. Management of atrial fibrillation by primary care physicians in Germany: baseline results of the ATRIUM registry. Clin Res Cardiol 2011;100(10):897‐905. - PMC - PubMed
Moe 1964
    1. Moe GK, Rheinboldt WC, Abildskov JA. A computer model of atrial fibrillation. American Heart Journal 1964;67:200‐20. - PubMed
Morady 2005
    1. Fred Morady. Mechanisms and catheter ablation therapy of atrial fibrillation. Cardiac arrhythmias 2005;32(2):199‐201. - PMC - PubMed
Nademanee 2007
    1. Nademanee K. Trials and travails of electrogram‐guided ablation of chronic atrial fibrillation. Circulation 2007;115(20):2592‐2594. - PubMed
Nademanee 2008
    1. Nademanee K, Schwab MC, Kosar EM, Karwecki M, Moran MD, Visessook N, et al. Clinical outcomes of catheter substrate ablation for high‐risk patients with atrial fibrillation. Journal of the American College of Cardiology 2008;51(8):843‐849. - PubMed
Ohki 2005
    1. Ohki R, Yamamoto K, Ueno S, Mano H, Misawa Y, Fuse K, et al. Gene expression profiling of human atrial myocardium with a fibrillation by DNA microarray analysis. International Journal of Cardiology 2005;102(2005):233‐8. - PubMed
Oral 2002
    1. Oral H, Knight BP, Tada H, Ozaydin M, Chugh A, Hassan S, et al. Pulmonary vein isolation for paroxysmal and persistent atrial fibrillation. Circulation 2002;105(9):1077‐1081. - PubMed
Ouyang 2005
    1. Ouyang F, Antz M, Ernst S, Hachiya H, Mavrakis H, Deger FT, et al. Recovered pulmonary vein conduction as a dominant factor for recurrent atrial tachyarrhythmias after complete circular isolation of the pulmonary veins: lessons from double Lasso technique. Circulation 2005;111(2):127‐135. - PubMed
Padanilam 2006
    1. Padanilam BJ. Cerebral microembolism during AF ablation: an innocent bystander or an accessory to brain injury?. of Cardiovascular Electrophysiology 2006;17(5):502‐3. - PubMed
Pappone 2000
    1. Pappone C, Rosanio S, Oreto G, Tocchi M, Gugliotta F, Vicedomini G, et al. Circumferential radiofrequency ablation of pulmonary vein ostia: A new anatomic approach for curing atrial fibrillation. Circulation 2000;102(21):2619‐2628. - PubMed
Pappone 2001
    1. Pappone C, Santinelli V. Pulmonary vein isolation by circumferential radiofrequency lesions in atrial fibrillation. From substrate to clinical outcome. Annual Isternal Super Sanita 2001;37(3):401‐407. - PubMed
Pappone 2007
    1. Pappone C, Augello G, Gugliotta F, Santinelli V. Robotic and magnetic navigation for atrial fibrillation ablation. How and why?. Expert Rev Med Devices 2007;4(6):885‐894. - PubMed
Pappone02 2006
    1. Pappone C, Vicedomini G, M anguso F, Gugliotta F, Mazzone P, Gulletta S, et al. Robotic magnetic navigation for atrial fibrillation ablation. J Am Coll Cardiol 2006;47(7):1390‐1400. - PubMed
Pontoppidan02 2009
    1. Pontoppidan J, Nielsen JC, Poulsen SH, Hansen PS. Symptomatic and asymptomatic atrial fibrillation after pulmonary vein ablation and the impact on quality of life. Pacing Clin Electrophysiol 2009;32(6):717‐726. - PubMed
Reynolds 2009
    1. Matthew R. Reynolds, Peter Zimetbaum, Mark E. Josephson, Ethan Ellis, Tatyana Danilov, David J. Cohen. Cost‐effectiveness of radiofrequency catheter ablation compared with antiarrhythmic drug therapy for paroxysmal atrial fibrillation. Circulation Arrhythmia Electrophysiology 2009;2:362‐369. - PMC - PubMed
Reynolds 2010
    1. Reynolds MR, Walczak J, White SA, Cohen DJ, Wilber DJ. Improvements in symptoms and quality of life in patients with paroxysmal atrial fibrillation treated with radiofrequency catheter ablation versus antiarrhythmic drugs. Circ Cardiovasc Qual Outcomes 2010;3(6):615‐623. - PubMed
Ryden 2001
    1. Ryden LE, Asinger RW, Cannom DS, Crijns HJ, Frye RL, Halperin JL. ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation: Executive summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to Develop Guidelines for the Management of Patients with Atrial Fibrillation). Circulation 2001;104(17):2118‐50. - PubMed
Sacher 2007
    1. Sacher F, Jais P, Stephenson K, O'neill MD, Hocini M, Clementy J, et al. Phrenic nerve injury after catheter ablation of atrial fibrillation. Indian Pacing Electrophysiology Journal 2007;7(1):1‐6. - PMC - PubMed
Sawhney 2010
    1. Sawhney N, Anousheh R, Chen W, Feld GK. Circumferential pulmonary vein ablation with additional linear ablation results in an increased incidence of left atrial flutter compared with segmental pulmonary vein isolation as an initial approach to ablation of paroxysmal atrial fibrillation. Circ Arrhythm Electrophysiol 2010;3(3):243‐248. - PubMed
Singh 2007
    1. Singh BN, Connolly SJ, Crijns HJ, Roy D, Kowey PR, Capucci A, et al. Dronedarone for maintenance of sinus rhythm in atrial fibrillation or flutter. New England Journal of Medicine 2007;357(10):987‐99. - PubMed
Snow 2003
    1. Snow V, Weiss KB, Lefevre M, McNamare R, Bass E, Green LA, et al. Management of newly detected atrial fibrillation: A clinical practice guideline from the American Academy of Family Physicians and the American College of Physicians. Annals of Internal Medicine 2003;139:1009‐17. - PubMed
STAF 2003
    1. Carlsson J, Miketic S, Windeler J, Cuneo A, Haun S, Micus S. Randomized trial of rate‐control versus rhythm‐control in persistent atrial fibrillation: the Strategies of Treatment of Atrial Fibrillation (STAF) study. Journal of the American College of Cardiology 2003;41(10):1690‐6. - PubMed
Tang 2006
    1. Tang RB, Dong JZ, Liu XP, Fang DP, Long de Y, Liu XH. Safety and efficacy of catheter ablation of atrial fibrillation in patients with diabetes mellitus‐single center experience. Journal of Interventional Cardiac Electrophysiology 2006;17(1):41‐6. - PubMed
Taylor 2010
    1. Taylor CJ, Hodgkinson J, Hobbs F.D.R. Rhythm control agents and adverse events in patients with atrial fibrillation. Int J Clin Pract 2010;64(8):1069‐1075. - PubMed
Tracy 2006
    1. Tracy CM, Akhtar M, DiMarco JP, Packer DL, Weitz HH. American College of Cardiology/American Heart Association 2006 Update of the Clinical Competence Statement on Invasive Electrophysiology Studies, Catheter Ablation, and Cardioversion. A Report of the American College of Cardiology/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training Developed in Collaboration With the Heart Rhythm Society. Journal of the American College of Cardiology 2006;48(7):1503‐17. - PubMed
Verma 2008
    1. Verma A, Novak P, Macle L, Whaley B, Beardsall M, Wulffhart Z, et al. A prospective, multicenter evaluation of ablating complex fractionated electrograms (CFEs) during atrial fibrillation (AF) identified by an automated mapping algorithm: acute effects on AF and efficacy as an adjuvant strategy. Heart Rhythm 2008;5(2):198‐205. - PubMed
Vickers 1998
    1. Vickers A, Goyal N, Harland R, Rees R. Do certain countries produce only positive results? A systematic review of controlled trials. Controlled Clinical Trials 1998;19:159‐66. - PubMed
Wattigney 2003
    1. Wattigney WA, Mensah GA, Croft JB. Increasing trends in hospitalization for atrial fibrillation in the United States, 1985 through 1999: implications for primary prevention. Circulation 2003;108(6):711‐6. - PubMed
Wijffels 1995
    1. Wijffels MC, Kirchhof CJ, Dorland R, Allessie MA. Atrial fibrillation begets atrial fibrillation. A study in awake chronically instrumented goats. Circulation 1995;92(7):1954‐68. - PubMed
Wu 2001
    1. Wu TJ, James JC, Chang CM, Doshi RN, Yashima M, Huang HLA, et al. Pulmonary veins and ligament of marshall as sources of rapid activations in a canine model of sustained atrial fibrillation. Circulation 2001;103(8):1157‐63. - PubMed
Wyse 2002
    1. Wyse DG, Waldo AL, DiMarco JP, Domanski MJ, Rosenberg Y, Schron EB, et al. A Comparison of rate control and rhythm control in patients with atrial fibrillation. New England Journal of Medicine 2002;347(23):1825‐33. - PubMed
Yamashita 2007
    1. Yamashita E, Tada H, Tadokoro K, Hashimoto T, Kaseno K, Miyaji K, et al. Left atrial catheter ablation promotes vasoconstriction of the right coronary artery. Pacing & Clinical Electrophysiology 2007;30(Suppl 1):S98‐S102. - PubMed
Yamashita 2011
    1. Yamashita T. Frontiers of anticoagulation therapy for atrial fibrillation. J Cardiol 2011;58(1):1‐5. - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources