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
. 2024 Jun 21:2024:9944490.
doi: 10.1155/2024/9944490. eCollection 2024.

Atrial Fibrillation Termination as a Predictor for Persistent Atrial Fibrillation Ablation: A Systemic Review and Meta-Analysis of Prospective Studies

Jialing He  1 , Zhen Zhang  1 , Duan Luo  1 , Xianchen Yang  2 , Guoshu Yang  1 , Hanxiong Liu  1
Affiliations
Meta-Analysis

Atrial Fibrillation Termination as a Predictor for Persistent Atrial Fibrillation Ablation: A Systemic Review and Meta-Analysis of Prospective Studies

Jialing He et al. Cardiovasc Ther. .

Abstract

Background: In this systematic review and meta-analysis, we aimed to validate the predictive role of atrial fibrillation (AF) termination in long-term arrhythmia recurrence. Method: Our search encompassed databases including MEDLINE, EMBASE, PubMed, and the Cochrane Library up to August 1, 2021. Three independent reviewers conducted screening and data extraction. The data included ablation strategy, recurrence mode, AF termination mode, numbers of patients, and recurrence cases in the termination and nontermination groups. The primary endpoint was the recurrence of atrial arrhythmia at long-term follow-up (≥ 12 months). Results: Our analysis included 22 publications, with 11 prospective studies being eligible for further meta-analysis. Among these, 14 studies reported significantly lower rates of arrhythmia recurrence in the AF termination group compared to the nontermination group. Among seven studies involving 1114 patients that examined single procedure outcomes, the pooled estimated effect was RR 0.78 (95% CI 0.68-1.90) with an I 2 value of 57%. Subgroup analysis focusing on termination mode as sinus rhythm yielded a pooled estimated effect of RR 0.74 (95% CI 0.59-0.92) with an I 2 value of 47%. Additionally, analysis of seven studies involving 1433 patients for repeat procedures demonstrated a significant preference for the AF termination group (RR 0.83, 95% CI 0.71-0.97, I 2 = 84%). Subgroup analysis indicated reduced heterogeneity when the termination mode was sinus rhythm (RR 0.68, 95% CI 0.51-0.90, I 2 = 57%). Conclusion: Our study establishes that AF termination serves as an effective predictor for the success of persistent AF ablation procedures. This finding holds potential implications for clinical practice and contributes to our understanding of long-term arrhythmia recurrence in the context of AF termination.

Keywords: atrial fibrillation; catheter ablation; recurrence; termination.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow chart of study selection.
Figure 2
Figure 2
Forest plot for single procedure outcome. Result of the effect of AF termination on recurrence for the single ablation procedure.
Figure 3
Figure 3
Forest plot for repeat procedure outcome. Result of the effect of AF termination on recurrence for repeat ablation procedure.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Feinberg W. M., Blackshear J. L., Laupacis A., Kronmal R., Hart R. G. Prevalence, age distribution, and gender of patients with atrial fibrillation. Analysis and implications. Archives of Internal Medicine . 1995;155(5):469–473. doi: 10.1001/archinte.1995.00430050045005. - DOI - PubMed
    1. Singh-Manoux A., Fayosse A., Sabia S., et al. Atrial fibrillation as a risk factor for cognitive decline and dementia. European Heart Journal . 2017;38(34):2612–2618. doi: 10.1093/eurheartj/ehx208. - DOI - PMC - PubMed
    1. Steinberg B. A., Hellkamp A. S., Lokhnygina Y., et al. Higher risk of death and stroke in patients with persistent vs. paroxysmal atrial fibrillation: results from the ROCKET-AF trial. European Heart Journal . 2015;36(5):288–296. doi: 10.1093/eurheartj/ehu359. - DOI - PMC - PubMed
    1. Hindricks G., Potpara T., Dagres N., et al. 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): the task force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. European Heart Journal . 2021;42(5):373–498. doi: 10.1093/eurheartj/ehaa612. - DOI - PubMed
    1. Verma A., Jiang C. Y., Betts T. R., et al. Approaches to catheter ablation for persistent atrial fibrillation. The New England Journal of Medicine . 2015;372(19):1812–1822. doi: 10.1056/NEJMoa1408288. - DOI - PubMed

LinkOut - more resources