Arrhythmias & electrophysiology
Adjunctive superior vena cava isolation to pulmonary vein isolation in atrial fibrillation ablation: A systematic review and meta-analysis of randomized trials
Authors' conclusion
Adjunctive SVCI to PVI vs PVI alone was associated with reduced atrial tachyarrhythmia recurrence but increased minor complications in AF ablation.
Study context
- Population
- Adults undergoing first-time atrial fibrillation (AF) ablation
- Participants
- 1,149 adults7 RCTs
- Comparison
- Adjunctive superior vena cava isolation (SVCI) plus pulmonary vein isolation (PVI) vs PVI alone
- Outcome
- Atrial tachyarrhythmia recurrence
Methodological detailsfixed- and random-effects models
- Fixed- and random-effects models
Pooled result
As reported in the abstract
SVCI plus PVI vs PVI aloneEstimate (95% CI)
I2 = 0%
OR 0.71(0.53–0.96)
Time-to-event analysis
HR 0.71(0.50–0.99)
Further pooled results
| Outcome | OR (95% CI) | |
|---|---|---|
| Atrial tachyarrhythmia recurrence, paroxysmal AF (subgroup) | 0.63 (0.44–0.88) | |
| Atrial tachyarrhythmia recurrence, radiofrequency ablation (subgroup) | 0.66 (0.47–0.93) | |
| 0.512Odds ratio (log scale) |
Safety
| Outcome | SVCI plus PVI | PVI alone | OR (95% CI) | |
|---|---|---|---|---|
| Minor complications | 13.7% | 2.7% | 4.44 (1.95–11.16) | |
| 0.050.21520Odds ratio (log scale) |
Transient phrenic nerve injury
Sinus node injury
Major complications
- Major complications were comparable
- 1.8% vs 1.0%
Original publication
Adjunctive superior vena cava isolation to pulmonary vein isolation in atrial fibrillation ablation: A systematic review and meta-analysis of randomized trials. Heart Rhythm. Published 11 December 2025. doi:10.
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