Arrhythmias & electrophysiology
Catheter and Surgical Ablation for Atrial Fibrillation : A Systematic Review and Meta-analysis
Authors' conclusion
Catheter ablation reduced the risks for ischemic stroke at more than 30 days, mortality, and HF hospitalization. Surgical ablation had uncertain benefit, except for stroke.
Study context
- Population
- Patients with atrial fibrillation in randomized controlled trials of catheter or surgical ablation versus no ablation with at least 1 month of follow-up reporting stroke and/or mortality
- Comparison
- Catheter or surgical ablation versus no ablation
- Primary endpoint
- Ischemic stroke at more than 30 days
- Follow-up
- After 30 days
Methodological detailsDual independent data extraction and risk-of-bias assessment, without language restrictions
- Dual independent data extraction and risk-of-bias assessment
- Without language restrictions
Primary result
As reported in the abstract
Each group vs medical therapyRelative risk (95% CI)
Catheter ablation
0.63(0.43–0.92)
Surgical ablation
0.63(0.37–1.06)
Further findings
| Outcome | RR (CI) | |
|---|---|---|
| MortalityCatheter ablationvs Medical therapy | 0.73 (0.60–0.88) | |
| MortalitySurgical ablationvs Medical therapy | 0.90 (0.70–1.15) | |
| Heart failure (HF) hospitalizationCatheter ablationvs Medical therapy | 0.68 (0.55–0.85) | |
| Heart failure (HF) hospitalizationSurgical ablationvs Medical therapy | 0.90 (0.60–1.35) | |
| Any ischemic strokeCatheter ablationvs Medical therapy | 0.77 (0.55–1.09) | |
| Any ischemic strokeSurgical ablationvs Medical therapy | 0.54 (0.34–0.86) | |
| All strokes (stroke from any cause)Catheter ablationvs Medical therapy | 0.77 (0.57–1.05) | |
| All strokes (stroke from any cause)Surgical ablationvs Medical therapy | 0.54 (0.35–0.82) | |
| 0.20.5125Relative risk (log scale) |
Safety
| Outcome | RR (CI) | |
|---|---|---|
| Ischemic stroke at or before 30 daysCatheter ablationvs Medical therapy | 6.81 (1.56–29.8) | |
| 0.050.21520Relative risk (log scale) |
Original publication
Catheter and Surgical Ablation for Atrial Fibrillation : A Systematic Review and Meta-analysis. Ann Intern Med. Published 1 July 2025. doi:10.
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