Arrhythmias & electrophysiology
Durability of pulmonary vein isolation for atrial fibrillation: a meta-analysis and systematic review
Authors' conclusion
We observed no significant difference in the durability of the ablation lesions of the four evaluated energies after adjusting for procedural and baseline populational characteristics.
Study context
- Population
- Patients with atrial fibrillation (AF) undergoing pulmonary vein isolation (PVI) with repeat invasive remapping of the overall cohort during follow-up; studies published January 2010–January 2023
- Participants
- 1,050 patients · 19 studies
- Comparison
- PVI energy sources: RFA vs cryoballoon vs laser-balloon vs PFA
- Outcome
- PVI-lesion durability on repeat invasive remapping
- Follow-up
- Time to remap 2-7 months
Pooled result
As reported in the abstract
PVs durably isolated at follow-up (pooled)
| Group | Value | Studies |
|---|---|---|
| RFA | 71% (95% CI 69–73) | 11 |
| Cryoballoon | 79% (95% CI 74–83) | 3 |
| Laser-balloon | 84% (95% CI 78–89) | 1 |
| PFA | 87% (95% CI 84–90) | 2 |
Value
RFA71% (95% CI 69–73)
Cryoballoon79% (95% CI 74–83)
Laser-balloon84% (95% CI 78–89)
PFA87% (95% CI 84–90)
Studies
RFA11
Cryoballoon3
Laser-balloon1
PFA2
Further pooled results
Overall durability across all energy sources (pooled)
- PVs successfully ablated at baseline
- 99.7%
- Patients successfully ablated at baseline
- 99.4%
- PVs remaining isolated at follow-up
- 75.5%
- Patients with all PVs persistently isolated at follow-up
- 51%
Original publication
Durability of pulmonary vein isolation for atrial fibrillation: a meta-analysis and systematic review. Europace. Published 7 November 2023. doi:10.
Summarised from the published abstract; every number is checked against it