Arrhythmias & electrophysiologyMeta-analysis
Durability of pulmonary vein isolation for atrial fibrillation: a meta-analysis and systematic review
- Systematic review and meta-analysis
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 |
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:10.1093/europace/euad335
Summarised from the published abstract; every number is checked against it