Arrhythmias & electrophysiology
Freedom from atrial arrhythmia and other clinical outcomes at 5 years and beyond after catheter ablation of atrial fibrillation: a systematic review and meta-analysis
Authors' conclusion
Nearly 70% of patients having multiple ablations remained free from atrial arrhythmia at 5 years, with the incidence slightly decreasing beyond this period. Risk of death, stroke, and major bleeding at 5 years were low but increased over time
Study context
- Population
- Patients undergoing catheter ablation of AF, outcomes ≥5 years
- Participants
- 67,159 patients73 studies
- Comparison
- Single ablation vs Multiple procedures
- Outcome
- Freedom from atrial arrhythmia
- Follow-up
- 5 years
Pooled result
As reported in the abstract
Freedom from atrial arrhythmia (pooled incidence)
Further pooled results
Freedom from atrial arrhythmia · 10 years
Freedom from atrial arrhythmia, paroxysmal vs non-paroxysmal AF (subgroup) · 5 years
- Single ablation: paroxysmal vs non-paroxysmal
- 59.7% vs. 33.3%, p = 0.002
- Multiple ablations: paroxysmal vs non-paroxysmal
- 80.8% vs. 60.6%, p < 0.001
- Comparable between radiofrequency and cryoablation
All-cause death (pooled incidence) · 5 years
- Death
- 6.0% (95%CI 3.2-9.7%)
Safety
Stroke and major bleeding (pooled incidence) · 5 years
- Stroke
- 2.4% (95%CI 1.4-3.7%)
- Major bleeding
- 1.2% (95%CI 0.8-2.0%)
- Risk of stroke and bleeding increased over time beyond 5 years
Original publication
Freedom from atrial arrhythmia and other clinical outcomes at 5 years and beyond after catheter ablation of atrial fibrillation: a systematic review and meta-analysis. Eur Heart J Qual Care Clin Outcomes. Published 19 June 2023. doi:10.
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