Arrhythmias & electrophysiologyMeta-analysis
Impact of catheter ablation timing according to duration of atrial fibrillation history on arrhythmia recurrences and clinical outcomes: a meta-analysis
- Systematic review and meta-analysis
- random-effects
Medline, Cochrane Library and Scopus searched through 18 February 2025
Authors' conclusion
Early catheter ablation within 1 year of AF diagnosis is associated with a lower risk of recurrence in both PAF and PsAF, with the strongest association observed in patients ≤ 55 years.
Study context
- Population
- Patients with paroxysmal or persistent atrial fibrillation (AF) undergoing catheter ablation
- Participants
- 41,431 patients · 28 studies
- Comparison
- Early vs delayed catheter ablation
- Outcome
- AF recurrence
- Follow-up
- median 24-month follow-up
Pooled result
As reported in the abstract
Hazard ratio
0.65
95% CI 0.59–0.73
Early ablation vs Delayed ablation
HR 0.65 (95% CI 0.59–0.73)
Further pooled results
| Outcome | HR (95% CI) | |
|---|---|---|
| AF recurrence, by AF type (subgroup) — Early ablation vs Delayed ablation · PAF | 0.72 (0.67–0.77) | |
| AF recurrence, by AF type (subgroup) — Early ablation vs Delayed ablation · PsAF | 0.70 (0.61–0.81) | |
| AF recurrence, age ≤ 55 years (subgroup) | 0.49 (0.34–0.71) | |
| 0.20.5125Hazard ratio (log scale) |
- AF recurrence, age ≤ 55 years (subgroup): greatest risk reduction; effect significant regardless of age
Repeat ablation, new cardioversion, CV hospitalization
- Early ablation associated with reduced risk vs delayed ablation
Effect modifiers
- Higher CHA₂DS₂-VASc scores, HF prevalence and lower mean LVEF associated with greater benefit from early ablation
Original publication
Impact of catheter ablation timing according to duration of atrial fibrillation history on arrhythmia recurrences and clinical outcomes: a meta-analysis. Europace. Published 28 May 2025. doi:10.1093/europace/euaf110
Summarised from the published abstract; every number is checked against it