Meta-analysis
Procedure-Related Complications of Catheter Ablation for Atrial Fibrillation
- Systematic review and pooled analysis of randomised trials
Authors' conclusion
Procedure-related complications and mortality rates associated with catheter ablation of AF are low and have declined in the past decade.
Study context
- Population
- Patients undergoing a first AF ablation (radiofrequency or cryoballoon) in RCTs, MEDLINE and EMBASE January 2013 to September 2022
- Participants
- 15,701 patients · 89 studies
- Outcome
- Rate of procedure-related complications of AF catheter ablation
Pooled result
As reported in the abstract
Procedure-related complications
- Overall complication rate
- 4.51% (95% CI: 3.76%-5.32%)
- Severe complication rate
- 2.44% (95% CI: 1.98%-2.93%)
- Vascular complications (most frequent)
- 1.31%
- Pericardial effusion/tamponade
- 0.78%
- Stroke/TIA
- 0.17%
Further pooled results
Procedure-related complication rate, by 5-year period of publication · significantly lower in the most recent period
P = 0.043
Pooled mortality, by 5-year period of publication
- Pooled mortality stable over the 2 time periods (most recent vs earlier 5-year period)
- 0.06% vs 0.05%; P = 0.892
Complications by type
- Vascular complications (most frequent)
- 1.31%
- Pericardial effusion/tamponade
- 0.78%
- Stroke/TIA
- 0.17%
Complication rate by AF pattern, ablation modality or strategy beyond pulmonary vein isolation
- No significant difference in complication rate by AF pattern, ablation modality, or ablation strategies beyond pulmonary vein isolation
Original publication
Procedure-Related Complications of Catheter Ablation for Atrial Fibrillation. J Am Coll Cardiol. Published 30 May 2023. doi:10.1016/j.jacc.2023.03.418
Summarised from the published abstract; every number is checked against it