Arrhythmias & electrophysiologyMeta-analysis
Progression of persistent atrial fibrillation and impact of ablation: A systematic review and meta-analysis
- systematic review and meta-analysis
- Random-effects meta-analysis
- 2 reviewers independently extracted data and assessed study quality
- meta-regression
Authors' conclusion
PsAF progression is heterogeneous, with contemporary cohorts suggesting lower rates than historical series. Pulmonary vein isolation exposure is associated with less progression at the population level. These findings may have implications for early rhythm control in PsAF. Standardized end points and contemporary cohorts are needed to refine risk estimates and guide timing and selection for rhythm-control strategies.
Study context
- Population
- Studies reporting progression from persistent atrial fibrillation (PsAF) to permanent atrial fibrillation (AF) and/or management pathways (PubMed and Embase to January 2026)studies, 17 contributed to the primary meta-analysis · primary meta-analysis 17
- Participants
- 21 studies
- Comparison
- Pooled progression rate from PsAF to permanent AF
Pooled result
As reported in the abstract
Pooled progression rate
16.42 per 100 person-years (PYs) (95% confidence interval 11.48-23.48)
Further pooled results
Progression rate by study era · lower rates in contemporary studies
P = 0.069
| Outcome | rate ratio (95% CI) | P value | |
|---|---|---|---|
| Progression by prevalence of prior pulmonary vein isolation (meta-regression) · higher prevalence associated with lower progression · study-level meta-regression | 0.82 (0.69–0.97) | P = 0.027 | |
| 0.512Rate ratio (log scale) |
Age, female sex, and heart failure (meta-regression)
- No clear study-level associations
Catheter ablation utilization
- Relatively low catheter ablation utilization despite increasing availability (observational data)
Original publication
Summarised from the published abstract; every number is checked against it