Arrhythmias & electrophysiologyMeta-analysis
Safety of catheter ablation compared with antiarrhythmic drugs for atrial fibrillation: A systematic review and meta-analysis of randomized trials
- systematic review and meta-analysis of randomized trials
- random-effects meta-analysis
Authors' conclusion
CA for AF rhythm management reduced SAEs, unplanned hospitalization and adverse cardiovascular events compared with AADs. When patient safety is being considered, AAD appears to have a less favorable safety profile than CA in AF.
Study context
- Population
- Patients with atrial fibrillation (AF) in randomized controlled trials comparing catheter ablation (CA) with AADs for rhythm managementparticipants in 24 randomized trials · CA group 3,554 · AAD group 3,111
- Participants
- 6,665 patients
- Comparison
- CA compared with AADs for AF rhythm management
- CAn = 3,554
- AADn = 3,111reference
- Outcome
- Composite of:
- Serious adverse events (SAEs)
- Including death
- Additional intervention
- Prolonged or unplanned hospitalization or disability
- Follow-up
- 12-month median (6-60 months)
Pooled result
As reported in the abstract
Relative risk
0.80
95% CI 0.69–0.93
P < 0.01
CA vs AAD
RR 0.80 (95% CI 0.69–0.93); P < 0.01
Safety
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| Unplanned hospitalization · 12-month median follow-up (6-60 months) · I2 73%; 47% reduction in risk with CA | 0.53 (0.38–0.72) | P < 0.01 | |
| Adverse cardiovascular events · I2 42%; 37% lower risk with CA | 0.63 (0.44–0.90) | P = 0.01 | |
| 0.20.5125Relative risk (log scale) |
Original publication
Safety of catheter ablation compared with antiarrhythmic drugs for atrial fibrillation: A systematic review and meta-analysis of randomized trials. Heart Rhythm. Published 19 March 2026. doi:10.1016/j.hrthm.2026.03.1885
Summarised from the published abstract; every number is checked against it