Arrhythmias & electrophysiology
Which ablation strategy is the most effective for treating persistent atrial fibrillation? A systematic review and Bayesian network meta-analysis of randomized controlled trials
Authors' conclusion
Pulmonary vein isolation + posterior wall box isolation + extra-pulmonary vein isolation was the most effective ablation therapy for PerAF. Most additional substrate modification ablation strategies do not show significant additional benefits. There were no significant differences in the incidence of procedure-related complications between the different ablation strategies. Pulmonary vein isolation combined with additional ablation sites increases the duration of the procedure.
Study context
- Population
- Patients with persistent atrial fibrillation (PerAF)patients in 52 studies conducted between 2004 and 2024, 22 different ablation strategies identified
- Participants
- 9,048 patients
- Comparison
- Different ablation strategies for PerAF
- Outcome
- Recurrence of any atrial arrhythmia after a single ablation procedure
- Follow-up
- During the
Pooled result
As reported in the abstract
- Pulmonary vein isolation + posterior wall box isolation + extra-pulmonary vein isolation was the most effective ablation therapy for PerAF
- Most additional substrate modification ablation strategies do not show significant additional benefits
Further pooled results
Any reported complication related to the procedure (primary safety outcome)
- No significant differences in the incidence of procedure-related complications between the different ablation strategies
Procedure time (secondary outcome)
- Pulmonary vein isolation combined with additional ablation sites increases the duration of the procedure
Original publication
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