Durability of pulmonary vein isolation for atrial fibrillation : a meta-analysis and systematic review
© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology..
AIMS: Pulmonary vein isolation (PVI) plays a central role in the interventional treatment of atrial fibrillation (AF). Uncertainties remain about the durability of ablation lesions from different energy sources. We aimed to systematically review the durability of ablation lesions associated with various PVI-techniques using different energy sources for the treatment of AF.
METHODS AND RESULTS: Structured systematic database search for articles published between January 2010 and January 2023 reporting PVI-lesion durability as evaluated in the overall cohort through repeat invasive remapping during follow-up. Studies evaluating only a proportion of the initial cohort in redo procedures were excluded. A total of 19 studies investigating 1050 patients (mean age 60 years, 31% women, time to remap 2-7 months) were included. In a pooled analysis, 99.7% of the PVs and 99.4% of patients were successfully ablated at baseline and 75.5% of the PVs remained isolated and 51% of the patients had all PVs persistently isolated at follow-up across all energy sources. In a pooled analysis of the percentages of PVs durably isolated during follow-up, the estimates of RFA were the lowest of all energy sources at 71% (95% CI 69-73, 11 studies), but comparable with cryoballoon (79%, 95%CI 74-83, 3 studies). Higher durability percentages were reported in PVs ablated with laser-balloon (84%, 95%CI 78-89, one study) and PFA (87%, 95%CI 84-90, 2 studies).
CONCLUSION: We observed no significant difference in the durability of the ablation lesions of the four evaluated energies after adjusting for procedural and baseline populational characteristics.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:25 |
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| Enthalten in: |
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology - 25(2023), 11 vom: 02. Nov. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Serban, Teodor [VerfasserIn] |
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| Links: |
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| Themen: |
Atrial Fibrillation |
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| Anmerkungen: |
Date Completed 23.11.2023 Date Revised 15.01.2024 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/europace/euad335 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM364358483 |
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| 100 | 1 | |a Serban, Teodor |e verfasserin |4 aut | |
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| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. | ||
| 520 | |a AIMS: Pulmonary vein isolation (PVI) plays a central role in the interventional treatment of atrial fibrillation (AF). Uncertainties remain about the durability of ablation lesions from different energy sources. We aimed to systematically review the durability of ablation lesions associated with various PVI-techniques using different energy sources for the treatment of AF | ||
| 520 | |a METHODS AND RESULTS: Structured systematic database search for articles published between January 2010 and January 2023 reporting PVI-lesion durability as evaluated in the overall cohort through repeat invasive remapping during follow-up. Studies evaluating only a proportion of the initial cohort in redo procedures were excluded. A total of 19 studies investigating 1050 patients (mean age 60 years, 31% women, time to remap 2-7 months) were included. In a pooled analysis, 99.7% of the PVs and 99.4% of patients were successfully ablated at baseline and 75.5% of the PVs remained isolated and 51% of the patients had all PVs persistently isolated at follow-up across all energy sources. In a pooled analysis of the percentages of PVs durably isolated during follow-up, the estimates of RFA were the lowest of all energy sources at 71% (95% CI 69-73, 11 studies), but comparable with cryoballoon (79%, 95%CI 74-83, 3 studies). Higher durability percentages were reported in PVs ablated with laser-balloon (84%, 95%CI 78-89, one study) and PFA (87%, 95%CI 84-90, 2 studies) | ||
| 520 | |a CONCLUSION: We observed no significant difference in the durability of the ablation lesions of the four evaluated energies after adjusting for procedural and baseline populational characteristics | ||
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Atrial Fibrillation | |
| 650 | 4 | |a Cryoballoon Ablation | |
| 650 | 4 | |a Laser Balloon | |
| 650 | 4 | |a Pulmonary Vein Isolation | |
| 650 | 4 | |a Pulsed-Field Ablation | |
| 650 | 4 | |a Radiofrequency Ablation | |
| 700 | 1 | |a Mannhart, Diego |e verfasserin |4 aut | |
| 700 | 1 | |a Abid, Qurrat-Ul-Ain |e verfasserin |4 aut | |
| 700 | 1 | |a Höchli, Andres |e verfasserin |4 aut | |
| 700 | 1 | |a Lazar, Sorin |e verfasserin |4 aut | |
| 700 | 1 | |a Krisai, Philipp |e verfasserin |4 aut | |
| 700 | 1 | |a Bettelini, Arianna Sofia |e verfasserin |4 aut | |
| 700 | 1 | |a Knecht, Sven |e verfasserin |4 aut | |
| 700 | 1 | |a Kühne, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Sticherling, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a du Fay de Lavallaz, Jeanne |e verfasserin |4 aut | |
| 700 | 1 | |a Badertscher, Patrick |e verfasserin |4 aut | |
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