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Long-term outcomes of catheter ablation of atrial fibrillation: a systematic review and meta-analysis
Open accessAbstract
BACKGROUND: In the past decade, catheter ablation has become an established therapy for symptomatic atrial fibrillation (AF). Until very recently, few data have been available to guide the clinical community on the outcomes of AF ablation at ≥3 years of follow-up. We aimed to systematically review the medical literature to evaluate the long-term outcomes of AF ablation. METHODS AND RESULTS: A structured electronic database search (PubMed, Embase, Web of Science, Cochrane) of the scientific literature was performed for studies describing outcomes at ≥3 years after AF ablation, with a mean follow-up of ≥24 months after the index procedure. The following data were extracted: (1) single-procedure success, (2) multiple-procedure success, and (3) requirement for repeat procedures. Data were extracted from 19 studies, including 6167 patients undergoing AF ablation. Single-procedure freedom from atrial arrhythmia at long-term follow-up was 53.1% (95% CI 46.2% to 60.0%) overall, 54.1% (95% CI 44.4% to 63.4%) in paroxysmal AF, and 41.8% (95% CI 25.2% to 60.5%) in nonparoxysmal AF. Substantial heterogeneity (I(2)>50%) was noted for single-procedure outcomes. With multiple procedures, the long-term success rate was 79.8% (95% CI 75.0% to 83.8%) overall, with significant heterogeneity (I(2)>50%).The average number of procedures per patient was 1.51 (95% CI 1.36 to 1.67). CONCLUSIONS: Catheter ablation is an effective and durable long-term therapeutic strategy for some AF patients. Although significant heterogeneity is seen with single procedures, long-term freedom from atrial arrhythmia can be achieved in some patients, but multiple procedures may be required.
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“Sinus rhythm without severely symptomatic recurrences of AF is found in up to 70% of patients with paroxysmal AF, and around 50% in persistent AF. 713,728,735,1042”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [728]
In the citing paper
“Very late recurrence of AF after years of sinus rhythm is not uncommon and may reflect disease progression, with important implications for continuation of AF therapies.728”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [728]
In the citing paper
“Most patients require more than one procedure to achieve symptom control.713,726,728”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [728]
In the citing paper
“Very late recurrence of AF after years of sinus rhythm is not uncommon and may reflect disease progression, with important implications for continuation of AF therapies.728”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [728]
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Citations
Cites
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Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins.
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BackgroundInfluentialGuidelines for the management of atrial fibrillation
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Cited by
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2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw210 · Cited by 6,418
“Most patients require more than one procedure to achieve symptom control.(713,726,728) In general, better rhythm outcome and lower procedure-related complications can be expected in younger patients with a short history of AF and frequent, short AF episodes in the absence of significant structural heart disease.”
InfluentialJoglar, J. A., Chung, M. K., Armbruster, A. L., Benjamin, E. J., Chyou, J. Y., Cronin, E. M., Deswal, A. M., Eckhardt, L. L., Goldberger, Z. D., Gopinathannair, R., et al. (2023) · Circulation · doi:10.1161/cir.0000000000001193 · Cited by 3,072
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2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
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“Transient ( 6 months) elevation of heart rate, inappropriate sinus tachycardia and reduction of heart rate variability have been observed after PVI.223,257 Others reported an immediate decrease in autonomic function such as deceleration capacity and acceleration capacity after PVI.”
BackgroundMethodInfluentialPathak, R. K., Middeldorp, M. E., Lau, D. H., Mehta, A. B., Mahajan, R., Twomey, D., Alasady, M., Hanley, L., Antic, N. A., McEvoy, R. D., et al. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2014.09.028 · Cited by 949
Self-citation2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation
Joglar, J. A., Chung, M. K., Armbruster, A. L., Benjamin, E. J., Chyou, J. Y., Cronin, E. M., Deswal, A., Eckhardt, L. L., Goldberger, Z. D., Gopinathannair, R., et al. (2024) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2023.08.017 · Cited by 933
Self-citationModifiable Risk Factors and Atrial Fibrillation
Lau, D. H., Nattel, S., Kalman, J. M., & Sanders, P. (2017) · Circulation · doi:10.1161/circulationaha.116.023163 · Cited by 614
Passive Detection of Atrial Fibrillation Using a Commercially Available Smartwatch
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Andrade, J. G., Aguilar, M., Atzema, C. L., Bell, A., Cairns, J. A., Cheung, C. C., Cox, J. L., Dorian, P., Gladstone, D. J., Healey, J. S., et al. (2020) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2020.09.001 · Cited by 593
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Paroxysmal AF Catheter Ablation With a Contact Force Sensing Catheter
Natale, A., Reddy, V. Y., Monir, G., Wilber, D. J., Lindsay, B. D., McElderry, H. T., Kantipudi, C., MANSOUR, M. C., Melby, D. P., Packer, D. L., et al. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2014.04.072 · Cited by 476
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Mont, L., Bisbal, F., Hernández-Madrid, A., Pérez-Castellano, N., Viñolas, X., Arenal, A., Arribas, F., Fernández-Lozano, I., Bodegas, A., Cobos, A., et al. (2014) · European Heart Journal · doi:10.1093/eurheartj/eht457 · Cited by 394
“In the present study, the results of CA in persistent AF were comparable with those in paroxysmal AF reported in the literature.(5) This is probably the result of strict patient selection criteria, which recruited”
BackgroundResultMitochondrial oxidative stress promotes atrial fibrillation
Xie, W., Santulli, G., Reiken, S. R., Yuan, Q., Osborne, B. W., Chen, B.-X., & Marks, A. R. (2015) · Scientific Reports · doi:10.1038/srep11427 · Cited by 303
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“freedom from symptoms can be achieved in up to 80%, but may require multiple procedures.(110,111) In patients with persistent AF and”
BackgroundComorbidity of atrial fibrillation and heart failure
Ling, L., Kistler, P. M., Kalman, J. M., SCHILLING, R. J., & Hunter, R. J. (2015) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2015.191 · Cited by 217
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“Despite a relatively high incidence of late recurrences, the long-term efficacy in maintaining sinus rhythm (SR) remains encouragingly high, especially when compared with pharmacological approaches.(2) Clinical Perspective on p 1018”
BackgroundMethodResultNovel mechanisms in the pathogenesis of atrial fibrillation: practical applications
Lau, D. H., Schotten, U., Mahajan, R., Antic, N. A., Hatem, S. N., Pathak, R. K., Hendriks, J., Kalman, J. M., & Sanders, P. (2015) · European Heart Journal · doi:10.1093/eurheartj/ehv375 · Cited by 173
“Catheter ablation strategies for treating AF have shown promising long-term results with declining complication rates.(17,18) However,”
BackgroundLate outcomes after the Cox maze IV procedure for atrial fibrillation
Henn, M. C., Lancaster, T. S., Miller, J. R., Sinn, L. A., Schuessler, R. B., Moon, M. R., Melby, S. J., Maniar, H. S., & Damiano, R. J. (2015) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/j.jtcvs.2015.07.102 · Cited by 177
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Risk Factor Management in Atrial Fibrillation
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Inflammasome Signaling in Atrial Fibrillation
Ajoolabady, A., Nattel, S., Lip, G. Y. H., & Ren, J. T. (2022) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2022.03.379 · Cited by 157
Catheter Ablation of Atrial Fibrillation: An Overview for Clinicians
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Feasibility, Safety, and Efficacy of Posterior Wall Isolation During Atrial Fibrillation Ablation
Thiyagarajah, A., Kadhim, K., Lau, D. H., Emami, M., Linz, D., Khokhar, K. B., Munawar, D. A., Mishima, R. S., Malik, V., O’Shea, C., et al. (2019) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.118.007005 · Cited by 145
Attuel, G., Gerasimova-Chechkina, E., Argoul, F., Yahia, H. M., & Arnéodo, A. (2018) · Frontiers in Physiology · doi:10.3389/fphys.2017.01139 · Cited by 142
“Despite the association of various strategies, clinical efficiency remains disappointing (Ganesan et al., 2013; Takigawa et al., 2014).”
BackgroundAtrial fibrillation ablation in practice: assessing CABANA generalizability
Noseworthy, P. A., Gersh, B. J., Kent, D. M., Piccini, J. P., Packer, D. L., Shah, N. D., & Yao, X. (2019) · European Heart Journal · doi:10.1093/eurheartj/ehz085 · Cited by 134
Mesquita, J., Ferreira, A. J. M., Cavaco, D., Costa, F. M., Carmo, P., Marques, H., Morgado, F., Mendes, M., & Adragão, P. (2017) · EP Europace · doi:10.1093/europace/eux265 · Cited by 132
Pallisgaard, J. L., Gislason, G., Hansen, J., Johannessen, A. C., Torp-Pedersen, C. T., Rasmussen, P. V., & Hansen, M. L. (2017) · European Heart Journal · doi:10.1093/eurheartj/ehx466 · Cited by 127
“In this meta-analysis a 64% AF free survival, equal to a recurrence rate of 36%, was found.(8) This again was in concordance with the recurrence rates found in our study.”
InfluentialSafety and chronic lesion characterization of pulsed field ablation in a Porcine model
Stewart, M. T., Haines, D. E., Damijan Miklavčič, A., Kos, B., Kirchhof, N., Barka, N., Mattison, L. M., Martien, M., Önal, B., Howard, B. T., et al. (2021) · Journal of Cardiovascular Electrophysiology · doi:10.1111/jce.14980 · Cited by 127
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Role of Contact Force Sensing in Catheter Ablation of Cardiac Arrhythmias
Ariyarathna, N., Kumar, S., Thomas, S. P., Stevenson, W. G., & Michaud, G. F. (2018) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2018.03.014 · Cited by 121
Treatment of Atrial Fibrillation
Prystowsky, E. N., Padanilam, B. J., & Fogel, R. I. (2015) · JAMA · doi:10.1001/jama.2015.7505 · Cited by 117
Kotecha, D., BREITHARDT, G. E., Camm, A. J., Lip, G. Y. H., Schotten, U., Ahlsson, A., Arnar, D. O., Atar, D., Auricchio, A., Bax, J. J., et al. (2018) · EP Europace · doi:10.1093/europace/eux318 · Cited by 117
“Between 2% and 5% of patients per year will experience late recurrences of AF, and this seems to continue up to 5 years post-ablation and beyond.(54,56) The minimum amount of AF required to increase the risk of stroke is unknown, and the risk stratification schemes such as CHA2DS2-VASc do not take account 400 D.”
BackgroundKhurram, I. M., Habibi, M., İpek, E. G., Chrispin, J., Yang, E., Fukumoto, K., Dewire, J., SPRAGG, D. D., Marine, J. E., Berger, R. D., et al. (2016) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2015.10.015 · Cited by 111
The long-term outcomes and durability of the Cox-Maze IV procedure for atrial fibrillation
Khiabani, A. J., MacGregor, R. M., Bakir, N. H., Manghelli, J. L., Sinn, L. A., Maniar, H. S., Moon, M. R., Schuessler, R. B., Melby, S. J., & Damiano, R. J. (2020) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/j.jtcvs.2020.04.100 · Cited by 117
Bovéda, S., Metzner, A., Nguyen, D. Q., Chun, K. R. J., Göhl, K., Noelker, G., Deharo, J., Andrikopoulos, G. K., Dahme, T., Lellouche, N., et al. (2018) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2018.07.007 · Cited by 111
“Early ablation of AF in the paroxysmal AF (PAF) disease state is on average more effective than ablations that are performed in a much later AF state, such as persistent or long-standing persistent AF (PerAF), when compared according to outcomes (3).”
ResultLifestyle modifications for treatment of atrial fibrillation
Middeldorp, M. E., Ariyaratnam, J., Lau, D. H., & Sanders, P. (2019) · Heart · doi:10.1136/heartjnl-2019-315327 · Cited by 114
Kornej, J., Hindricks, G., Kosiuk, J., Arya, A., Sommer, P., Husser, D., Rolf, S., Richter, S., Huo, Y., Piorkowski, C., et al. (2014) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.113.001182 · Cited by 110
“Although catheter ablation is superior to antiarrhythmic drugs,(4) up to 30% to 50% of AF patients suffer recurrences within the first year.(5) On the one hand, AF recurrences are associated with impaired quality of life, but on the other, they are also related to poor clinical outcomes such as increased morbidity and…”
BackgroundLong-Term Follow-Up After Catheter Ablation of Paroxysmal Atrial Fibrillation
Takigawa, M., Takahashi, A., Kuwahara, T., et al. (2014) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.113.000471 · Cited by 109
“45 procedures).(16) The present study describes a similar incidence of AF recurrence and the necessity of repeat ablation.”
BackgroundImpact of SGLT2 Inhibitors on AF Recurrence After Catheter Ablation in Patients With Type 2 Diabetes
Abu-Qaoud, M. R., Kumar, A., Tarun, T., Abraham, S., Ahmad, J., Khadke, S., Husami, R., Kulbak, G., Sahoo, S., Januzzi, J. L., et al. (2023) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2023.06.008 · Cited by 104
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Sex Differences in Atrial Fibrillation
Andrade, J. G., Deyell, M. W., Lee, A. K. Y., & Macle, L. (2017) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2017.11.022 · Cited by 100
Supervised Obesity Reduction Trial for AF ablation patients: results from the SORT-AF trial
Geßler, N., Willems, S., Steven, D., Aberle, J., Akbulak, R. Ö., Gosau, N., Hoffmann, B. A., Meyer, C. G., Sultan, A., Tilz, R. R., et al. (2021) · EP Europace · doi:10.1093/europace/euab122 · Cited by 98
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Lip, G. Y. H., Heinzel, F. R., Gaïta, F., González‐Juanatey, J. R., Heuzey, J. Y. L., Potpara, T., Svendsen, J. H., Vos, M. A., Anker, S. D., Coats, A. J. S., et al. (2015) · EP Europace · doi:10.1093/europace/euv191 · Cited by 99
New Findings in Atrial Fibrillation Mechanisms
Lau, D. H., Linz, D., & Sanders, P. (2019) · Cardiac Electrophysiology Clinics · doi:10.1016/j.ccep.2019.08.007 · Cited by 93
Structural Cardiac Remodeling in Atrial Fibrillation
Beyer, C., Tokarska, L., Stuehlinger, M., Feuchtner, G. M., Hintringer, F., Honold, S., Fiedler, L., Schönbauer, M.-S., Schönbauer, R., & Plank, F. (2021) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2021.04.027 · Cited by 95
Wang, S., Wu, S., Xu, L., Xiao, F., Whinnett, Z. I., Vijayaraman, P., Su, L., & Huang, W. (2019) · Journal of the American Heart Association · doi:10.1161/jaha.119.014253 · Cited by 95
Pulsed-Field Ablation on Mitral Isthmus in Persistent Atrial Fibrillation
Davong, B., Adeliño, R., Delasnerie, H., Albenque, J., Combes, N., Cardin, C., Voglimacci‐Stephanopoli, Q., Combes, S., & Bovéda, S. (2023) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2023.03.021 · Cited by 90
Anselmino, M., Matta, M., D'ascenzo, F., Pappone, C., Santinelli, V., Bunch, T. J., Neumann, T., Schilling, R. J., Hunter, R. J., Noelker, G., et al. (2015) · Europace · doi:10.1093/europace/euv214 · Cited by 88
“With the inclusion of redo procedures, the long-term SR maintenance rate improved to 66%: this result is comparable with long-term outcomes reported in general AFCA populations, which typically include patients with both their first and redo ablations.(10,30,31) The relatively large proportion (37%) of patients requir…”
ResultDagres, N., Chao, T., Fenelon, G., Aguinaga, L., Benhayon, D. A., Benjamin, E. J., Bunch, T. J., Chen, L. Y., Chen, S., Darrieux, F., et al. (2018) · Journal of Arrhythmia · doi:10.1002/joa3.12050 · Cited by 89
Costa, F. M., Ferreira, A. M., Oliveira, S. M., Santos, P. G., Durazzo, A., Carmo, P., Santos, K. R., Cavaco, D., Parreira, L., Morgado, F., et al. (2015) · International Journal of Cardiology · doi:10.1016/j.ijcard.2015.01.060 · Cited by 83
“Despite high early success rates, late recurrence of AF after an ablation procedure is common [3].”
BackgroundZhao, D.-S., Shen, Y., Zhang, Q., Lin, G., Lu, Y.-H., Chen, B.-T., Shi, L.-S., Huang, J.-F., & Lu, H.-H. (2015) · EP Europace · doi:10.1093/europace/euv339 · Cited by 85
“The results of our study are consistent with these previous data.(10,32,33) Mechanisms of recurrence Eight studies(14,16,17,19,23,24,26,27) involved the information about PV reconnection in repeat ablations (40–100%).”
BackgroundMethodResultInfluentialPathak, R. K., Evans, M., Middeldorp, M. E., Mahajan, R., Mehta, A. B., Meredith, M., Twomey, D. J., Wong, C. X. J., Hendriks, J., Abhayaratna, W. P., et al. (2017) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2016.12.015 · Cited by 87
Atrial fibrillation in women: treatment
Ko, D., Rahman, F., Martins, M. A. P., Hylek, E. M., Ellinor, P. T., Schnabel, R. B., Benjamin, E. J., & Christophersen, I. E. (2016) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2016.171 · Cited by 87
Atrial Fibrillation Mechanisms and Implications for Catheter Ablation
Cheniti, G., Vlachos, K. G., Pambrun, T., Hooks, D. A., Frontera, A., Takigawa, M., Bourier, F. J., Kitamura, Τ., Lam, A., Martin, C., et al. (2018) · Frontiers in Physiology · doi:10.3389/fphys.2018.01458 · Cited by 87
“It is notable that higher rates of success are reported after multiple procedures (Ganesan et al., 2013).”
BackgroundAtrial Fibrillation and Endothelial Dysfunction
Corban, M., Toya, T., Ahmad, A., Lerman, L. O., Lee, H.-C., & Lerman, A. (2021) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2020.11.005 · Cited by 87
Cabins, castles, and constant hearts: rhythm control therapy in patients with atrial fibrillation
Willems, S., Meyer, C. G., de Bono, J. P., Brandes, A., Eckardt, L., Elvan, A., Gelder, I. C. V., Goette, A., Gulizia, M. M., Haegeli, L., et al. (2019) · European Heart Journal · doi:10.1093/eurheartj/ehz782 · Cited by 80
“Amiodarone is the only antiarrhythmic drug with sufficient safety data in patients with reduced left ventricular ejection fraction.8 Large randomized trials of antiarrhythmic drugs compared to rate control in patients with AFþHF did not find differences in all-cause mortality, cardiovascular mortality, or heart failur…”
BackgroundInfluentialIncreasing trends in hospitalisations due to atrial fibrillation in Australia from 1993 to 2013
Gallagher, C., Hendriks, J., Giles, L. C., Karnon, J. D., Pham, C. T., Elliott, A. D., Middeldorp, M. E., Mahajan, R., Lau, D. H., Sanders, P., et al. (2019) · Heart · doi:10.1136/heartjnl-2018-314471 · Cited by 81
Varela, M., Bisbal, F., Zacur, E., Berruezo, A., Aslanidi, O. V., Mont, L., & Lamata, P. (2017) · Frontiers in Physiology · doi:10.3389/fphys.2017.00068 · Cited by 78
“…a medium-term success rate of up to 90%, but in patients with persistent forms of the disease, the success of the procedure drops to less than 70% (Ganesan et al., 2013) and more than half of patients experience additional AF episodes (AF recurrence), requiring multiple procedures to achieve…”
BackgroundCheung, J. W., Cheng, E. P., X. W., Yeo, I., Christos, P. J., Kamel, H., Markowitz, S. M., Liu, C. F., Thomas, G., Ip, J. E., et al. (2019) · European Heart Journal · doi:10.1093/eurheartj/ehz151 · Cited by 78
“Studies examining sex-based outcomes after AF ablation have yielded conflicting results.(8) Currently, there are limited contemporary populationbased data on differences in AF ablation outcomes between females and males.”
ResultErhard, N., Metzner, A., & Fink, T. (2022) · Herzschrittmachertherapie + Elektrophysiologie · doi:10.1007/s00399-021-00836-6 · Cited by 79
Optical Magnetic Induction Tomography of the Heart
Marmugi, L., & Renzoni, F. (2016) · Scientific Reports · doi:10.1038/srep23962 · Cited by 77
Greef, Y. D., Ströker, E., Schwagten, B., Kupics, K., Cocker, J. D., Chierchia, G., de Asmundis, C., Stockman, D., & Buysschaert, I. (2017) · EP Europace · doi:10.1093/europace/eux233 · Cited by 75
Pulmonary Vein Antrum Isolation in Patients With Paroxysmal Atrial Fibrillation
Gökoğlan, Y., Mohanty, S., Günes, M. F., Trivedi, C. G., Santangeli, P., Gianni, C., Asfour, I., Bai, R., Burkhardt, J. D., Horton, R., et al. (2016) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.115.003660 · Cited by 73
“A meta-analysis evaluating studies reporting >3 years of outcome after catheter ablation (CA) found that nearly 80% multiprocedure success rates can be achieved in patients with PAF.(21)”
BackgroundInfluentialYang, W., Du, X., Jiang, C., et al. (2019) · EP Europace · doi:10.1093/europace/euz235 · Cited by 73
Kornej, J., Hindricks, G., Arya, A., et al. (2017) · PLoS ONE · doi:10.1371/journal.pone.0169933 · Cited by 73
Nyns, E. C. A., Poelma, R. H., Volkers, L., Plomp, J. J., Bart, C. I., Kip, A., van Brakel, T. J., Zeppenfeld, K., Schalij, M. J., Zhang, G., et al. (2019) · Science Translational Medicine · doi:10.1126/scitranslmed.aau6447 · Cited by 71
“(F) Optical voltage trace showing rapid and chaotic atrial electrical activation during AF, which converts to sinus rhythm with 1:1 ventricular conduction after exposure of the RA to a 100-ms light pulse (l = 470 nm; irrandiance, 3.5 mW/mm2; light blue box). int., intensity; a.u., arbitrary units.”
BackgroundInfluentialGreef, Y. D., Schwagten, B., Chierchia, G., de Asmundis, C., Stockman, D., & Buysschaert, I. (2017) · EP Europace · doi:10.1093/europace/euw426 · Cited by 71
“beyond one year) ranging from 3% to 25%.(12) Interestingly, when looking at our own data, one can remark that outcome has been improving over the years.”
BackgroundSimader, F. A., Howard, J. P., Ahmad, Y., Saleh, K., Naraen, A., Samways, J., Mohal, J. S., Reddy, R. K., Kaza, N., Keene, D., et al. (2022) · EP Europace · doi:10.1093/europace/euac173 · Cited by 70
“Catheter ablation for AF, typically by pulmonary vein isolation using either radiofrequency or cryothermal energy, has been robustly shown to reduce the incidence and burden of atrial fibrillation.(3) Symptom improvements have also been seen, albeit in un-blinded studies.”
BackgroundLee, K., Roh, S., Baek, Y., Park, H., Ahn, J., Kim, D., Lee, D. I., Shim, J., Choi, J., Park, S. W., et al. (2018) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.117.005019 · Cited by 68
In Vitro Cell Selectivity of Reversible and Irreversible
Hunter, D. W., Kostecki, G., Fish, J. M., Jensen, J. A., & Tandri, H. S. (2021) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.120.008817 · Cited by 69
Conti, S., Weerasooriya, R., NOVAK, P. G., Champagne, J., Lim, H. E., Macle, L., Khaykin, Y., Pantano, A. A., & Verma, A. (2017) · Heart Rhythm · doi:10.1016/j.hrthm.2017.10.010 · Cited by 65
Kumar, S., Walters, T. E., Halloran, K., Morton, J. B., Hepworth, G., Wong, C. X. J., Kistler, P. M., Sanders, P., & Kalman, J. M. (2013) · EP Europace · doi:10.1093/europace/eut162 · Cited by 64
“5 procedures/patient.(38) Perhaps more importantly, catheter ablation is superior to anti-”
BackgroundGrecu, M., Blomström‐Lundqvist, C., Kautzner, J., Laroche, C., Gelder, I. C. V., Jordaens, L. J. L. M., Tavazzi, L., Cihak, R. J., Campal, J. M. R., Kalarus, Z. F., et al. (2019) · EP Europace · doi:10.1093/europace/euz225 · Cited by 64
EP-PINNs: Cardiac Electrophysiology Characterisation Using Physics-Informed Neural Networks
Martín, C. H., Oved, A., Chowdhury, R. A., et al. (2022) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2021.768419 · Cited by 63
“Catheter ablation of atrial myocardium believed to host the sources of the arrhythmia is the mainstay of AF treatment, but its long-term efficacy is disappointing (54%), especially in patients with persistent forms of the disease (43%) (2).”
BackgroundMethodInfluentialMicroRNA Expression Changes after Atrial Fibrillation Catheter Ablation
Sardu, C., Santamaria, M., Paolisso, G., & Marfella, R. (2015) · Pharmacogenomics · doi:10.2217/pgs.15.117 · Cited by 64
Carandina, A., Rodrigues, G. D., Francesco, P. D., Filtz, A., Bellocchi, C., Furlan, L., Carugo, S., Montano, N., & Tobaldini, E. (2021) · Autonomic Neuroscience · doi:10.1016/j.autneu.2021.102893 · Cited by 61
Update on Management of Cardiovascular Diseases in Women
Lucà, F., Abrignani, M. G., Parrini, I., Fusco, S. A. D., Giubilato, S., Rao, C. M., Piccioni, L., Cipolletta, L., Passaretti, B., Giallauria, F., et al. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11051176 · Cited by 67
Bajraktari, G., Bytyçi, I., & Henein, M. Y. (2019) · Clinical Physiology and Functional Imaging · doi:10.1111/cpf.12595 · Cited by 59
“…of CA for AF over and above antiarrhythmic medications, the procedure has not shown any favourable impact in reducing all-cause mor- tality or incidence of strokes (Wynn et al., 2014), perhaps because of the known heterogeneity of the patients recruited in various trials (Ganesan et al., 2013).”
BackgroundSaglietto, A., Gaïta, F., Blomström‐Lundqvist, C., Arbelo, E., Dagres, N., Brugada, J., Maggioni, A. P., Tavazzi, L., Kautzner, J., Ferrari, G. M. D., et al. (2022) · EP Europace · doi:10.1093/europace/euac145 · Cited by 59
“However, recurrent AF after catheter ablation remains relatively common and multiple procedures are often required.(5,6) Freedom from recurrent AF improves the benefit deriving from AF catheter ablation in terms of symptom relief and possibly also of serious adverse events, given the known association of sinus rhythm…”
BackgroundŠramko, M., Peichl, P., Wichterle, D., Tintěra, J., Weichet, J., Maxian, R., Pasnisinova, S., Kočková, R., & Kautzner, J. (2014) · International Journal of Cardiology · doi:10.1016/j.ijcard.2014.11.072 · Cited by 58
“Radiofrequency catheter ablation has proved an effective therapy of atrialfibrillation (AF) [1].”
BackgroundCasella, M., Russo, A. D., Russo, E., Catto, V., Pizzamiglio, F., Zucchetti, M., Majocchi, B., Riva, S. I., Vettor, G., Dessanai, M. A., et al. (2018) · Journal of the American Heart Association · doi:10.1161/jaha.117.008233 · Cited by 58
Boyalla, V., Harling, L., Snell, A., Kralj‐Hans, I., Barradas‐Pires, A., Haldar, S., Khan, H. R., Cleland, J. G. F., Athanasiou, T., Harding, S. E., et al. (2022) · Clinical Research in Cardiology · doi:10.1007/s00392-021-01978-w · Cited by 57
Electrogram morphology recurrence patterns during atrial fibrillation
Ng, J., Gordon, D., PASSMAN, R. S., et al. (2014) · Heart Rhythm · doi:10.1016/j.hrthm.2014.08.002 · Cited by 57
“However, ablation strategies that isolate the veins are effective in only a subset of patients with AF.(9) The rapid and seemingly chaotic electrogram activity that is characteristic of AF cannot currently be used to determine whether AF in a particular patient has a PV origin or is maintained by other foci/mechanisms.”
BackgroundInfluentialNakamori, S., Ngo, L. H., Tugal, D., Manning, W. J., & Nezafat, R. (2018) · Journal of the American Heart Association · doi:10.1161/jaha.118.009793 · Cited by 53
“Coronary artery disease (%) 21 (9) 15 (11) 6 (7) 0.”
Roy, A., Varela, M., & Aslanidi, O. V. (2018) · Frontiers in Physiology · doi:10.3389/fphys.2018.01352 · Cited by 51
“In these patients, the success rate with CA drops to 42% (Ganesan et al., 2013), often requiring additional ablation procedures.”
BackgroundMechanisms of Long-Term Recurrence 3 Years After Catheter Ablation of Atrial Fibrillation
Park, J., Yu, H. T., Kim, T., Uhm, J., Joung, B., Lee, M., & Pak, H. (2020) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2020.04.035 · Cited by 53
Recurrence of Atrial Fibrillation in Dependence of Left Atrial Volume Index
Kranert, M., Shchetynska‐Marinova, T., Liebe, V., Doesch, C., Papavassiliu, T., Akın, İ., Borggrefe, M., & Hohneck, A. L. (2020) · In Vivo · doi:10.21873/invivo.11854 · Cited by 53
Tanaka, N., Inoue, K., Kobori, A., Kaitani, K., Morimoto, T., Kurotobi, T., Morishima, I., Yamaji, H., Matsui, Y., Nakazawa, Y., et al. (2020) · EP Europace · doi:10.1093/europace/euaa104 · Cited by 49
Alhusseini, M. I., Vidmar, D., Meckler, G., Kowalewski, C., Shenasa, F., Wang, P. J., Narayan, S. M., & Rappel, W. (2017) · Journal of Cardiovascular Electrophysiology · doi:10.1111/jce.13177 · Cited by 51
Metadata
- Authors
- Ganesan, A. N., Shipp, N. J., Brooks, A. G., Kuklik, P., Lau, D. H., Lim, H. S., Sullivan, T., Roberts‐Thomson, K. C., & Sanders, P.
- Affiliations
- Royal Adelaide Hospital (AU)
- Centre for Heart Rhythm Disorders (CHRD), University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
- Corresponding author
- Sanders, Prashanthan
- Venue
- Journal of the American Heart Association
- Published
- 2013-03-12
- Volume
- 2
- Issue
- 2
- Pages
- e004549-e004549
- ISSN
- 2047-9980 (ISSN-L)
- PMC
- PMC3647286
- OpenAlex
- W2165779304
- Cited by
- 800
- References
- 45
- Citations by year
- 2026: 43 · 2025: 36 · 2024: 62 · 2023: 61 · 2022: 63 · 2021: 65 · 2020: 76 · 2019: 77 · 2018: 74 · 2017: 75 · 2016: 60 · 2015: 53 · 2014: 43 · 2013: 11
- FWCI
- 9.52
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Journal of the American Heart Association (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, other-oa)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Keywords
- atrial fibrillation, catheter ablation, long-term outcomes, procedural success, repeat procedures, atrial arrhythmia recurrence, paroxysmal atrial fibrillation, non-paroxysmal atrial fibrillation
- MeSH terms
- Anti-Arrhythmia Agents, Atrial Fibrillation, Humans, Longitudinal Studies, Recurrence, Treatment Outcome, Catheter Ablation
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