Atrial Fibrillation Termination Success During Ablation: Insights From Pooled Clinical Studies.

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Reviews in cardiovascular medicine Pub Date : 2025-07-30 eCollection Date: 2025-07-01 DOI:10.31083/RCM33419

Changjian He, Wenchang Zhang, Feng Li, Huaiqiang Wang, Xiongyi Han, Zihan Zhao, Guojie Ye, Tengfei Liu, Da Zhang, Haiyan Liu, Jie Liu, Jingning Zhao, Chunhua Ding

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引用次数: 0

Abstract

Background: The optimal endpoint for ablation in persistent atrial fibrillation (pers-AF) remains unclear. This study aimed to systematically evaluate the prognostic value of acute AF termination in predicting the recurrence of arrhythmias.

Methods: A systematic search of the PubMed, Cochrane Library, Web of Science, and Embase databases was conducted from inception to July 2023. Only studies with reports of acute termination for pers-AF and its predictive role in arrhythmia recurrence were included. Subgroup analysis was performed to identify potential confounders for the effect of AF termination.

Results: A total of 22 studies were included in the meta-analysis. The pooled analysis indicated that acute termination of AF is significantly associated with an increased long-term success rate (relative risk (RR), 1.53; 95% CI, 1.41-1.66; p < 0.001; I² = 35.4%). Moreover, subgroup analysis revealed that patients with an AF duration >12 months (RR, 1.92; 95% CI, 1.57-2.35; p < 0.001), aged >60 years (RR, 1.92; 95% CI, 1.60-2.31; p < 0.001) may derive benefits from AF termination during ablation. Interestingly, a significant interaction was observed in the study design subgroup, where multi-center studies showed a success rate of RR, 1.31 (95% CI, 1.14-1.50; p < 0.001), while single-center studies exhibited a higher success rate of RR, 1.65 (95% CI, 1.49-1.82; p < 0.001), with an interaction p-value of 0.008. Importantly, acute termination of AF did not significantly increase procedural complications (RR, 1.19; 95% CI, 0.59-2.39; p = 0.627; I² = 0.0%).

Conclusions: Our study suggests that AF acute termination during ablation for pers-AF provides a better long-term clinical outcome.

The prospero registration: CRD42023431015, https://www.crd.york.ac.uk/PROSPERO/view/CRD42023431015.

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查看原文本刊更多论文

消融期间房颤终止成功：来自临床研究汇总的见解。

背景：持续性心房颤动（pers-AF）消融的最佳终点尚不清楚。本研究旨在系统评价急性房颤终止对心律失常复发的预测价值。方法：系统检索PubMed、Cochrane Library、Web of Science和Embase数据库，检索时间为20123年7月。仅纳入了有报道的急性终止的研究及其在心律失常复发中的预测作用。进行亚组分析以确定AF终止影响的潜在混杂因素。结果：meta分析共纳入22项研究。合并分析表明，急性房颤终止与长期成功率增加显著相关(相对风险（RR）， 1.53；95% ci, 1.41-1.66；P < 0.001；I2 = 35.4%)。此外，亚组分析显示，AF持续时间为10 ~ 12个月的患者(RR, 1.92；95% ci, 1.57-2.35；p < 0.001)， 60岁以下(RR, 1.92；95% ci, 1.60-2.31；p < 0.001)可能从消融期间房颤终止获益。有趣的是，在研究设计亚组中观察到显著的相互作用，其中多中心研究显示RR成功率为1.31 (95% CI, 1.14-1.50；p < 0.001)，而单中心研究的RR成功率更高，为1.65 (95% CI, 1.49-1.82；P < 0.001)，交互作用P值为0.008。重要的是，急性房颤终止并没有显著增加手术并发症(RR, 1.19；95% ci, 0.59-2.39；P = 0.627；I2 = 0.0%)。结论：我们的研究表明，在消融过程中急性终止房颤可以提供更好的长期临床结果。普洛斯彼罗注册：CRD42023431015， https://www.crd.york.ac.uk/PROSPERO/view/CRD42023431015。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Reviews in cardiovascular medicine 医学-心血管系统

CiteScore

2.70

自引率

3.70%

发文量

377

审稿时长

1 months

期刊介绍： RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.