Hybrid ablation for persistent/long-standing persistent atrial fibrillation: a meta-analysis and trial sequential analysis of randomized controlled trials.

• Tác giả: Marcelo Antonio Pinheiro Braga, Alexander Dal Forno, André d'Avila, Douglas Mesadri Gewehr, Andrew H Locke, André Rivera, Caique M P Ternes, Felipe Villa Martignoni
• Ngôn ngữ: eng
• Thông tin xuất bản: Netherlands : Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing , 2025
• Bộ sưu tập: NCBI
• ID: 157569

Tóm tắt

 The efficacy and safety of hybrid ablation (HA) for patients with non-paroxysmal atrial fibrillation (AF) remain unclear. PubMed, Embase, Cochrane, and ClinicalTrials.gov were searched for randomized controlled trials (RCTs) comparing HA (endo-epicardial ablation) versus endocardial ablation (EA) for patients with persistent/long-standing persistent AF. Risk ratios (RRs) and 95% confidence intervals (CIs) were pooled. Our meta-analysis included 3 RCTs comprising 358 patients, of whom 233 (65.1%) were randomized to HA. Compared with EA, HA reduced the recurrence of atrial tachyarrhythmias (RR 0.53
  95% CI 0.41-0.69
  p <
  0.01) but had no subgroup interaction according to AF type (p = 0.90). There was no significant difference in major adverse events (RR 1.22
  95% CI 0.46-3.25
  p = 0.68). Trial sequential analysis indicates that the observed effects can be deemed conclusive. In conclusion, in patients with persistent/long-standing persistent AF, HA substantially reduced the recurrence of atrial tachyarrhythmias. Notably, patients with long-standing persistent AF may benefit more from this ablation strategy.