Which ablation strategy is the most effective for treating persistent atrial fibrillation? A systematic review and bayesian network meta-analysis of randomized controlled trials.

• Tác giả: YongBing Fu, TingBo Jiang, Lin Ling, MingZhu Xu, Feng Xue, NingNing Zheng
• Ngôn ngữ: eng
• Ký hiệu phân loại: 004.338 Systems analysis and design, computer architecture, performance evaluation of real-time computers
• Thông tin xuất bản: United States : Heart rhythm , 2025
• Bộ sưu tập: NCBI
• ID: 218478

Tóm tắt

There is no consensus on the most efficient ablation strategy for patients with persistent atrial fibrillation (PerAF). This study aimed to conduct a systematic review and network meta-analysis (NMA) to evaluate the effectiveness of different ablation strategies for PerAF. The primary efficacy outcome was the recurrence of any atrial arrhythmia after a single ablation procedure during the follow-up period. The primary safety outcome of interest was any reported complication related to the procedure. The secondary outcome was the procedure time. Fifty-two studies with 9048 patients were included in this NMA. The studies were conducted between 2004 and 2024, and 22 different ablation strategies were identified. 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.