BACKGROUND: The time from the initial diagnosis of atrial fibrillation (AF) to the index ablation procedure, known as diagnosis-to-ablation time (DAT), is a modifiable risk factor that is correlated to affect the recurrence of AF. The objective of this meta-analysis was to examine the correlation between diagnosis-to-ablation time and AF recurrence. METHODS: A systematic search was performed in PubMed, Google Scholar, and Cochrane Library from database inception till June 2024. Studies reporting diagnosis-to-ablation time and its relation with AF recurrence were included. The primary analysis evaluated outcomes segregated by DAT ≤ 1 year versus >
1 year. Random-effects model with the Mantel-Haenszel method was used to evaluate AF recurrence. RESULTS: Of the 9177 articles, only 6 observational studies got through the inclusion criteria with a total participant count of 14,862. DAT of greater than 1 year was associated with increased risk of AF recurrence in all the included studies while DAT of ≤ 1 year was correlated with lower risk of AF recurrence (RR, 0.76 (95% CI, 0.73-0.79)
P <
0.01). Similarly, DAT of ≤ 3 years was correlated with lower AF recurrence risk (RR, 0.82 (95% CI, 0.79-0.85)
P <
0.01). CONCLUSION: Evidence from observational cohorts suggests that the optimum time for ablation in AF patients is less than 1 year and a DAT of ≤ 1 year is linked to 24% lower chances of recurrence in AF patients, compared to DAT of ≥ 1 year.