Impact of atrial fibrillation catheter ablation on mortality, stroke, and heart failure hospitalizations: A meta-analysis

Andrea Saglietto, Roberto De Ponti, Luigi Di Biase, Mario Matta, Fiorenzo Gaita, Jorge Romero, Gaetano M. De Ferrari, Matteo Anselmino

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Background: The impact of atrial fibrillation catheter ablation (AFCA) on hard clinical endpoints remains controversial. Objective: Our aim was to conduct a random-effect model meta-analysis on efficacy data from high-quality large matched database/registry studies and randomized clinical trials. We compared long-term all-cause mortality, stroke, and hospitalization for heart failure in patients undergoing AFCA vs patients treated with medical therapy alone (rhythm and/or rate control medications) in a general AF population. Methods and Results: PubMed/MEDLINE and Embase databases were screened and a total of nine studies were selected (one randomized clinical trial—CABANA—and eight large matched population studies). A total of 241 372 patients (27 711 in the ablation group, 213 661 in the nonablation group) were included. After a median follow-up of 3.5 years, AFCA decreased the risk of mortality (hazard ratio [HR], 0.62; 95% confidence interval [CI], 0.54-0.72; I2 = 54%; number needed to treat [NNT] = 28), stroke (HR, 0.63; 95% CI, 0.56-0.70; I2 = 23%; NNT = 59) and hospitalization for heart failure (HR, 0.64; 95% CI, 0.51-0.80; I2 = 28%; NNT = 33) compared with AF patients treated with medical therapy alone. Conclusion: Based on the currently available efficacy and effectiveness evidence, AFCA significantly reduces the risk of death, stroke, and hospitalization compared with medical therapy alone.

Original languageEnglish (US)
Pages (from-to)1040-1047
Number of pages8
JournalJournal of cardiovascular electrophysiology
Volume31
Issue number5
DOIs
StatePublished - May 1 2020

Keywords

  • all-cause mortality, stroke, hard clinical outcomes
  • atrial fibrillation
  • catheter ablation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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