Which are the most reliable predictors of recurrence of atrial fibrillation after transcatheter ablation?

A meta-analysis

F. D'Ascenzo, A. Corleto, G. Biondi-Zoccai, M. Anselmino, F. Ferraris, Luigi Di Biase, A. Natale, R. J. Hunter, R. J. Schilling, S. Miyazaki, H. Tada, K. Aonuma, L. Yenn-Jiang, H. Tao, C. Ma, D. Packer, S. Hammill, F. Gaita

Research output: Contribution to journalArticle

94 Citations (Scopus)

Abstract

Context: Transcatheter ablation of atrial fibrillation (AF) has undergone important development, with acceptable midterm results in terms of the safety and recurrence. A meta-analysis was performed to identify the periprocedural complications, midterm success rates and predictors of recurrence after AF ablation. Methods and results: 4357 patients with paroxysmal AF, 1083 with persistent AF and 1777 with long standing AF were included. The pooled analysis showed that there was an in-hospital complication rate of tamponade requiring drainage of 0.99% (0.44-1.54; CI 99%), stroke with neurological persistent impairment of 0.22% (0.04-0.47; CI 99%), and stroke without of 0.36% (0.03-0.70; CI 99%) After a follow up of 22 (13-28) months and 1.23 (1.19-1.5; CI 99%) procedures per patient, the AF recurrence rate was 31.20% (24.87-34.81; CI 99%). The persistent AF patients exhibited a greater risk of recurrence after the first ablation (OR 1.78 [1.14, 2.77] CI 99%), but a trend towards non significance was present in the patients with more than one procedure (OR 1.69 [0.95, 3.00] CI 99%). The most powerful predictors of an AF ablation failure in the overall population were a recurrence within 30-days (OR 4.30; 2.00-10.80), valvular AF (OR 5.20; 2.22-9.50) and a left atrium diameter of more than 50 mm (OR 5.10 2.00-12.90; all CI 95%). Conclusions: Persistent AF remains burdened from higher recurrence rates, however not so following redo-procedures. Three predictors, valvular AF, a left atrium diameter longer than 50 mm and recurrence within 30 days, could be appraised to drive selection of patients and therapeutic strategy.

Original languageEnglish (US)
Pages (from-to)1984-1989
Number of pages6
JournalInternational Journal of Cardiology
Volume167
Issue number5
DOIs
StatePublished - Sep 1 2013
Externally publishedYes

Fingerprint

Atrial Fibrillation
Meta-Analysis
Recurrence
Heart Atria
Stroke
Patient Selection
Drainage
Safety

Keywords

  • Atrial fibrillation
  • Catheter ablation
  • Meta-analysis
  • Multivariate predictors
  • Recurrence
  • Systematic review

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Which are the most reliable predictors of recurrence of atrial fibrillation after transcatheter ablation? A meta-analysis. / D'Ascenzo, F.; Corleto, A.; Biondi-Zoccai, G.; Anselmino, M.; Ferraris, F.; Di Biase, Luigi; Natale, A.; Hunter, R. J.; Schilling, R. J.; Miyazaki, S.; Tada, H.; Aonuma, K.; Yenn-Jiang, L.; Tao, H.; Ma, C.; Packer, D.; Hammill, S.; Gaita, F.

In: International Journal of Cardiology, Vol. 167, No. 5, 01.09.2013, p. 1984-1989.

Research output: Contribution to journalArticle

D'Ascenzo, F, Corleto, A, Biondi-Zoccai, G, Anselmino, M, Ferraris, F, Di Biase, L, Natale, A, Hunter, RJ, Schilling, RJ, Miyazaki, S, Tada, H, Aonuma, K, Yenn-Jiang, L, Tao, H, Ma, C, Packer, D, Hammill, S & Gaita, F 2013, 'Which are the most reliable predictors of recurrence of atrial fibrillation after transcatheter ablation? A meta-analysis', International Journal of Cardiology, vol. 167, no. 5, pp. 1984-1989. https://doi.org/10.1016/j.ijcard.2012.05.008
D'Ascenzo, F. ; Corleto, A. ; Biondi-Zoccai, G. ; Anselmino, M. ; Ferraris, F. ; Di Biase, Luigi ; Natale, A. ; Hunter, R. J. ; Schilling, R. J. ; Miyazaki, S. ; Tada, H. ; Aonuma, K. ; Yenn-Jiang, L. ; Tao, H. ; Ma, C. ; Packer, D. ; Hammill, S. ; Gaita, F. / Which are the most reliable predictors of recurrence of atrial fibrillation after transcatheter ablation? A meta-analysis. In: International Journal of Cardiology. 2013 ; Vol. 167, No. 5. pp. 1984-1989.
@article{30f4d38a787d450abbb1cbc398eebd29,
title = "Which are the most reliable predictors of recurrence of atrial fibrillation after transcatheter ablation?: A meta-analysis",
abstract = "Context: Transcatheter ablation of atrial fibrillation (AF) has undergone important development, with acceptable midterm results in terms of the safety and recurrence. A meta-analysis was performed to identify the periprocedural complications, midterm success rates and predictors of recurrence after AF ablation. Methods and results: 4357 patients with paroxysmal AF, 1083 with persistent AF and 1777 with long standing AF were included. The pooled analysis showed that there was an in-hospital complication rate of tamponade requiring drainage of 0.99{\%} (0.44-1.54; CI 99{\%}), stroke with neurological persistent impairment of 0.22{\%} (0.04-0.47; CI 99{\%}), and stroke without of 0.36{\%} (0.03-0.70; CI 99{\%}) After a follow up of 22 (13-28) months and 1.23 (1.19-1.5; CI 99{\%}) procedures per patient, the AF recurrence rate was 31.20{\%} (24.87-34.81; CI 99{\%}). The persistent AF patients exhibited a greater risk of recurrence after the first ablation (OR 1.78 [1.14, 2.77] CI 99{\%}), but a trend towards non significance was present in the patients with more than one procedure (OR 1.69 [0.95, 3.00] CI 99{\%}). The most powerful predictors of an AF ablation failure in the overall population were a recurrence within 30-days (OR 4.30; 2.00-10.80), valvular AF (OR 5.20; 2.22-9.50) and a left atrium diameter of more than 50 mm (OR 5.10 2.00-12.90; all CI 95{\%}). Conclusions: Persistent AF remains burdened from higher recurrence rates, however not so following redo-procedures. Three predictors, valvular AF, a left atrium diameter longer than 50 mm and recurrence within 30 days, could be appraised to drive selection of patients and therapeutic strategy.",
keywords = "Atrial fibrillation, Catheter ablation, Meta-analysis, Multivariate predictors, Recurrence, Systematic review",
author = "F. D'Ascenzo and A. Corleto and G. Biondi-Zoccai and M. Anselmino and F. Ferraris and {Di Biase}, Luigi and A. Natale and Hunter, {R. J.} and Schilling, {R. J.} and S. Miyazaki and H. Tada and K. Aonuma and L. Yenn-Jiang and H. Tao and C. Ma and D. Packer and S. Hammill and F. Gaita",
year = "2013",
month = "9",
day = "1",
doi = "10.1016/j.ijcard.2012.05.008",
language = "English (US)",
volume = "167",
pages = "1984--1989",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",
number = "5",

}

TY - JOUR

T1 - Which are the most reliable predictors of recurrence of atrial fibrillation after transcatheter ablation?

T2 - A meta-analysis

AU - D'Ascenzo, F.

AU - Corleto, A.

AU - Biondi-Zoccai, G.

AU - Anselmino, M.

AU - Ferraris, F.

AU - Di Biase, Luigi

AU - Natale, A.

AU - Hunter, R. J.

AU - Schilling, R. J.

AU - Miyazaki, S.

AU - Tada, H.

AU - Aonuma, K.

AU - Yenn-Jiang, L.

AU - Tao, H.

AU - Ma, C.

AU - Packer, D.

AU - Hammill, S.

AU - Gaita, F.

PY - 2013/9/1

Y1 - 2013/9/1

N2 - Context: Transcatheter ablation of atrial fibrillation (AF) has undergone important development, with acceptable midterm results in terms of the safety and recurrence. A meta-analysis was performed to identify the periprocedural complications, midterm success rates and predictors of recurrence after AF ablation. Methods and results: 4357 patients with paroxysmal AF, 1083 with persistent AF and 1777 with long standing AF were included. The pooled analysis showed that there was an in-hospital complication rate of tamponade requiring drainage of 0.99% (0.44-1.54; CI 99%), stroke with neurological persistent impairment of 0.22% (0.04-0.47; CI 99%), and stroke without of 0.36% (0.03-0.70; CI 99%) After a follow up of 22 (13-28) months and 1.23 (1.19-1.5; CI 99%) procedures per patient, the AF recurrence rate was 31.20% (24.87-34.81; CI 99%). The persistent AF patients exhibited a greater risk of recurrence after the first ablation (OR 1.78 [1.14, 2.77] CI 99%), but a trend towards non significance was present in the patients with more than one procedure (OR 1.69 [0.95, 3.00] CI 99%). The most powerful predictors of an AF ablation failure in the overall population were a recurrence within 30-days (OR 4.30; 2.00-10.80), valvular AF (OR 5.20; 2.22-9.50) and a left atrium diameter of more than 50 mm (OR 5.10 2.00-12.90; all CI 95%). Conclusions: Persistent AF remains burdened from higher recurrence rates, however not so following redo-procedures. Three predictors, valvular AF, a left atrium diameter longer than 50 mm and recurrence within 30 days, could be appraised to drive selection of patients and therapeutic strategy.

AB - Context: Transcatheter ablation of atrial fibrillation (AF) has undergone important development, with acceptable midterm results in terms of the safety and recurrence. A meta-analysis was performed to identify the periprocedural complications, midterm success rates and predictors of recurrence after AF ablation. Methods and results: 4357 patients with paroxysmal AF, 1083 with persistent AF and 1777 with long standing AF were included. The pooled analysis showed that there was an in-hospital complication rate of tamponade requiring drainage of 0.99% (0.44-1.54; CI 99%), stroke with neurological persistent impairment of 0.22% (0.04-0.47; CI 99%), and stroke without of 0.36% (0.03-0.70; CI 99%) After a follow up of 22 (13-28) months and 1.23 (1.19-1.5; CI 99%) procedures per patient, the AF recurrence rate was 31.20% (24.87-34.81; CI 99%). The persistent AF patients exhibited a greater risk of recurrence after the first ablation (OR 1.78 [1.14, 2.77] CI 99%), but a trend towards non significance was present in the patients with more than one procedure (OR 1.69 [0.95, 3.00] CI 99%). The most powerful predictors of an AF ablation failure in the overall population were a recurrence within 30-days (OR 4.30; 2.00-10.80), valvular AF (OR 5.20; 2.22-9.50) and a left atrium diameter of more than 50 mm (OR 5.10 2.00-12.90; all CI 95%). Conclusions: Persistent AF remains burdened from higher recurrence rates, however not so following redo-procedures. Three predictors, valvular AF, a left atrium diameter longer than 50 mm and recurrence within 30 days, could be appraised to drive selection of patients and therapeutic strategy.

KW - Atrial fibrillation

KW - Catheter ablation

KW - Meta-analysis

KW - Multivariate predictors

KW - Recurrence

KW - Systematic review

UR - http://www.scopus.com/inward/record.url?scp=84883276058&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84883276058&partnerID=8YFLogxK

U2 - 10.1016/j.ijcard.2012.05.008

DO - 10.1016/j.ijcard.2012.05.008

M3 - Article

VL - 167

SP - 1984

EP - 1989

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

IS - 5

ER -