Prophylactic Cavotricuspid Isthmus Ablation in Atrial Fibrillation without Documented Typical Atrial Flutter: A Systematic Review and Meta-analysis
Background: The advantage of prophylactic cavotricuspid isthmus (CTI) ablation for AF patients without documented atrial flutter is still unclear. The present study aimed to evaluate the role of prophylactic CTI ablation in this population. Methods: A systematic review and meta-analysis study was co...
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| Format: | Article |
| Language: | English |
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Radcliffe Medical Media
2022-07-01
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| Series: | Arrhythmia & Electrophysiology Review |
| Online Access: | https://www.aerjournal.com/articleindex/aer.2021.37 |
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| author | Yoga Waranugraha Ardian Rizal Mohammad Saifur Rohman Chia-Ti Tsai Fu-Chun Chiu |
| author_facet | Yoga Waranugraha Ardian Rizal Mohammad Saifur Rohman Chia-Ti Tsai Fu-Chun Chiu |
| author_sort | Yoga Waranugraha |
| collection | DOAJ |
| description | Background: The advantage of prophylactic cavotricuspid isthmus (CTI) ablation for AF patients without documented atrial flutter is still unclear. The present study aimed to evaluate the role of prophylactic CTI ablation in this population. Methods: A systematic review and meta-analysis study was conducted. The overall effects estimation was conducted using random effects models. The pooled effects were presented as the risk difference and standardised mean difference for dichotomous and continuous outcomes, respectively. Results: A total of 1,476 patients from four studies were included. The risk of atrial tachyarrhythmias following a successful catheter ablation procedure was greater in the pulmonary vein isolation + CTI ablation group than pulmonary vein isolation alone group (34.8% versus 28.2%; risk difference 0.08; 95% CI [0.00–0.17]; p=0.04). Prophylactic CTI ablation was associated with a higher recurrent AF rate (33.8% versus 27.1%; risk difference 0.07; 95% CI [0.01–0.13]; p=0.02). Additional prophylactic CTI ablation to pulmonary vein isolation significantly increased the radio frequency application time (standardised mean difference 0.52; 95% CI [0.04–1.01]; p=0.03). Conclusion: This study suggested that prophylactic CTI ablation was an ineffective and inefficient approach in AF without documented typical atrial flutter patients. |
| format | Article |
| id | doaj-art-51efd58d76224e2d873f6b39f0b6cd21 |
| institution | OA Journals |
| issn | 2050-3369 2050-3377 |
| language | English |
| publishDate | 2022-07-01 |
| publisher | Radcliffe Medical Media |
| record_format | Article |
| series | Arrhythmia & Electrophysiology Review |
| spelling | doaj-art-51efd58d76224e2d873f6b39f0b6cd212025-08-20T02:37:51ZengRadcliffe Medical MediaArrhythmia & Electrophysiology Review2050-33692050-33772022-07-011110.15420/aer.2021.37Prophylactic Cavotricuspid Isthmus Ablation in Atrial Fibrillation without Documented Typical Atrial Flutter: A Systematic Review and Meta-analysisYoga Waranugraha0Ardian Rizal1Mohammad Saifur Rohman2Chia-Ti Tsai3Fu-Chun Chiu4Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Brawijaya, Malang, IndonesiaDepartment of Cardiology and Vascular Medicine, Faculty of Medicine, University of Brawijaya, Malang, IndonesiaDepartment of Cardiology and Vascular Medicine, Faculty of Medicine, University of Brawijaya, Malang, IndonesiaDivision of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, TaiwanDivision of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin, TaiwanBackground: The advantage of prophylactic cavotricuspid isthmus (CTI) ablation for AF patients without documented atrial flutter is still unclear. The present study aimed to evaluate the role of prophylactic CTI ablation in this population. Methods: A systematic review and meta-analysis study was conducted. The overall effects estimation was conducted using random effects models. The pooled effects were presented as the risk difference and standardised mean difference for dichotomous and continuous outcomes, respectively. Results: A total of 1,476 patients from four studies were included. The risk of atrial tachyarrhythmias following a successful catheter ablation procedure was greater in the pulmonary vein isolation + CTI ablation group than pulmonary vein isolation alone group (34.8% versus 28.2%; risk difference 0.08; 95% CI [0.00–0.17]; p=0.04). Prophylactic CTI ablation was associated with a higher recurrent AF rate (33.8% versus 27.1%; risk difference 0.07; 95% CI [0.01–0.13]; p=0.02). Additional prophylactic CTI ablation to pulmonary vein isolation significantly increased the radio frequency application time (standardised mean difference 0.52; 95% CI [0.04–1.01]; p=0.03). Conclusion: This study suggested that prophylactic CTI ablation was an ineffective and inefficient approach in AF without documented typical atrial flutter patients.https://www.aerjournal.com/articleindex/aer.2021.37 |
| spellingShingle | Yoga Waranugraha Ardian Rizal Mohammad Saifur Rohman Chia-Ti Tsai Fu-Chun Chiu Prophylactic Cavotricuspid Isthmus Ablation in Atrial Fibrillation without Documented Typical Atrial Flutter: A Systematic Review and Meta-analysis Arrhythmia & Electrophysiology Review |
| title | Prophylactic Cavotricuspid Isthmus Ablation in Atrial Fibrillation without Documented Typical Atrial Flutter: A Systematic Review and Meta-analysis |
| title_full | Prophylactic Cavotricuspid Isthmus Ablation in Atrial Fibrillation without Documented Typical Atrial Flutter: A Systematic Review and Meta-analysis |
| title_fullStr | Prophylactic Cavotricuspid Isthmus Ablation in Atrial Fibrillation without Documented Typical Atrial Flutter: A Systematic Review and Meta-analysis |
| title_full_unstemmed | Prophylactic Cavotricuspid Isthmus Ablation in Atrial Fibrillation without Documented Typical Atrial Flutter: A Systematic Review and Meta-analysis |
| title_short | Prophylactic Cavotricuspid Isthmus Ablation in Atrial Fibrillation without Documented Typical Atrial Flutter: A Systematic Review and Meta-analysis |
| title_sort | prophylactic cavotricuspid isthmus ablation in atrial fibrillation without documented typical atrial flutter a systematic review and meta analysis |
| url | https://www.aerjournal.com/articleindex/aer.2021.37 |
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