Atrial Fibrillation Termination Success During Ablation: Insights From Pooled Clinical Studies
Background: The optimal endpoint for ablation in persistent atrial fibrillation (pers-AF) remains unclear. This study aimed to systematically evaluate the prognostic value of acute AF termination in predicting the recurrence of arrhythmias....
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| Format: | Article |
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IMR Press
2025-07-01
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| Series: | Reviews in Cardiovascular Medicine |
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| Online Access: | https://www.imrpress.com/journal/RCM/26/7/10.31083/RCM33419 |
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| author | Changjian He Wenchang Zhang Feng Li Huaiqiang Wang Xiongyi Han Zihan Zhao Guojie Ye Tengfei Liu Da Zhang Haiyan Liu Jie Liu Jingning Zhao Chunhua Ding |
| author_facet | Changjian He Wenchang Zhang Feng Li Huaiqiang Wang Xiongyi Han Zihan Zhao Guojie Ye Tengfei Liu Da Zhang Haiyan Liu Jie Liu Jingning Zhao Chunhua Ding |
| author_sort | Changjian He |
| collection | DOAJ |
| description | Background: The optimal endpoint for ablation in persistent atrial fibrillation (pers-AF) remains unclear. This study aimed to systematically evaluate the prognostic value of acute AF termination in predicting the recurrence of arrhythmias. Methods: A systematic search of the PubMed, Cochrane Library, Web of Science, and Embase databases was conducted from inception to July 2023. Only studies with reports of acute termination for pers-AF and its predictive role in arrhythmia recurrence were included. Subgroup analysis was performed to identify potential confounders for the effect of AF termination. Results: A total of 22 studies were included in the meta-analysis. The pooled analysis indicated that acute termination of AF is significantly associated with an increased long-term success rate (relative risk (RR), 1.53; 95% CI, 1.41–1.66; p < 0.001; I2 = 35.4%). Moreover, subgroup analysis revealed that patients with an AF duration >12 months (RR, 1.92; 95% CI, 1.57–2.35; p < 0.001), aged >60 years (RR, 1.92; 95% CI, 1.60–2.31; p < 0.001) may derive benefits from AF termination during ablation. Interestingly, a significant interaction was observed in the study design subgroup, where multi-center studies showed a success rate of RR, 1.31 (95% CI, 1.14–1.50; p < 0.001), while single-center studies exhibited a higher success rate of RR, 1.65 (95% CI, 1.49–1.82; p < 0.001), with an interaction p-value of 0.008. Importantly, acute termination of AF did not significantly increase procedural complications (RR, 1.19; 95% CI, 0.59–2.39; p = 0.627; I2 = 0.0%). Conclusions: Our study suggests that AF acute termination during ablation for pers-AF provides a better long-term clinical outcome. The PROSPERO Registration: CRD42023431015, https://www.crd.york.ac.uk/PROSPERO/view/CRD42023431015. |
| format | Article |
| id | doaj-art-efe1d44fbfeb4bc5a18d12cb3e399753 |
| institution | DOAJ |
| issn | 1530-6550 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Reviews in Cardiovascular Medicine |
| spelling | doaj-art-efe1d44fbfeb4bc5a18d12cb3e3997532025-08-20T02:56:30ZengIMR PressReviews in Cardiovascular Medicine1530-65502025-07-012673341910.31083/RCM33419S1530-6550(25)01818-6Atrial Fibrillation Termination Success During Ablation: Insights From Pooled Clinical StudiesChangjian He0Wenchang Zhang1Feng Li2Huaiqiang Wang3Xiongyi Han4Zihan Zhao5Guojie Ye6Tengfei Liu7Da Zhang8Haiyan Liu9Jie Liu10Jingning Zhao11Chunhua Ding12Cardiac Department, Aerospace Center Hospital (Peking University Aerospace School of Clinical Medicine), 100049 Beijing, ChinaCardiac Department, Aerospace Center Hospital (Peking University Aerospace School of Clinical Medicine), 100049 Beijing, ChinaDepartment of Cardiology, The Second Affiliated Hospital of Soochow University, 215004 Suzhou, Jiangsu, ChinaCardiac Department, Aerospace Center Hospital (Peking University Aerospace School of Clinical Medicine), 100049 Beijing, ChinaCardiac Department, Aerospace Center Hospital (Peking University Aerospace School of Clinical Medicine), 100049 Beijing, ChinaCardiac Department, Aerospace Center Hospital (Peking University Aerospace School of Clinical Medicine), 100049 Beijing, ChinaCardiac Department, Aerospace Center Hospital (Peking University Aerospace School of Clinical Medicine), 100049 Beijing, ChinaCardiac Department, Aerospace Center Hospital (Peking University Aerospace School of Clinical Medicine), 100049 Beijing, ChinaCardiac Department, Aerospace Center Hospital (Peking University Aerospace School of Clinical Medicine), 100049 Beijing, ChinaCardiac Department, Aerospace Center Hospital (Peking University Aerospace School of Clinical Medicine), 100049 Beijing, ChinaCardiac Department, Aerospace Center Hospital (Peking University Aerospace School of Clinical Medicine), 100049 Beijing, ChinaCardiac Department, Aerospace Center Hospital (Peking University Aerospace School of Clinical Medicine), 100049 Beijing, ChinaCardiac Department, Aerospace Center Hospital (Peking University Aerospace School of Clinical Medicine), 100049 Beijing, ChinaBackground: The optimal endpoint for ablation in persistent atrial fibrillation (pers-AF) remains unclear. This study aimed to systematically evaluate the prognostic value of acute AF termination in predicting the recurrence of arrhythmias. Methods: A systematic search of the PubMed, Cochrane Library, Web of Science, and Embase databases was conducted from inception to July 2023. Only studies with reports of acute termination for pers-AF and its predictive role in arrhythmia recurrence were included. Subgroup analysis was performed to identify potential confounders for the effect of AF termination. Results: A total of 22 studies were included in the meta-analysis. The pooled analysis indicated that acute termination of AF is significantly associated with an increased long-term success rate (relative risk (RR), 1.53; 95% CI, 1.41–1.66; p < 0.001; I2 = 35.4%). Moreover, subgroup analysis revealed that patients with an AF duration >12 months (RR, 1.92; 95% CI, 1.57–2.35; p < 0.001), aged >60 years (RR, 1.92; 95% CI, 1.60–2.31; p < 0.001) may derive benefits from AF termination during ablation. Interestingly, a significant interaction was observed in the study design subgroup, where multi-center studies showed a success rate of RR, 1.31 (95% CI, 1.14–1.50; p < 0.001), while single-center studies exhibited a higher success rate of RR, 1.65 (95% CI, 1.49–1.82; p < 0.001), with an interaction p-value of 0.008. Importantly, acute termination of AF did not significantly increase procedural complications (RR, 1.19; 95% CI, 0.59–2.39; p = 0.627; I2 = 0.0%). Conclusions: Our study suggests that AF acute termination during ablation for pers-AF provides a better long-term clinical outcome. The PROSPERO Registration: CRD42023431015, https://www.crd.york.ac.uk/PROSPERO/view/CRD42023431015.https://www.imrpress.com/journal/RCM/26/7/10.31083/RCM33419atrial fibrillationcatheter ablationacute terminationmeta-analysis |
| spellingShingle | Changjian He Wenchang Zhang Feng Li Huaiqiang Wang Xiongyi Han Zihan Zhao Guojie Ye Tengfei Liu Da Zhang Haiyan Liu Jie Liu Jingning Zhao Chunhua Ding Atrial Fibrillation Termination Success During Ablation: Insights From Pooled Clinical Studies Reviews in Cardiovascular Medicine atrial fibrillation catheter ablation acute termination meta-analysis |
| title | Atrial Fibrillation Termination Success During Ablation: Insights From Pooled Clinical Studies |
| title_full | Atrial Fibrillation Termination Success During Ablation: Insights From Pooled Clinical Studies |
| title_fullStr | Atrial Fibrillation Termination Success During Ablation: Insights From Pooled Clinical Studies |
| title_full_unstemmed | Atrial Fibrillation Termination Success During Ablation: Insights From Pooled Clinical Studies |
| title_short | Atrial Fibrillation Termination Success During Ablation: Insights From Pooled Clinical Studies |
| title_sort | atrial fibrillation termination success during ablation insights from pooled clinical studies |
| topic | atrial fibrillation catheter ablation acute termination meta-analysis |
| url | https://www.imrpress.com/journal/RCM/26/7/10.31083/RCM33419 |
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