Where data were available , the relative benefits seen held true both after a single or multiple procedure(s ) .
For patients with persistent atrial fibrillation , CA achieves significantly greater freedom from recurrent atrial fibrillation compared with medical therapy .
BACKGROUND Catheter ablation ( CA ) is commonly performed for persistent atrial fibrillation , but few high- quality r and omized controlled trials ( RCTs ) exist , leading to funding restrictions being proposed in several countries .
We performed a r and om-effects meta- analysis of RCTs and non- RCTs to assess the efficacy of CA for persistent atrial fibrillation .
Role of pulmonary veins isolation in persistent atrial fibrillation ablation: the pulmonary vein isolation in persistent atrial fibrillation (PIPA) study.
BACKGROUND The role of pulmonary veins ( PV ) isolation in patients with persistent atrial fibrillation ( AF ) is still debated . The aim of this study was to evaluate the adjunctive role of PV isolation in patients with persistent AF who underwent circumferential PV ablation ( anatomical approach ) . METHODS We treated 97 consecutive patients presenting with drug-refractory persistent AF by an anatomical approach ( group A , n = 36 , mean age = 60 + /- 8 years , 29 males ) or an integrated approach ( group B , n = 61 , mean age 59 + /- 10 years , 48 males ) . In all patients , radiofrequency ( RF ) ablation was performed by means of a nonfluoroscopic navigation system , in order to anatomically create circumferential lines around the PV . In group B , the persistence of PV potentials was ascertained with a multipolar circular catheter . If PV potentials persisted , RF energy targeting the electrophysiological breakthroughs was delivered to disconnect the PV . Past a 2-month period of observation , success was defined as absence of any atrial tachyarrhythmia recurrence lasting > 30 seconds . RESULTS Total procedure duration ( 220 + /- 62 minutes vs 140 + /- 43 minutes , P < 0.001 ) , fluoroscopy time ( 35 + /- 15 minutes vs 17 + /- 9 minutes , P < 0.001 ) , and RF delivery time ( 48 + /- 22 minutes vs 27 + /- 9 minutes , P < 0.001 ) were significantly longer in group B than in group A. One cardiac perforation occurred in group A. After 15 + /- 9.1 months , 21 patients in group A ( 58 % ) and 34 patients in group B ( 56 % ) were free of atrial tachyarrhythmia recurrence ( P = 0.9 ) . CONCLUSIONS In patients with persistent AF , who underwent an anatomical approach , electrophysiological confirmation of PV disconnection significantly increased the fluoroscopy and procedural times , without effect on the long-term outcomes
Where data were available , the relative benefits seen held true both after a single or multiple procedure(s ) .
For patients with persistent atrial fibrillation , CA achieves significantly greater freedom from recurrent atrial fibrillation compared with medical therapy .
BACKGROUND Catheter ablation ( CA ) is commonly performed for persistent atrial fibrillation , but few high- quality r and omized controlled trials ( RCTs ) exist , leading to funding restrictions being proposed in several countries .
We performed a r and om-effects meta- analysis of RCTs and non- RCTs to assess the efficacy of CA for persistent atrial fibrillation .