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 .
Cooled-tip vs. 8 mm-tip catheter for circumferential pulmonary vein ablation: comparison of efficacy, safety, and lesion extension.
AIMS In many laboratories , cooled-tip catheters have replaced 8 mm-tip catheters due to their theoretical advantage of achieving larger lesions and avoiding charring . However , direct comparisons between the catheters in the subset of atrial fibrillation ( AF ) ablation are scarce . The aim of this study was to compare the efficacy , safety , and lesion extension created by 8 mm-tip vs. cooled-tip catheter with different energy setting s for circumferential pulmonary vein ablation ( CPVA ) . METHODS AND RESULTS A series of 221 consecutive patients with symptomatic AF were included in the study . Circumferential pulmonary vein ablation was performed using an 8 mm-tip catheter ( 55 W , 50 degrees C ) in 90 patients ( Group 1 ) , a cooled-tip ( 30 W , 45 degrees C ) in 42 ( Group 2 ) , and a cooled-tip ( 40 W , 45 degrees C ) in 89 ( Group 3 ) . In a subgroup of 60 patients , troponin I ( TpnI ) , creatinine kinase , and myoglobin values were obtained before and at 12 and 24 h after ablation . At 1 year follow-up , the probability of being arrhythmia-free after a single procedure was 53 , 35 , and 55 % in patients from Groups 1 , 2 , and 3 , respectively . Ablation with a cooled-tip catheter at 30 W led to a higher recurrence rate ( P = 0.030 ) and was identified in Cox regression analysis as an independent predictor of AF recurrence ( HR , 1.713 ; 95 % CI , 1.02 - 2.90 ; P = 0.045 ) . There were no differences in intra-procedure complications ( 2.2 vs. 5.6 vs. 4.9 % , P = 0.542 ) . The myocardial lesion according to TpnI was smaller in Group 2 ( P = 0.02 ) . CONCLUSION The cooled-tip catheter at 30 W was less efficacious than both the 8 mm catheter and the cooled-tip with a 40 W power setting
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 .