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 .
Comparison of voltage map-guided left atrial anterior wall ablation versus left lateral mitral isthmus ablation in patients with persistent atrial fibrillation.
BACKGROUND Left lateral mitral isthmus ( LLMI ) ablation achieves a low percentage of bidirectional conduction block in atrial fibrillation ( AF ) ablation . OBJECTIVE The purpose of this study was to investigate whether linear ablation through the lowest voltage area on the left atrial anterior wall ( LAAW ) can lead to better clinical outcomes compared to LLMI ablation . METHODS We obtained high-density three-dimensional ( 3D ) voltage mapping ( CARTO ) of the LA in 29 patients with persistent AF and determined the area of low voltage . In the multicenter prospect i ve study , clinical outcomes of LAAW ( n = 100 ) and LLMI ablations ( n = 100 ) were compared in patients with persistent AF ( 79.4 % male , 59.4 ± 10.6 years ) . RESULTS ( 1 ) The low-voltage area consistently existed on LAAW and had a correlation with the LA-aorta contact area ( R = 0.921 , P < .0001 ) . Mean voltage of LAAW was significantly lower than that of LLMI ( P < .0001 ) . ( 2 ) The length of LAAW ablation ( 37.9 ± 3.4 mm vs 26.6 ± 3.2 mm , P < .0001 ) was longer , but achievement of bidirectional block was higher ( 68.0 % vs 32.0 % , P = .0001 ) than in LLMI ablation . Mean duration of LAAW and LLMI ablations was 19.3 ± 2.9 minutes and 18.2 ± 3.7 minutes , respectively ( P = .086 ) . ( 3 ) During follow-up of 23.3 ± 7.4 months , the recurrence rate of AF after LAAW ablation ( 26.0 % ) was significantly lower than that of LLMI ablation ( 41.0 % , P = .021 ) after a single procedure . CONCLUSION The voltage map is useful for guiding linear ablation in persistent AF patients . LAAW is the most frequent low-voltage area around the mitral annulus , and linear ablation along LAAW results in a better clinical outcome with a higher rate of bidirectional conduction block compared to LLMI ablation
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 .