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 .
Steerable Versus Nonsteerable Sheath Technology in Atrial Fibrillation Ablation: A Prospective, Randomized Study
Background — Steerable sheath technology is design ed to facilitate catheter access , stability , and tissue contact in target sites of atrial fibrillation ( AF ) catheter ablation . We hypothesized that rhythm control after interventional AF treatment is more successful using a steerable as compared with a nonsteerable sheath access . Methods and Results — One hundred thirty patients with paroxysmal or persistent drug-refractory AF undergoing their first ablation procedure were prospect ively included in a r and omized fashion in 2 centers .  Ablation was performed by 10 operators with different levels of clinical experience . Treatment outcome was measured with serial 7-day Holter ECGs and additional symptom-based arrhythmia documentation . Single procedure success ( freedom from AF and /or atrial macroreentrant tachycardia ) was significantly higher in patients ablated with a steerable sheath ( 78 % versus 55 % after 3 months , P=0.005 ; 76 % versus 53 % after 6 months , P=0.008 ) . Rate of pulmonary vein isolation , procedure duration , and radiofrequency application time did not differ significantly , whereas fluoroscopy time was lower in the steerable sheath group ( 33±14 minutes versus 45±17 minutes , P<0.001 ) . Complication rates showed no significant difference ( 3.2 % versus 5 % , P=0.608 ) . On multivariable analysis , steerable sheath usage remained the only powerful predictor for rhythm outcome after 6 months of follow-up ( hazard ratio , 2.837 [ 1.197 to 6.723 ] ) . Conclusions — AF catheter ablation using a manually controlled , steerable sheath for catheter navigation result ed in a significantly higher clinical success rate , with comparable complication rates and with a reduction in periprocedural fluoroscopy time . Clinical Trial Registration — URL : http:// clinical trials.gov . Unique identifier : NCT00469638
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 .