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 .
Completion of mitral isthmus ablation using a steerable sheath: prospective randomized comparison with a nonsteerable sheath.
BACKGROUND Although mitral isthmus ( MI ) ablation in atrial fibrillation ( AF ) patients has been shown to be an effective ablative strategy , the establishment of the bidirectional conduction block of the MI is technically challenging . We investigated the usefulness of a steerable sheath for MI ablation in patients with persistent AF and its impact on the clinical outcome of persistent AF ablation . METHODS A total of 80 consecutive patients undergoing MI ablation  were r and omized to 1 of the following 2 groups : group S ( using a steerable long sheath ) or group NS ( using a nonsteerable long sheath ) . MI ablation was performed by using an open-irrigated ablation catheter with the guidance of a 3-dimensional mapping system . The endpoint of the MI ablation was the achievement of a bidirectional block . RESULTS Bidirectional block through the MI was achieved in 87.5 % ( 70/80 ) of patients with 14.0 ± 6.7 minutes of radiofrequency application . The bidirectional block was more frequently achieved in patients in group S compared to group NS ( 97.5 % ( 39/40 ) vs 77.5 % ( 31/40 ) , P = 0.02 ) . Additionally , epicardial ablation within the coronary sinus was less frequently required in group S compared to group NS ( 12.5 % ( 5/40 ) vs 72.5 % ( 29/40 ) , P < 0.0001 ) . Atrial tachycardia after the procedure more frequently occurred in the patients in whom MI block had not been achieved during the initial procedure ( 40.0 % ( 4/10 ) vs 10.0 % ( 7/70 ) , P = 0.04 ) . CONCLUSIONS The MI block could be achieved in the majority of patients by using a steerable sheath . An incomplete MI block increased the risk of AT following persistent AF 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 .