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 .
Image integration-guided catheter ablation of atrial fibrillation: a prospective randomized study.
BACKGROUND Several studies have provided details of left atrial anatomy by means of the image integration techniques , particularly focusing on the atypical patterns of the pulmonary veins . OBJECTIVE To compare , in a prospect i ve , r and omized fashion , the conventional method of pulmonary vein disconnection and the image integration-guided approach . METHODS Two hundred and ninety consecutive patients ( 290 patients , mean age 55 + /- 11 years ) with drug-refractory paroxysmal or persistent atrial fibrillation were enrolled in the study and were divided into two treatment groups : group 1 ( 145 patients ) undergoing an imaging integration-guided ( CartoMerge TM ) ablation ; group 2 ( 145 patients ) treated by a conventional radiofrequency catheter ablation procedure .  The arrhythmia was refractory to at least two antiarrhythmic drugs ( IC , amiodarone )  . RESULTS Electrical disconnection of all identified pulmonary veins was obtained in all patients of both groups . Bidirectional block of the cavotricuspid isthmus was achieved in 34 group 1 patients and in 40 group 2 patients . Left mitral isthmus ablation was attempted in 52 group 1 patients and in 56 group 2 patients . At a mean follow-up of 14 + /- 12 months , the atrial fibrillation-free survival rate was significantly higher in group 1 patients compared with group 2 patients ( 88 % vs 69 % , P = 0.017 ) . The analysis for the subset of patients with previously ineffective ablation ( 98 patients : 52 group 1 patients and 46 group 2 patients ) showed a significantly lower recurrence rate in group 1 versus group 2 ( 19 % vs 48 % , P < 0.01 ) . CONCLUSIONS Our data indicate a superior efficacy of the image-integration guided catheter ablation of atrial fibrillation over the long term
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 .