AIMS: In persistent @entity955 (PsAF), success rates for @entity358 ( @entity358 ) alone are limited and additional substrate modification is often performed. The two most widely used substrate-based strategies are the ablation of complex fractionated atrial electrograms (CFAE) and left @entity955 (LALA) at the roof and mitral isthmus. However, it is unclear whether adjunctive CFAE ablation or LALA add significant benefit to @entity358 alone. We performed a meta-analysis to better gauge the benefit of adjunctive CFAE ablation and LALA in PsAF. METHODS AND RESULTS: Electronic databases were systematically searched. We included studies that examined the impact of CFAE ablation or LALA in addition to a @entity358 -based strategy on clinical outcomes in PsAF. We included both randomized and non-randomized studies. Totally 10 studies (n = 1821) were included: 6 evaluating CFAE ablation, 3 LALA, and 1 both approaches. In comparison with @entity358 alone, the addition of CFAE ablation [RR 0.86; 95% confidence intervals (CI) 0.64, 1.16; P = 0.32] or LALA (RR 0.64; 95% CI 0.37, 1.09; P = 0.10) offered no significant improvement in @entity943 -free survival. However, adjunctive CFAE ablation was associated with significant increases (P < 0.05) and LALA non-significant increases in procedure and fluoroscopy times. CONCLUSION: In PsAF, the addition of CFAE ablation or LALA, in comparison with @entity358 alone, offers no significant improvement in @entity943 -free survival. Furthermore, they are associated with increases in both procedural and fluoroscopy times. The optimal ablation strategy for PsAF is currently unclear and needs further refinement.

The impact of adjunctive complex fractionated atrial electrogram ablation and linear lesions on outcomes in persistent XXXX : a meta-analysis.

@entity358 :: ('MESH:D008171', 'Disease') :: ['PVI', 'pulmonary vein isolation'] @entity943 :: ('MESH:D001145', 'Disease') :: ['arrhythmia'] @entity955 :: ('MESH:D001281', 'Disease') :: ['atrial linear ablation', 'atrial fibrillation']
@entity955 :: (MESH:D001281,Disease) :: ['atrial fibrillation']
