The short and long-term efficacy of pulmonary vein isolation as a sole treatment strategy for paroxysmal atrial fibrillation: A systematic review and meta-analysis
Background: Pulmonary vein isolation (PVI) is an accepted treatment strategy for catheter ablation (CA) of paroxysmal atrial fibrillation (PAF). In this study, we aimed to assess the short, mid- and long-term outcome of PVI as a sole treatment strategy for PAF. Methods: Six bibliographic electronic databases were searched to identify all published relevant studies until December 14, 2015. Search of the scientific literature was performed for studies describing outcomes with mean follow-up > 24 months after PAF ablation. Only articles with 1, 3 or 5-year follow up were included, from the same group of investigators. Results: Of the 2398 references reviewed for eligibility, 13 articles (enrolling a total of 1774 pa-tients) were included in the final analysis. Pooled analysis showed that the 12- and 62 -month success rate of a single CA procedure was 78% (95% CI 0.76% to 0.855) and 59% (95% CI 0.56% to 0.64%), respectively. The results did not differ by type of CA performed. Major complications mentioned in the enrolled studies were cerebrovascular event, pericardial tamponade and PV stenosis. Conclusion: There is a progressive and significant decline in freedom from AF between 1, 3 and 5-year after successful PVI in patients with PAF. Our analysis suggests that a high short-time success rate after PVI does not necessarily result in high chronic success rate.
|Keywords||Catheter ablation, Cerebrovascular event, Efficacy of ablation, Paroxysmal atrial fibrillation, Pulmonary vein isolation, Transient ischemic attack|
|Persistent URL||dx.doi.org/10.2174/1573403X13666170117125124, hdl.handle.net/1765/101395|
|Journal||Current Cardiology Reviews|
Kis, Z. (Zsuzsanna), Muka, T, Franco, O.H. (Oscar H.), Bramer, W.M, de Vries, L.J, Kardos, A, & Szili-Torok, T. (2017). The short and long-term efficacy of pulmonary vein isolation as a sole treatment strategy for paroxysmal atrial fibrillation: A systematic review and meta-analysis. Current Cardiology Reviews (Vol. 13, pp. 199–208). doi:10.2174/1573403X13666170117125124