Addition of catheter ablation strategies improve efficacy of pulmonary vein isolation in AF

Written By : Medha Baranwal |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2022-06-05T19:45:35+05:30 | Updated On 5 Jun 2022 7:45 PM IST

Sweden: The efficacy of pulmonary vein isolation (PVI) alone can be increased by combining it with additional catheter ablation (CA) strategies, such as autonomic modulation and additional lines, a recent study in BMC Medicine has suggested.

Also, no differences in safety were observed implying that these strategies could be considered in treating patients with atrial fibrillation (AF). The study provides decision-makers with comprehensive and comparative evidence about the safety and efficacy of different CA strategies.

There is no consensus on the most efficient strategy of catheter ablation for atrial fibrillation patients. Emmanouil Charitakis, Linköping University, Linköping, Sweden, and colleagues aimed to compare the safety and efficacy of different CA strategies for AF ablation through network meta-analysis (NMA).

For this purpose, the researchers conducted a systematic search of online databases up to October 5th, 2020. It included randomized controlled trials (RCT) comparing different CA approaches. Efficacy was defined as recurrence of arrhythmia after CA and safety as any reported complication related to the procedure during a minimum follow-up time of 6 months.

A total of 67 RCTs (n = 9871) comparing 19 different CA strategies were included.

Key findings of the study include:

The risk of recurrence was significantly decreased compared to pulmonary vein isolation alone for PVI with renal denervation (RR: 0.60), PVI with ganglia-plexi ablation (RR: 0.62), PVI with additional ablation lines (RR: 0.8), and PVI in combination with bi-atrial modification (RR: 0.32).
Strategies including PVI appeared superior to non-PVI strategies such as electrogram-based approaches.
No significant differences in safety were observed.

To conclude, the CA strategies described in the study could be considered to yield higher efficacy, without hampering safety. Additionally, CA seems to be superior to AADs apart from non-PVI strategies.

"This is the first study to provide decision-makers with robust, comprehensive, and comparative evidence about the safety and efficacy of different CA strategies that reflect the available evidence," the researchers wrote.

Reference:

Charitakis, E., Metelli, S., Karlsson, L.O. et al. Comparing efficacy and safety in catheter ablation strategies for atrial fibrillation: a network meta-analysis. BMC Med 20, 193 (2022). https://doi.org/10.1186/s12916-022-02385-2

BMC Medicinecatheter ablationatrial fibrillation

Source : BMC Medicine

Medha Baranwal

MSc. Biotechnology

Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751