Key result
Early catheter ablation cuts AF recurrence ~31% vs delayed ablation.
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Why the study?
There was a lack of high-quality pooled data comparing clinical outcomes of early versus delayed catheter ablation using a standardized diagnosis-to-ablation time.
Does early catheter ablation (<12 months) reduce AF recurrence compared with delayed ablation (>12 months) in patients with atrial fibrillation?
Meta-Analysis (n=22,748)
Does early catheter ablation (<12 months) reduce AF recurrence compared with delayed ablation (>12 months) in patients with atrial fibrillation?
Relative Risk: 0.69 (95% CI 0.54–0.88)
p-value: p=0.007
Early catheter ablation (within 12 months of diagnosis) significantly reduces the risk of atrial fibrillation recurrence, electrical cardioversion, and AF-related hospitalizations compared to delayed ablation.
Supports early ablation to reduce AF recurrence; extends emerging evidence and warrants RCTs for long-term outcomes.
BACKGROUND: Atrial fibrillation (AF) is the most common cardiac arrhythmia worldwide. Catheter ablation (CA) is an effective therapy for symptomatic AF. Emerging evidence indicates that early CA may attenuate disease progression and reduce major adverse cardiovascular and cerebrovascular events (MACCE). There is a lack of high-quality pooled data comparing clinical outcomes of early versus delayed CA using a standardized diagnosis-to-ablation time. This meta-analysis evaluates whether early CA (<12 months) versus delayed CA (>12 months) after AF diagnosis is linked to differences in clinical outcomes, including AF/atrial arrhythmia recurrence, mortality, AF-related hospitalization, and MACCE. METHODS: A systematic literature search of PubMed, EMBASE, Scopus and the Cochrane Central Register of Controlled Trials and observational cohort studies until December 1, 2025, was conducted. The primary outcome was AF recurrence. RESULTS: A total of 10 studies including 22,748 patients were analyzed. For the primary outcome, early CA (<12 months) was associated with a significantly lower risk of AF recurrence compared with delayed ablation (>12 months) (RR 0.69; 95% CI, 0.54-0.88; p = 0.007, I CONCLUSION: Early CA (<12 months) was associated with significantly lower rates of AF recurrence, electrical cardioversion, and AF-related hospitalizations compared with delayed CA (>12 months). Future randomized controlled trials are needed to evaluate potential long-term benefits and to identify patient subgroups most likely to benefit from early CA.
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Bradach et al. (2026) conducted a meta-analysis in Atrial fibrillation (n=22,748). Early catheter ablation (<12 months) vs. Delayed catheter ablation (>12 months) was evaluated on AF recurrence (RR 0.69, 95% CI 0.54-0.88, p=0.007). Early catheter ablation (<12 months) significantly reduced the risk of atrial fibrillation recurrence compared with delayed ablation (>12 months) (RR 0.69; 95% CI 0.54-0.88; p=0.007).
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