Catheter ablation for atrial fibrillation

Q: What is the clinical evidence from this study?

Study design: Systematic Review. Population: Atrial fibrillation (first diagnosed, paroxysmal, persistent, and long-standing persistent). Intervention: Catheter ablation (pulmonary vein electrical isolation with or without other catheter ablation techniques) vs. Medical rhythm control (class I and class III antiarrhythmic drugs: flecainide, propafenone, quinidine, amiodarone, sotalol, dofetilide, or dronedarone). Primary outcome: Recurrent atrial fibrillation episodes outside the 3-month blanking period (defined as a 30-second episode of irregular atrial rhythm).

Samer Al Said; Pankaj Garg; Sam Jenkins; Mahmood Ahmad; Mohammed Qintar; Andreas Kyriacou; Nishant Verma; Rui Providência; A. John Camm; Samer Alabed

doi:10.1002/14651858.cd014810

January 9, 2022Cochrane libraryOpen Access

Catheter ablation for atrial fibrillation

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Key result

Cochrane protocol outlines planned systematic review comparing catheter ablation to antiarrhythmic drugs for AF.

Why the study?

To determine the efficacy and safety of any catheter ablation versus any medical therapy in people with first diagnosed, paroxysmal, persistent, and long-standing persistent AF.

Does catheter ablation improve efficacy and safety outcomes compared to medical rhythm control therapy in adults with first diagnosed, paroxysmal, persistent, or long-standing persistent atrial fibrillation?

Key Points

To determine the efficacy and safety of any catheter ablation procedure versus any medical therapy in people with first diagnosed, paroxysmal, persistent, and long-standing persistent atrial fibrillation.
Protocol for a Cochrane Review of interventions comparing catheter ablation against medical therapy.
The planned review covers patients with first diagnosed, paroxysmal, persistent, and long-standing persistent atrial fibrillation.
Planned analyses include subgroup investigations to evaluate potential sources of clinical and methodological heterogeneity.
Because this document is an intervention review protocol, no comparative clinical results, event rates, or meta-analyses are reported.
The planned full review will evaluate comparative efficacy and procedure-related adverse events, including vascular injury, cardiac tamponade, stroke, and pulmonary vein stenosis.

Study Design

Type

Systematic Review

Structured PICO

Does catheter ablation improve efficacy and safety outcomes compared to medical rhythm control therapy in adults with first diagnosed, paroxysmal, persistent, or long-standing persistent atrial fibrillation?

P

Population

Protocol for a Cochrane Systematic Review including adults aged ≥18 years with first diagnosed, paroxysmal, persistent, or long-standing persistent atrial fibrillation enrolled in randomized controlled trials.

I

Intervention

Catheter ablation, including pulmonary vein electrical isolation (PVI) with or without additional ablation techniques (superior vena cava isolation, left atrium appendage and posterior wall ablation, crista terminalis ablation, coronary sinus ostium ablation, interatrial septum ablation, and ligament of Marshall ablation).

C

Comparator

Medical rhythm control using FDA- or EMA-approved class I and class III antiarrhythmic drugs (flecainide, propafenone, quinidine, amiodarone, sotalol, dofetilide, or dronedarone), with any equal co-medications.

O

Outcome

Recurrent atrial fibrillation episodes (commonly defined as a 30-second episode of irregular atrial rhythm) occurring outside the 3-month post-ablation blanking period, assessed at the longest available follow-up.surrogate

This Cochrane Review protocol outlines the methodology to systematically evaluate the efficacy and safety of catheter ablation versus antiarrhythmic drug therapy across different types of atrial fibrillation.

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Implication

Cochrane protocol will synthesize ablation versus drug outcomes in AF; extends evidence base to inform future guidelines.

Abstract

OBJECTIVES: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. To determine the efficacy and safety of any catheter ablation in people with first diagnosed, paroxysmal, persistent, and long-standing persistent atrial fibrillation versus any medical therapy.

Discussion

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Cite This Study

Said et al. (2022) conducted a systematic review in Atrial fibrillation (first diagnosed, paroxysmal, persistent, and long-standing persistent). Catheter ablation (pulmonary vein electrical isolation with or without other catheter ablation techniques) vs. Medical rhythm control (class I and class III antiarrhythmic drugs: flecainide, propafenone, quinidine, amiodarone, sotalol, dofetilide, or dronedarone) was evaluated on Recurrent atrial fibrillation episodes outside the 3-month blanking period (defined as a 30-second episode of irregular atrial rhythm). Catheter ablation versus antiarrhythmic drug therapy for atrial fibrillation will be evaluated for efficacy and safety in this Cochrane Review protocol.

synapsesocial.com/papers/6a7c5b4a24f98b6d3fc2cba5 https://doi.org/10.1002/14651858.cd014810

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Catheter ablation for atrial fibrillation

Key Points

Study Design

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Catheter ablation for atrial fibrillation

Key Points

Study Design

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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