Key result
Surgical ablation cuts AF recurrence by ~60% vs. catheter-based ablation.
Why the study?
Ablation is a modality of choice in select patients with AF, but the relative efficacy of surgical versus catheter-based approaches required comparison.
Does surgical ablation reduce arrhythmia recurrence compared to catheter-based ablation in patients with atrial fibrillation?
Meta-Analysis (n=744)
Does surgical ablation reduce arrhythmia recurrence compared to catheter-based ablation in patients with atrial fibrillation?
Hazard Ratio: 0.4 (95% CI 0.35–0.45)
p-value: p=< 0.001
Surgical ablation significantly reduces the risk of atrial fibrillation recurrence compared to catheter ablation, though it is associated with increased adverse effects and longer hospitalization.
Surgical ablation may reduce AF recurrence at higher risk of complications; extends comparative data but safety precludes first-line adoption.
Ablation remains a modality of choice in select patients with Atrial fibrillation (AF). Which is done via a surgical or catheter-based approach. This meta-analysis aimed to compare the efficacy of Surgical and Catheter ablation in the management of AF. Electronic search on PubMed (MEDLINE), EBSCO, EuropePMC, Clinicaltrials.gov, and Google Scholar was done. Studies comparing the use of surgical or catheter ablation in patients with AF were included. The Primary outcome of interest was Arrhythmia free patients at 12 months post-ablation. Eight studies (744 patients) reported a statistically significant difference in Arrhythmia recurrence rate between surgical and catheter-based ablation. The pooled hazard ratio was chosen to compare the risk of AF recurrence between these groups with pooled Hazard ratio comparing surgical to catheter approach of 0.40 [0.35,0.45], p < 0.001 favoring surgical approach; low heterogeneity I2 22%, p = 0.25. Meta-analyses were also performed on procedural time, length of stay and major adverse events. The increased rate of adverse effects and length of hospitalization impedes the implementation of surgical ablation as primary ablation method of AF in general. However, the result of our meta-analysis shows the promising result of surgical ablation compared to catheter-based ablation.
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Yonas et al. (2019) conducted a meta-analysis in Atrial fibrillation (n=744). Surgical ablation vs. Catheter-based ablation was evaluated on Arrhythmia recurrence at 12 months post-ablation (HR 0.40, 95% CI 0.35-0.45, p=< 0.001). Surgical ablation significantly reduced the risk of atrial fibrillation recurrence compared to catheter-based ablation (HR 0.40; 95% CI 0.35-0.45; p < 0.001).
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