Surgical versus catheter ablation in atrial fibrillation: A systematic review and meta‐analysis of randomized controlled trials

Introduction Atrial fibrillation (AF) is the most common cardiac arrhythmia with a high stroke and mortality rate. The video‐assisted thoracoscopic radiofrequency pulmonary vein ablation is a treatment option for patients who fail catheter ablation. Randomized data comparing surgical versus catheter...

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Bibliographic Details
Published in:Journal of cardiovascular electrophysiology 2022-10, Vol.33 (10), p.2152-2163
Main Authors: Rattanawong, Pattara, Kanitsoraphan, Chanavuth, Kewcharoen, Jakrin, Sriramoju, Anil, Shanbhag, Anusha, Ko Ko, Nway L., Barry, Timothy, Vutthikraivit, Wasawat, Shen, Win‐Kuang
Format: Article
Language:English
Subjects:
Ablation
Arrhythmia
atrial fibrillation
Cardiac arrhythmia
catheter ablation
Catheters
Clinical trials
Confidence intervals
Fibrillation
Meta-analysis
Patients
Radiofrequency ablation
surgical ablation
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Summary:Introduction Atrial fibrillation (AF) is the most common cardiac arrhythmia with a high stroke and mortality rate. The video‐assisted thoracoscopic radiofrequency pulmonary vein ablation is a treatment option for patients who fail catheter ablation. Randomized data comparing surgical versus catheter ablation are limited. We performed a meta‐analysis of randomized control trials to explore the outcome efficacy between surgical and catheter radiofrequency pulmonary vein ablation in patients with AF. Methods We comprehensively searched the databases of MEDLINE and EMBASE from inception to December 2020. Included studies were published randomized control trials that compared video‐assisted thoracoscopic and catheter radiofrequency pulmonary vein ablation. Data from each study were combined using the fixed‐effects, generic inverse variance method of DerSimonian, and Laird to calculate odds ratios and 95% confidence intervals. Results Six studies from November 2013 to 2020 were included in this meta‐analysis involving 511 AF patients (79% paroxysmal) with 263 catheter ablation (mean age 56 ± 3 years) and 248 surgical ablations (mean age 52 ± 4 years). Catheter ablation was associated with increased atrial arrhythmias recurrence when compared to surgical ablation (pooled relative risk = 1.85, 95% confidence interval: 1.44−2.39, p 
ISSN:1045-3873
1540-8167
DOI:10.1111/jce.15617