Abstract 4366463: Left Atrial Posterior Wall Isolation Plus Pulmonary Vein Isolation vs. Pulmonary Vein Isolation Alone by Pulsed Field Ablation for Persistent Atrial Fibrillation: A Meta-Analysis
Abstract
Background:
Pulsed field ablation (PFA) is an emerging energy source in catheter ablation for atrial fibrillation (AF), offering tissue selectivity and procedural efficiency. While pulmonary vein isolation (PVI) remains the cornerstone of ablation, adjunctive posterior wall isolation (PWI) is increasingly considered, particularly in persistent atrial fibrillation (AF). However, the comparative benefits and risks of PVI + PWI versus PVI alone using PFA remain unclear. This meta-analysis aimed to evaluate the clinical efficacy and safety outcomes of PVI + PWI compared to PVI alone in patients with persistent AF undergoing PFA.
Methods:
A comprehensive literature search was conducted using PubMed, Embase, and Google Scholar databases. Random-effects models were used to calculate Mantel-Haenszel odds ratios (ORs) with 95% confidence intervals (CIs). The inverse variance method with DerSimonian–Laird (DL) of Tau2 was used to calculate mean differences (MDs) with CIs. Statistical significance was set at p < 0.05. The primary endpoint was the recurrence of atrial fibrillation or atrial tachycardias (AF/AT) over the average follow-up of one year after the procedure. Secondary outcomes included in-hospital complications, mean procedure time, and mean fluoroscopy time.
Results:
Five studies, including 1,046 patients with persistent atrial fibrillation (AF), were included. There was no statistically significant difference in the recurrence of atrial fibrillation or atrial tachycardia…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,046 participants or records.
Read the paper
Related studies
- Chaos and quantum thermalization
- The Dalton quantum chemistry program system
- Cord Blood Leptin and Adiponectin as Predictors of Adiposity in Children at 3 Years of Age: A Prospective Cohort Study
- Quantitative metabolomics by H-NMR and LC-MS/MS confirms altered metabolic pathways in diabetes
- Stable adiabatic quantum batteries
- A novel self-lipid antigen targets human T cells against CD1c(+) leukemias
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.