Comparing the efficacy of catheter ablation strategies for persistent atrial fibrillation: a Bayesian analysis of randomized controlled trials

Wu, Sijia; Li, Hongkai; Yi, Shao-lei; Yao, Jianming; Chen, Xueming

doi:10.1007/s10840-022-01246-5

Cited by 8 publications

(7 citation statements)

References 69 publications

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“…In a recently reported Bayesian network meta-analysis of 3394 persistent AF patients and 22 ablation strategies, a strategy involving PVI with left atrial posterior wall and non-PV trigger ablation was characterized as the most effective regarding freedom from atrial tachyarrhythmia recurrence [ 130 ]. Concomitant hybrid surgical and CA could also emerge as the most effective alternative in patients with nonparoxysmal AF, despite the increased rate of major adverse events and procedure duration [ 131 ].…”

Section: Atrial Fibrillation Catheter Ablationmentioning

confidence: 99%

Percutaneous Treatment Approaches in Atrial Fibrillation: Current Landscape and Future Perspectives

Theofilis

Oikonomou²,

Antonopoulos³

et al. 2022

Biomedicines

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Atrial fibrillation (AF), the most common sustained arrhythmia in clinical practice, represents a major cause of morbidity and mortality, with an increasing prevalence. Pharmacologic treatment remains the cornerstone of its management through rhythm and rate control, as well as the prevention of thromboembolism with the use of oral anticoagulants. Recent progress in percutaneous interventional approaches have provided additional options in the therapeutic arsenal, however. The use of the different catheter ablation techniques can now lead to long arrhythmia-free intervals and significantly lower AF burden, thus reducing the rate of its complications. Particularly encouraging evidence is now available for patients with persistent AF or concomitant heart failure, situations in which catheter ablation could even be a first-line option. In the field of stroke prevention, targeting the left atrial appendage with percutaneous device implantation may reduce the risk of thromboembolism to lower rates than that predicted with conventional ischemic risk scores. Left atrial appendage occlusion through the approved Watchman or Amplatzer devices is a well-established, efficacious, and safe method, especially in high-ischemic and bleeding risk patients with contraindications for oral anticoagulation.

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Section: Atrial Fibrillation Catheter Ablationmentioning

confidence: 99%

Percutaneous Treatment Approaches in Atrial Fibrillation: Current Landscape and Future Perspectives

Theofilis

Oikonomou²,

Antonopoulos³

et al. 2022

Biomedicines

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“…In general, three types of ablation strategies have been employed in clinical practice [6]. The first type is the linear line ablation, including the cavotricuspid isthmus, the mitral isthmus, the left atrial roof line and the left atrial posterior wall (LAPW) ablation.…”

Section: Extra-pulmonary Vein Ablation In Atrial Fibrillationmentioning

confidence: 99%

Risk and benefit of extrapulmonary vein ablation in atrial fibrillation

Liao

Katrapati

Bai

2022

Current Opinion in Cardiology

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Purpose of reviewThis review aims to summarize the recent development, benefit, and safety of extrapulmonary vein ablation for atrial fibrillation. Recent findingStudies have shown that extrapulmonary vein ablation can help maintain normal sinus rhythm for patients with persistent atrial fibrillation. As prior strategies targeting anatomical lines and triggers are well utilized, novel techniques for substrate mapping have been rapidly developing. These strategies are well tolerated and could be chosen based on patients'conditions and physicians experience. SummaryExtrapulmonary vein ablation could be safely and effectively performed for patients with atrial fibrillation. It provides further consolidation of normal sinus rhythm.

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“…[27][28][29][30][31][32][33] Even with more sophisticated approaches, superior longterm effective treatment for AF above what is achievable with PVI alone has been a challenge. [34][35][36][37][38] However, could a key missing link lie outside the heart itself and be nestled within the nervous system? It is well understood that the autonomic nervous system (ANS) plays a dominant role in several arrhythmias, including AF, via a complex network of neural inputs, outputs and plexi, and is often an untargeted trigger in many management modalities.Modulating, or in some instances eliminating, key neural connections to the heart have been studied as a means to reduce AF burden including vagal nerve stimulation and ablation of ganglionated plexi (GPs) located within or near the heart, but it is not common practice.…”

mentioning

confidence: 99%

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confidence: 99%

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Ganglionic Plexus Ablation: A Step-by-step Guide for Electrophysiologists and Review of Modalities for Neuromodulation for the Management of Atrial Fibrillation

Aksu

Skeete

Huang

2023

Arrhythm Electrophysiol Rev

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As the most common sustained arrhythmia, AF is a complex clinical entity which remains a difficult condition to durably treat in the majority of patients. Over the past few decades, the management of AF has focused mainly on pulmonary vein triggers for its initiation and perpetuation. It is well known that the autonomic nervous system (ANS) has a significant role in the milieu predisposing to the triggers, perpetuators and substrate for AF. Neuromodulation of ANS – ganglionated plexus ablation, vein of Marshall ethanol infusion, transcutaneous tragal stimulation, renal nerve denervation, stellate ganglion block and baroreceptor stimulation – constitute an emerging therapeutic approach for AF. The purpose of this review is to summarise and critically appraise the currently available evidence for neuromodulation modalities in AF.

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Comparing the efficacy of catheter ablation strategies for persistent atrial fibrillation: a Bayesian analysis of randomized controlled trials

Cited by 8 publications

References 69 publications

Percutaneous Treatment Approaches in Atrial Fibrillation: Current Landscape and Future Perspectives

Percutaneous Treatment Approaches in Atrial Fibrillation: Current Landscape and Future Perspectives

Risk and benefit of extrapulmonary vein ablation in atrial fibrillation

Ganglionic Plexus Ablation: A Step-by-step Guide for Electrophysiologists and Review of Modalities for Neuromodulation for the Management of Atrial Fibrillation

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