Curative ablation for atrial fibrillation: a systematic review.
OBJECTIVE
To perform a systematic review of randomized controlled trials (RCTs) on catheter ablation for atrial fibrillation (AF).


BACKGROUND
Radiofrequency catheter (RF)-ablation around pulmonary vein ostia and in left atrium may reduce or prevent recurrence of AF, as documented in observational studies and registry reports; however, few RCTs are available.


METHODS
Using relevant search phrases, Cochrane Library, MEDLINE and EMBASE were searched for RCTs, last time in May 2007. Titles and abstracts were screened. When entry criteria were fulfilled, full-text papers were read and graded according to quality and relevance.


RESULTS
One thousand and ninety four abstracts were evaluated, and five RCTs included (578 randomized patients). The studies had moderate quality and relevance, but the results were consistent: ablation is better than drug treatment in preventing AF recurrence; the relative risk (95% CI)) one year after ablation ranged from 0.20 (0.08-0.51) to 0.62 (0.39-0.99).


CONCLUSIONS
Results from observational and registry studies are confirmed: RF-ablation reduces recurrence rate of AF, and can be done with few serious complications. Limitations are few patients>70 years, and only one year follow-up.
Gjesdal
Knut
K
Faculty Division Ullevål, Oslo University and Department of Cardiology, Ullevål University Hospital, Oslo, Norway. knut.gjesdal@medisin.uio.no
Vist
Gunn E
GE
Bugge
Einar
E
Rossvoll
Ole
O
Johansen
Marit
M
Norderhaug
Inger
I
Ohm
Ole-J
OJ
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects; D019317:Evidence-Based Medicine; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D055502:Secondary Prevention; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents