title: Catheter ablation versus anti-arrhythmic drug therapy for the management of a trial fibrillation: a meta-analysis.
abstract: OBJECTIVE
  The current study was a meta-analysis designed to compare the therapeutic efficacy and safety of catheter ablation with those of anti-arrhythmic drugs, over the short and long term.
  
  
  METHODS
  Comparative studies (randomized controlled trials) of catheter ablation vs. anti-arrhythmic drugs for the treatment of AF were retrieved from MEDLINE and EM BASE. The primary (no recurrence of AF) and secondary (major adverse events) outcomes were compared by meta-analysis, with sub-group analysis of short-term (1 year or less) and long-term (>1 year) effects.
  
  
  RESULTS
  Of the 223 studies originally identified, 214 were excluded (duplication, non-randomized design, lack of relevance or lack of usable data). Compared with anti-arrhythmic drug therapy, catheter ablation was associated with superior efficacy (odds ratio [OR], 9.41; 95 % confidence interval [95 % CI], 5.00-17.71; P < 0.01). Treatment success was higher for catheter ablation both in the short term (OR, 10.84; 95 % CI, 5.83-20.16; P < 0.001) and long term (OR, 7.65; 95 % CI, 1.97-29.73; P = 0.03). There was a trend toward a lower incidence of adverse events in the catheter ablation group (OR, 2.19; 95 % CI, 0.99-4.85), but this did not reach statistical significance (P = 0.05).
  
  
  CONCLUSIONS
  Compared with anti-arrhythmic drugs, management of AF with catheter ablation showed superior efficacy in the short term that was maintained over the longer term.
authors.affiliation: Cardiovascular Department, Xin Qiao Hospital of the Third Military Medical University, Chongqing, 400037, China, 632012067@qq.com.
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Cheng
authors.forename: Xiaoqing
authors.initials: X
authors.lastname: Li
authors.forename: Yun
authors.initials: Y
authors.lastname: He
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Liu
authors.forename: Guoqiang
authors.initials: G
authors.lastname: Wang
authors.forename: Li
authors.initials: L
authors.lastname: Cheng
authors.forename: Jianbo
authors.initials: J
authors.lastname: Hu
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000628:therapy*; D017115:Catheter Ablation / Q000706:statistics & numerical data*; D015984:Causality; D015897:Comorbidity; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents