title: The Short and Long-Term Efficacy of Pulmonary Vein Isolation as a Sole Treatment Strategy for Paroxysmal Atrial Fibrillation: A Systematic Review and Meta-Analysis.
abstract: BACKGROUND
  Pulmonary vein isolation (PVI) is an accepted treatment strategy for catheter ablation (CA) of paroxysmal atrial fibrillation (PAF). In this study, we aimed to assess the short, mid- and long-term outcome of PVI as a sole treatment strategy for PAF.
  
  
  METHODS
  Six bibliographic electronic databases were searched to identify all published relevant studies until December 14, 2015. Search of the scientific literature was performed for studies describing outcomes with mean follow-up &gt; 24 months after PAF ablation. Only articles with 1, 3 or 5-year follow up were included, from the same group of investigators.
  
  
  RESULTS
  Of the 2398 references reviewed for eligibility, 13 articles (enrolling a total of 1774 patients) were included in the final analysis. Pooled analysis showed that the 12- and 62 -month success rate of a single CA procedure was 78% (95% CI 0.76% to 0.855) and 59% (95% CI 0.56% to 0.64%), respectively. The results did not differ by type of CA performed. Major complications mentioned in the enrolled studies were cerebrovascular event, pericardial tamponade and PV stenosis.
  
  
  CONCLUSIONS
  There is a progressive and significant decline in freedom from AF between 1, 3 and 5- year after successful PVI in patients with PAF. Our analysis suggests that a high short-time success rate after PVI does not necessarily result in high chronic success rate.
authors.affiliation: Erasmus Medical Center, Department of Cardiology, Electrophysiology, Rotterdam, Netherlands.
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Kis
authors.affiliation: Erasmus Medical Center, Department of Epidemiology, Rotterdam, Netherlands.
authors.forename: Taulant
authors.initials: T
authors.lastname: Muka
authors.affiliation: Erasmus Medical Center, Department of Epidemiology, Rotterdam, Netherlands.
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Franco
authors.affiliation: Erasmus Medical Center, Department of Biomedicine, Rotterdam, Netherlands.
authors.forename: Wichor M
authors.initials: WM
authors.lastname: Bramer
authors.affiliation: Erasmus Medical Center, Department of Cardiology, Electrophysiology, Rotterdam, Netherlands.
authors.forename: Lennart J
authors.initials: LJ
authors.lastname: De Vries
authors.affiliation: Gottsegen György National Cardiology Institute, Department of Electrophysiology, Budapest, Hungary.
authors.forename: Attila
authors.initials: A
authors.lastname: Kardos
authors.affiliation: Department of Clinical Electrophysiology, Erasmus MC, Postbus 2040, 3000 CA Rotterdam, Netherlands.
authors.forename: Tamas
authors.initials: T
authors.lastname: Szili-Torok
mesh_terms: D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D011667:Pulmonary Veins / Q000601:surgery*; D013614:Tachycardia, Paroxysmal; D013997:Time Factors; D016896:Treatment Outcome
keywords: Paroxysmal atrial fibrillation; catheter ablation; cerebrovascular
  event; efficacy of ablation; pulmonary vein isolation; transient ischemic attack