Angiology: Open Access
Open Access
ISSN: 2329-9495
ISSN: 2329-9495
Min Xu* , Qidong Gao, Sitai Liu, Yunfeng Di, Hanlin Wang, Dayong Zhang
Background: Pulmonary Vein Isolation (PVI) is an effective treatment for Paroxysmal Atrial Fibrillation (PAF) but has limited efficacy in Non-Paroxysmal Atrial Fibrillation (NPAF). Spatial/Temporal Dispersion (STD)-guided Catheter Ablation (CA) could offer potential additional benefits. This meta-analysis assessed the advantages and safety of the PVI+STDCA over PVI+Conventional Catheter Ablation (CCA) approaches in NPAF patients, with subgroup analyses highlighting the strategy's potential and challenges. Methods and results: Clinical trials focusing on the PVI+STDCA approach in patients with NPAF were searched in PubMed, MEDLINE, etc. followed by quality checks. Heterogeneity among the pooled data was assessed by the I2 test in a suitable effect model. In this analysis, 17 studies (n=2,203, 82.9% NPAF) were reviewed. The 12-month follow-up revealed that PVI+STDCA significantly increased Freedom from Atrial Tachyarrhythmias (FFATAs) in the non-FIRM sub-group (OR 2.44, 95% CI 1.93-3.08, P<0.00001, I2=0%), supported by RCTs (OR 2.43, 95% CI 1.81-3.26, P<0.00001, I2=0%), which was attributed to force-sensing catheters (OR 2.08, 95% CI 1.41-3.07, P=0.0002, I2=61%). PVI+STDCA also improved Freedom from Atrial Fibrillation (FFAF) across mapping techniques (OR 3.53, 95% CI 2.75-4.53, P<0.00001, I2=43%), without significant differences in post-procedural Atrial Tachycardia (AT), Radiofrequency (RF) time, or Serious Adverse Events (SAEs). Conclusions: The PVI+STDCA strategy enhances sinus rhythm maintenance during mid to long-term follow-up in patients with NPAF, while ensuring comparable safety.
Published Date: 2026-02-16; Received Date: 2024-12-27