Table 1. Characteristics of the studies included in the current review.
| Study | Area | Number of Patients | Age (yrs) | Men | Paroxysmal AF Persistent AF Permanent AF | Follow-Up (mon) | Duration of AF | Comorbidities | Medications | Type of Ablation | Type of Imaging | LVEF (%) | Patients with Recurrence | Success Rate |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Dagres [9] | Greece | 289 | 56±9 | 214 | 289 | 12 | 68±58mon | HTN (43%); | NA | PVCA | TTE | 62±10 | 123 | 166/289 |
| 2009 | (74%) | NA | DM (5%); | (57%) | ||||||||||
| NA | CAD (5%) | |||||||||||||
| Erdei [10] | Hungary | 36 | 57±9 | 26 | 36 | 12 | 6.7±7.3yrs | HTN (75%); | AAD | CCA | TTE | 63±5 | 21 | 15/36 |
| 2012 | (72%) | NA | IHD (11%); | (42%) | ||||||||||
| NA | OB (28%) | |||||||||||||
| Hof [11] | Netherlands | 206 | 57±10 | 165 | 114 | 16 | 7±6yrs | HTN (35%); | AAD | PVAI | CMR | NA | 37 | 169/206 |
| 2013 | (80%) | 92 | IHD (10%) | (Class I and III) | (82%) | |||||||||
| NA | ||||||||||||||
| Jahnke [12] | Germany | 41 | 57±10 | 28 | 25 | 12 | NA | HTN (66%); | NA | PVI | CMR | 58±5 | 10 | 31/41 |
| 2011 | (68%) | 16 | DM (5%); | (76%) | ||||||||||
| NA | CAD (20%); | |||||||||||||
| HLP (59%) | ||||||||||||||
| Machino- | Japan | 123 | 60±9 | 104 | NA | 18 | 5.2±4.3yrs | HTN (56%); | AAD | PVI | TTE | NA | 45 | 78/123 |
| Ohtsuka[13] | (85%) | 123 | DM (7%); | (63%) | ||||||||||
| 2013 | NA | CAD (6%) | ||||||||||||
| Masuda [14] | Japan | 115 | 62±10 | 82 | 92 | 3 | 44.6±51.9mon | HTN (50%); | AAD | PVCA | MDCT | 67±7 | 32 | 83/115 |
| 2012 | (71%) | 23 | DM (13%) | (72%) | ||||||||||
| NA | ||||||||||||||
| Montserrat | Spain | 158 | 53±11 | 120 | 77 | 6 | 52±34mon | HTN (44%) | AAD | RFCA | TTE | 59±9 | 82 | 76/158 |
| [15] 2011 | (76%) | 77 | (48%) | |||||||||||
| NA | ||||||||||||||
| Nori [16] | America | 29 | 54±11 | 18 | 16 | 3 | 4.1±3.4yrs* | HTN (48%); | NA | PVAI | CMR | 63±11* | NA | NA |
| 2009 | (62%) | 13 | 2.0±1.0yrs# | DM (17%); | 60±10# | |||||||||
| NA | CAD (38%); | |||||||||||||
| HLP (55%) | ||||||||||||||
| Rodrigues | Brazil | 28 | 53±13 | 22 | 28 | 8 | 6 yrs | HTN (39%) | Amiodarone; | PVCA | TTE | NA | 11 | 17/28 |
| [17] 2009 | (79%) | NA | (3mon-20yrs) | Propafenone; | (61%) | |||||||||
| NA | β-blocker | |||||||||||||
| Teh [18] | Australia | 11 | 59±8 | 8 | 7 | 10 | 5.6±4.8yrs | NA | NA | RFCA | TTE | 60±7 | NA | NA |
| 2012 | (73%) | 4 | ||||||||||||
| NA | ||||||||||||||
| Tops [19] | Netherlands | 148 | 54±9 | 117 | 112 | 13 | 5.3±4.5yrs | HTN (42%); | AAD; | PVI | TTE | 57±7 | 49 | 99/148 |
| 2011 | (79%) | 36 | CAD (6%) | ACEI (49%) | (67%) | |||||||||
| NA | ||||||||||||||
| Yoshida [20] | Japan | 67 | 64±8 | 58 | 34 | 6 | NA | NA | NA | PVI | TTE | NA | 11 | 56/67 |
| 2013 | (87%) | 33 | (84%) | |||||||||||
| NA | ||||||||||||||
| Reant [24] | France | 48 | 53±9* | 40 | 37 | 11 | 6±5yrs* | NA | β-blocker (29%); | PVI | TTE | 62±5* | 13 | 35/48 |
| 2005 | 55±11& | (83%) | NA | 12±9yrs& | Amiodarone(2%); | 53±8& | (73%) | |||||||
| 11& | Flecainide (14%) | |||||||||||||
| Delgado | Spain | 34 | 53±13 | 24 | 23 | 6 | 90±72mon | HTN (24%) | AAD | CPVA | 3D-TTE | NA | 13 | 21/34 |
| [29] 2008 | (70%) | 6 | (62%) | |||||||||||
| 5 | ||||||||||||||
| Verma [27] | America | 67 | 56±10 | 49 | 40 | 6 | 5.8±5.1yrs | HTN (31%); | AAD | PVAI | TTE, | 50±13 | NA | NA |
| 2006 | (73%) | 27 | DM (9%); | CT | ||||||||||
| NA | CAD (19%); | |||||||||||||
| VHD (15%) | ||||||||||||||
| Lemola [23] | America | 36 | 55±11 | 24 | 27 | 5 | 5±4yrs | CAD (9%) | NA | LACA | CT | 56±5 | NA | NA |
| 2005 | (67%) | NA | ||||||||||||
| 9& | ||||||||||||||
| Perea [33] | Spain | 55 | 52±11 | 44 | 41 | 12 | 8.4±8yrs | HTN (22%); | AAD | CPVA | CMR | 60±9 | 17 | 38/55 |
| 2008 | (80%) | 14 | SHD (16%) | (69%) | ||||||||||
| NA | ||||||||||||||
| Muller [32] | Switzerland | 91 | 59±8 | 79 | 72 | 6 | 6.4±5.8yrs | HTN (33%); | ACEI and/or ARB(30%); | PVI | TTE | NA | 21 | 70/91 |
| 2008 | (87%) | 11 | IHD (7%) | Diuretic (15%); | (77%) | |||||||||
| 8 | Amiodarone (24%); | |||||||||||||
| Sotalol (12%); | ||||||||||||||
| Ic (31%); | ||||||||||||||
| β-blocker (43%) | ||||||||||||||
| Marsan [31] | Netherlands | 57 | 56±9 | 44 | 43 | 8 | 4.6±4.1yrs | HTN (44%); | Amiodarone; | RFCA | 3D-TTE | 57±9 | 19 | 38/57 |
| 2008 | (77%) | 14 | DM (11%); | Propafenone; | (67%) | |||||||||
| NA | CAD (5%) | Flecainide; | ||||||||||||
| Sotalol; | ||||||||||||||
| ACEI and/or ARBs(46%) | ||||||||||||||
| Beukema | Netherlands | 105 | 53±10 | 88 | 52 | 15 | 6±5.1yrs* | HTN (26%); | AAD | PVI | TTE | 54±4 | 34 | 71/105 |
| [22] 2005 | (84%) | 53 | 7.6±6yrs# | DM (5%) | (68%) | |||||||||
| NA | ||||||||||||||
| Choi [28] | Korea | 33 | 56±10 | 27 | 21 | 3 | 63±47mon | HTN (21%); | ACEI or ARB (24%); | RFCA | TTE | 53±6 | NA | NA |
| 2008 | (82%) | 12 | DM (6%); | CCB (30%); | ||||||||||
| NA | CAD (6%) | β-blocker (15%); | ||||||||||||
| Amiodarone (30%); | ||||||||||||||
| Propafenone (30%); | ||||||||||||||
| Flecainide (6%) | ||||||||||||||
| Liu [30] | China | 120 | 60±9 | 80 | 120 | 12 | 2.6±1.4yrs | NA | Amiodarone; | CPVA | TTE | 67±3 | 42 | 78/120 |
| 2008 | (83%) | NA | Losartan | SPVI | (65%) | |||||||||
| NA | ||||||||||||||
| Tops [26] | Netherlands | 57 | 53±8 | 45 | 35 | 3 | 6±5yrs | HTN (30%); | AAD | RFCA | TTE | 55±7 | 18 | 39/57 |
| 2006 | (79%) | 18 | CAD (7%); | (68%) | ||||||||||
| 4 | VHD (11%) | |||||||||||||
| Lemola [21] | America | 41 | 54±12 | 33 | 25 | 4 | 5±3yrs | HTN (21%); | NA | LACA | CT | 55±8 | 8 | 33/41 |
| 2004 | (80%) | NA | SHD (41%) | (80%) | ||||||||||
| 16 | ||||||||||||||
| Tsao [25] | China | 45 | 60±13 | 36 | 45 | 21 | NA | NA | AAD | PVI | CMR | NA | 10 | 35/45 |
| 2005 | Taiwan | (80%) | NA | (77%) | ||||||||||
| NA |
* Paroxysmal Atrial Fibrillation
# Persistent Atrial Fibrillation
& Chronic Atrial Fibrillation
NA = Not Available; mon = months; yrs = years
HTN = Hypertension; DM = Diabetes Mellitus; CAD = Coronary Artery Disease; OB = Obesity; IHD = Ischemic Heart Disease; HLP = Hyperlipidemia; VHD = Valvular Heart Disease; SHD = Structural heart disease.
ACEI = Angiotensin Converting Enzyme Inhibitors; ARB = Angiotensin Receptor Blocker; CCB = Calcium-channel Blocker; AAD = Anti-Arrhythmic Drugs.
RFCA = Radiofrequency Catheter Ablation; CCA = Cryoballoon Catheter Ablation; PVI = Pulmonary vein isolation; PVAI = Pulmonary Vein Antrum Isolation; CPVA/PVCA = Circumferential Pulmonary Vein Catheter Ablation; SPVI = Segmental Pulmonary Vein Isolation; LACA = Radiofrequency Left Atrial Circumferential Ablation. CMR = Cardiac Magnetic Resonance Imaging; TTE = Transthoracic Echocardiography; TEE = Transesophageal Echocardiography; MDCT = Multidetector Computed Tomography.
Atrial fibrillation recurrence is defined as documented by body surface 12-lead electrocardiogram (ECG) or 24-hour Holter ECG lasting 30 seconds, despite being symptomatic or not, at any time from 3 months after catheter ablation.