Table 3: Recent Studies on the Effects of Catheter AF Ablation on Stroke Risk.
| Study | Year | Study Design | Prospective or Retrospective | No. Patients | Follow-up Duration | Results of Catheter Ablation versus Non-ablation |
|---|---|---|---|---|---|---|
| Friberg et al.[54] | 2016 | PSM cohort study | Retrospective | 4,992 | 4.4 years | Lower risk of ischaemic stroke (HR 0.69, 95% CI [0.51–0.93]); most prominent among patients with CHA2DS2-VASc score ≥2 (HR 0.39, 95% CI [0.19–0.78]) and all-cause death (HR 0.50, 95% CI [0.37–0.62]) |
| Saliba et al.[55] | 2017 | PSM cohort study | Retrospective | 4,741 | 4,237 person-years | Lower risk of ischaemic stroke (HR 0.62, 95% CI [0.47–0.82]), TIA (HR 0.47, 95% CI [0.20–0.78]) and all-cause death (HR 0.57, 95% CI [0.47–0.66]) |
| Jarman et al.[52] | 2017 | PSM cohort study | Retrospective | 9,982 | 2 years | Lower annual rates of stroke or TIA (0.64% versus 1.84%, p<0.0001) |
| Joza et al.[88] | 2018 | PSM cohort study | Retrospective | 3,667 | 3.6 years | No significant difference in the risk of stroke (HR 0.88, 95% CI [0.63–1.21]) or major bleeding (HR 0.88, 95% CI [0.73–1.06]) |
| Srivatsa et al.[53] | 2018 | PSM cohort study | Retrospective | 8,338 | 3.6 years | Lower risk of all-cause death (HR 0.59, 95% CI [0.45–0.77]), ischaemic stroke (HR 0.68, 95% CI [0.47–0.97]) and haemorrhagic stroke (HR 0.36, 95% CI [0.20–0.64]) |
| Bunch et al.[56] | 2018 | PSM cohort study | Retrospective | 971 | 5 years | No significant difference in the risk of stroke (HR 0.82, p=0.39) and all-cause death (HR 0.92, p=0.70), but with increased risk of heart failure (HR 3.08, p=0.001) |
| Noseworthy et al.[89] | 2019 | PSM cohort study | Retrospective | 183,760 | 2.1–2.3 years | Lower risk of composite outcome including all-cause death, stroke, major bleeding and cardiac arrest (HR 0.75, 95% CI [0.70–0.81]) |
| Yang et al.[51] | 2020 | Cohort study | Retrospective | 27,955 | 43 months | Lower risk of composite outcome including all-cause death, heart failure admission and stroke/SE (HR 0.47, 95% CI [0.43–0.52]), all-cause death (HR 0.41, 95% CI [0.36–0.47]), heart failure admission (HR 0.43, 95% CI [0.37–0.50]) and ischaemic stroke/SE (HR 0.39, 95% CI [0.34–0.44]) |
| Saglietto et al.[58] | 2020 | Meta-analysis of 9 studies | NA | 241,372 | 3.5 years | Lower risk of all-cause death (HR 0.62, 95% CI [0.54–0.72]), stroke (HR 0.63, 95% CI [0.56–0.70]) and hospitalisation for heart failure (HR 0.64, 95% CI [0.51–0.80]) |
| Liu et al.[59] | 2020 | Meta-analysis of 25 studies | NA | 104,687 | 6–144 months | Lower risk of thromboembolic events (RR 0.65, 95% CI [0.51–0.82]) |
| Kim et al.[57] | 2021 | PSM cohort study | Retrospective | 8,145 | 51 months | Lower risk of ischaemic stroke (HR 0.25, 95% CI [0.14–0.42]) and ICH (HR 0.20, 95% CI [0.05–0.84]) |
ICH = intracranial haemorrhage; NA = not available or not applicable; PSM = propensity score matched; SE = systemic embolism; TIA = transient ischaemic attack.