Longer diagnosis‐to‐ablation time is associated with recurrence of atrial fibrillation after catheter ablation—Systematic review and meta‐analysis

Journal of Arrhythmia. 2020;36(2):289-294 DOI 10.1002/joa3.12294

 

Journal Homepage

Journal Title: Journal of Arrhythmia

ISSN: 1880-4276 (Print); 1883-2148 (Online)

Publisher: Wiley

Society/Institution: Japanese Heart Rhythm Society

LCC Subject Category: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system

Country of publisher: Australia

Language of fulltext: English

Full-text formats available: PDF, HTML

 

AUTHORS


Raymond Pranata (Faculty of Medicine Universitas Pelita Harapan Tangerang Indonesia)

Veresa Chintya (Faculty of Medicine Universitas Kristen Krida Wacana Jakarta Indonesia)

Sunu B. Raharjo (Department of Cardiology and Vascular Medicine Faculty of Medicine Universitas Indonesia National Cardiovascular Center Harapan Kita Jakarta Indonesia)

Muhammad Yamin (Division of Cardiology Department of Internal Medicine Faculty of Medicine Universitas Indonesia Cipto Mangunkusumo National General Hospital Jakarta Indonesia)

Yoga Yuniadi (Department of Cardiology and Vascular Medicine Faculty of Medicine Universitas Indonesia National Cardiovascular Center Harapan Kita Jakarta Indonesia)

EDITORIAL INFORMATION

Blind peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 45 weeks

 

Abstract | Full Text

Abstract Background Diagnosis‐to‐ablation time (DTAT) has been postulated to be one of the predictors of atrial fibrillation (AF) recurrence, and it is a “modifiable” risk factor unlike that of many electrocardiographic or echocardiographic parameters. This development may change our consideration for ablation. In this systematic review and meta‐analysis, we aim to analyze the latest evidence on the importance of DTAT and whether they predict the AF recurrence after catheter ablation. Methods We performed a comprehensive search on topics that assess diagnosis‐to‐ablation time (DTAT) and AF recurrence from inception up until August 2019 through PubMed, EuropePMC, Cochrane Central Database, and ClinicalTrials.gov. Results There was a total of 3548 patients from six studies. Longer DTAT was associated with increased risk for AF recurrence in all studies included. Meta‐analysis of these studies showed that DTAT had a hazard ratio (HR) of 1.19 [1.02, 1.39], P = .03; I2: 92% for AF recurrence. Upon sensitivity analysis by removing a study, HR became 1.24 [1.16, 1.32], P < .001; I2: 29%. Meta‐analysis on DTAT time >3 years had HR 1.73 [1.54, 1.93], P < .001; I2: 45% for the recurrence of AF. Upon subgroup analysis of data that compared >6 years to <1 year, the HR was 1.93 [1.62, 2.29], P < .001; I2: 0%. Conclusion Longer DTAT time is associated with an increased risk of AF recurrence. Hence, determining management at the earliest possible moment to avoid delay is of utmost importance.