{"id":"21145b99fe7c","type":"article","url":"https://hartvaat.nl/2016/03/01/aanvullende-cfae-ablatie-en-lineaire-laesies-bij-persistend-atriumfibrilleren-me/","title":"Aanvullende CFAE-ablatie en lineaire laesies bij persistend atriumfibrilleren: meta-analyse","title_en":"The impact of adjunctive complex fractionated atrial electrogram ablation and linear lesions on outcomes in persistent atrial fibrillation: a meta-analysis.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":["pulmonaalvenenisolatie"],"journal":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","doi":"10.1093/europace/euv351","source_url":"https://doi.org/10.1093/europace/euv351","authors":["Paul A Scott","John Silberbauer","Francis D Murgatroyd"],"significance":6,"published":"2016-03-01","source_date":"2016-03-01","image":"","kennis":["https://hartvaat.nl/kennis/atriumfibrilleren/katheterablatie-af/","https://hartvaat.nl/kennis/atriumfibrilleren/pathofysiologie-af/"],"congress":"","summary_en":"This meta-analysis showed that adding complex fractionated atrial electrogram ablation or linear lesions to pulmonary vein isolation in persistent AF does not consistently improve outcomes, questioning routine substrate modification strategies.","created":"2026-07-03T10:25:58Z","updated":"2026-07-03T18:38:22Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Meta-analyse die onderzocht of toevoeging van complexe gefractioneerde atriale elektrogramablatie (CFAE) en lineaire laesies aan pulmonaalvene-isolatie (PVI) de uitkomsten verbetert bij persisterend AF. De twee meest gebruikte substraatmodificatiestrategieën vergeleken.","abstract_original":"AIMS: In persistent atrial fibrillation (PsAF), success rates for pulmonary vein isolation (PVI) alone are limited and additional substrate modification is often performed. The two most widely used substrate-based strategies are the ablation of complex fractionated atrial electrograms (CFAE) and left atrial linear ablation (LALA) at the roof and mitral isthmus. However, it is unclear whether adjunctive CFAE ablation or LALA add significant benefit to PVI alone. We performed a meta-analysis to better gauge the benefit of adjunctive CFAE ablation and LALA in PsAF. METHODS AND RESULTS: Electronic databases were systematically searched. We included studies that examined the impact of CFAE ablation or LALA in addition to a PVI-based strategy on clinical outcomes in PsAF. We included both randomized and non-randomized studies. Totally 10 studies (n = 1821) were included: 6 evaluating CFAE ablation, 3 LALA, and 1 both approaches. In comparison with PVI alone, the addition of CFAE ablation [RR 0.86; 95% confidence intervals (CI) 0.64, 1.16; P = 0.32] or LALA (RR 0.64; 95% CI 0.37, 1.09; P = 0.10) offered no significant improvement in arrhythmia-free survival. However, adjunctive CFAE ablation was associated with significant increases (P < 0.05) and LALA non-significant increases in procedure and fluoroscopy times. CONCLUSION: In PsAF, the addition of CFAE ablation or LALA, in comparison with PVI alone, offers no significant improvement in arrhythmia-free survival. Furthermore, they are associated with increases in both procedural and fluoroscopy times. The optimal ablation strategy for PsAF is currently unclear and needs further refinement."}