{"id":"59ea23c3ca1c","type":"article","url":"https://hartvaat.nl/2018/11/01/uitkomsten-van-ablatie-bij-persisterend-en-langdurig-persisterend-af-meta-analys/","title":"Uitkomsten van ablatie bij persisterend en langdurig persisterend AF: meta-analyse","title_en":"Outcomes of persistent and long-standing persistent atrial fibrillation ablation: a systematic review and meta-analysis.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":[],"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/eux297","source_url":"https://doi.org/10.1093/europace/eux297","authors":["Jock A Clarnette","Anthony G Brooks","Rajiv Mahajan","Adrian D Elliott","Darragh J Twomey","Rajeev K Pathak","Sharath Kumar","Dian A Munawar","Glenn D Young","Jonathan M Kalman","Dennis H Lau","Prashanthan Sanders"],"significance":6,"published":"2018-11-01","source_date":"2018-11-01","image":"","kennis":[],"congress":"","summary_en":"This meta-analysis of ablation outcomes in persistent and longstanding persistent AF documented the expected success rates and predictors of recurrence, helping set realistic expectations for rhythm control in advanced AF.","created":"2026-07-03T10:27:35Z","updated":"2026-07-03T13:26:49Z","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":"Systematische review en meta-analyse van ablatie-uitkomsten bij persisterend en langdurig persisterend AF. Verwachtingsmanagement voor moeilijker te behandelen AF.","abstract_original":"AIMS: Several techniques have been utilized for the ablation of persistent (P) and long-standing persistent (LsP) atrial fibrillation (AF); however, the best approach of substrate ablation remains poorly defined. This study aims to examine the impact of ablation approach on outcomes associated with P or LsP AF ablation by conducting a meta-analysis and regression on contemporary literature. METHODS AND RESULTS: A systematic literature review was conducted up to 29 July 2015 for scientific literature reporting on outcomes associated with P or LsP AF ablation. One hundred and thirteen studies reported outcomes in a total of 18 657 patients undergoing various ablation approaches for the treatment of P-LsP AF between 2001 and 2015. The point efficacy estimate of a single-AF ablation procedure without the use of anti-arrhythmic drugs was 43% (95% CI; 39-47%). Multiple procedures and/or the use of anti-arrhythmic drugs increase success to 69% (95% CI; 66-71%). Meta-regression revealed that ablation technique (P < 0.001) and left atrial size (P = 0.02) were predictive of single procedure, drug-free success. The addition of extra-pulmonary substrate approaches was associated with declining efficacy when compared to a pulmonary vein ablation alone. CONCLUSION: The efficacy of a single-AF ablation procedure for P or LsP AF is 43%; however, can be increased to 69% with the use of multiple procedures and/or anti-arrhythmic drugs. Current literature supports the finding that pulmonary vein antrum ablation/isolation is at least equivalently efficacious to other contemporary P-LsP ablation strategies."}