{"id":"0114720b0e72","type":"article","url":"https://hartvaat.nl/2021/02/05/laa-isolatie-tijdens-af-ablatie-geactualiseerde-meta-analyse/","title":"LAA-isolatie tijdens AF-ablatie: geactualiseerde meta-analyse","title_en":"Efficacy and safety of left atrial appendage electrical isolation during catheter ablation of atrial fibrillation: an updated 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/euaa266","source_url":"https://doi.org/10.1093/europace/euaa266","authors":["Jorge Romero","Mohamed Gabr","Kavisha Patel","David Briceno","Juan Carlos Diaz","Isabella Alviz","Chintan Trivedi","Sanghamitra Mohanty","Dalvert Polanco","Domenico Giovanni Della Rocca","Dhanunjaya Lakkireddy","Andrea Natale","Luigi Di Biase"],"significance":6,"published":"2021-02-05","source_date":"2021-02-05","image":"","kennis":[],"congress":"","summary_en":"This updated meta-analysis of left atrial appendage electrical isolation during AF ablation confirmed improved freedom from arrhythmia recurrence with LAAEI, supporting this technique as an adjunctive strategy in non-paroxysmal AF.","created":"2026-07-03T10:29:02Z","updated":"2026-07-03T13:28:11Z","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":"Geactualiseerde meta-analyse naar werkzaamheid en veiligheid van linker-hartoorisolatie tijdens katheterablatie voor AF.","abstract_original":"AIMS: Left atrial appendage electrical isolation (LAAEI) has been shown to improve freedom from all-atrial arrhythmia recurrence in patients with non-paroxysmal atrial fibrillation (AF). The aim of this study is to investigate the long-term efficacy and safety outcomes of LAAEI in patients with non-paroxysmal AF undergoing catheter ablation. METHODS AND RESULTS: A systematic review of Medline, Cochrane, and Embase was performed for clinical studies evaluating the benefit of LAAEI in non-paroxysmal AF. Nine studies with a total of 2336 patients were included (mean age: 65 ± 9 years, 63% male). All studies included patients with persistent AF, long-standing persistent AF, or both. At a mean follow-up of 40.5 months, patients who underwent LAAEI had significantly higher freedom from all-atrial arrhythmia recurrence than patients who underwent standard ablation alone [69.3% vs. 46.4%; risk ratio (RR) 0.54; 95% confidence interval (CI) 0.42-0.69; P < 0.0001]. A 46% relative risk reduction and 22.9% absolute risk reduction in atrial-arrhythmia recurrence was noted with LAAEI. Rates of cerebral thromboembolism were not significantly different between the two groups (LAAEI 3% vs. standard ablation 1.6%, respectively; RR 1.76; 95% CI 0.61-5.04; P = 0.29). Furthermore, there was no significant difference in the acute procedural complication rates between the two groups (LAAEI 4% vs. standard ablation 3%, respectively; RR 1.29; 95% CI 0.83-2.02; P = 0.26). CONCLUSION: At long-term follow-up, LAAEI led to a significantly higher improvement in freedom from all-atrial arrhythmia recurrence in patients with non-paroxysmal AF, when compared to standard ablation alone. Importantly, this benefit was achieved without an increased risk of acute procedural complications or cerebral thromboembolic events."}