{"id":"fa5264c30465","type":"article","url":"https://hartvaat.nl/2023/02/08/voorspellers-van-af-recidief-na-ablatie-en-cardioversie-umbrella-review/","title":"Voorspellers van AF-recidief na ablatie en cardioversie: umbrella review","title_en":"Predictors of recurrence after catheter ablation and electrical cardioversion of atrial fibrillation: an umbrella review of meta-analyses.","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/euac143","source_url":"https://doi.org/10.1093/europace/euac143","authors":["Emmanouil Charitakis","Elena Dragioti","Maria Stratinaki","Dafni Korela","Stylianos Tzeis","Henrik Almroth","Ioan Liuba","Anders Hassel Jönsson","Georgios Charalambous","Lars O Karlsson","Dimitrios Tsartsalis"],"significance":6,"published":"2023-02-08","source_date":"2023-02-08","image":"","kennis":["https://hartvaat.nl/kennis/atriumfibrilleren/elektrisch-remodellering-atrium/","https://hartvaat.nl/kennis/atriumfibrilleren/chadsvasc-score/"],"congress":"","summary_en":"This umbrella review of meta-analyses identified the strongest predictors of AF recurrence after catheter ablation and cardioversion — left atrial size, AF duration, age, and body mass index — providing a practical risk assessment framework.","created":"2026-07-03T10:30:14Z","updated":"2026-07-03T13:29:18Z","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":"Umbrella review van meta-analyses identificeerde de belangrijkste voorspellers van AF-recidief: linkeratriumdiameter, AF-duur, leeftijd en CHA₂DS₂-VASc-score. Deze factoren kunnen de patiëntenselectie voor ritmecontrole verbeteren.","abstract_original":"AIMS: The recurrence rates after catheter ablation (CA) and direct current (DC) cardioversion remain high, although they have been established treatments of rhythm control of atrial fibrillation (AF). This umbrella review systematically appraises published meta-analyses of both observational and randomized controlled trials (RCTs) for the association of risk and protective factors for arrhythmia recurrence after CA and DC cardioversion of AF. METHODS AND RESULTS: Three bibliographic databases were searched up to June 2021. Evidence of association was rated as convincing, highly suggestive, suggestive, weak, or not significant with respect to observational studies and as high, moderate, low, or very low with respect to RCTs, according to established criteria. Thirty-one meta-analyses were included. Of the 28 associations between CA and the risk of arrhythmia recurrence, none presented convincing evidence, and only the time from diagnosis to ablation over 1 year provided highly suggestive evidence. The association between hypertension and metabolic profile provided suggestive evidence. The associations of Class IC and III antiarrhythmic drugs use with the recurrence after DC cardioversion were supported by an intermediate level of evidence. CONCLUSION: Although AF is a major health issue, few risk- and protective factors for AF recurrence have been identified. None of these factors examined were supported by convincing evidence, whereas established factors such as female gender and left atrial volume showed only weak association. An early CA strategy combined with treatment of metabolic syndrome and hypertension prior to CA may reduce the risk of arrhythmia recurrence. The use of antiarrhythmics can increase the success rate of DC cardioversion. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registry number: CRD42021270613."}