{"id":"565ef1c3df7a","type":"article","url":"https://hartvaat.nl/2025/06/03/af-ablatie-timing-naar-af-duur-impact-op-aritmierecidief/","title":"AF-ablatie timing naar AF-duur: impact op aritmierecidief","title_en":"Impact of catheter ablation timing according to duration of atrial fibrillation history on arrhythmia recurrences and clinical outcomes: a 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/euaf110","source_url":"https://doi.org/10.1093/europace/euaf110","authors":["Paschalis Karakasis","Stylianos Tzeis","Konstantinos Pamporis","Art Schuermans","Panagiotis Theofilis","Nikias Milaras","Dimitrios Tsiachris","Michael Efremidis","Antonios P Antoniadis","Nikolaos Fragakis"],"significance":6,"published":"2025-06-03","source_date":"2025-06-03","image":"","kennis":[],"congress":"","summary_en":"This analysis showed that earlier catheter ablation (shorter duration of AF history) is associated with fewer arrhythmia recurrences, reinforcing the time-sensitive nature of rhythm control intervention.","created":"2026-07-03T10:31:40Z","updated":"2026-07-03T13:30:40Z","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":"Analyse onderzocht de impact van ablatie-timing op aritmierecidief naar duur van AF-historie. Vroege ablatie (kortere AF-duur) geeft betere uitkomsten, consistent met het concept van vroege interventie.","abstract_original":"AIMS: Catheter ablation is a well-established treatment for symptomatic paroxysmal atrial fibrillation (PAF) or persistent atrial fibrillation (PsAF) refractory to antiarrhythmic agents, and current guidelines have also upgraded its role as a first-line option for recurrent PAF. However, the optimal timing to maximize rhythm outcomes remains uncertain. To address this gap, the present study sought to investigate the association between diagnosis-to-ablation time (DAT) and age-stratified atrial fibrillation (AF) recurrence and clinical outcomes. METHODS AND RESULTS: Medline, the Cochrane Library, and Scopus were searched through 18 February 2025. Triple-independent selection, extraction, and quality assessment were conducted, with evidence pooled via random-effects meta-analyses. Among the 28 studies (41 431 participants) with a median 24-month follow-up, early ablation (DAT ≤ 1 year) significantly reduced AF recurrence compared to delayed ablation [hazard ratio (HR) 0.65, 95% confidence interval (CI) 0.59-0.73]. The benefit of early ablation was consistent for both PAF (HR 0.72, 95% CI 0.67-0.77) and PsAF (HR 0.70, 95% CI 0.61-0.81). Age-stratified analysis revealed that this effect was significant regardless of age, with the greatest risk reduction observed in individuals ≤ 55 years (HR 0.49, 95% CI 0.34-0.71). Early ablation was also associated with a reduced risk of repeat ablation, new cardioversion, and cardiovascular hospitalization compared to delayed ablation. Higher CHA₂DS₂-VASc scores, heart failure prevalence, and lower mean left ventricular ejection fraction were associated with greater benefits from early ablation. CONCLUSION: Early catheter ablation within 1 year of AF diagnosis is associated with a lower risk of recurrence in both PAF and PsAF, with the strongest association observed in patients ≤ 55 years."}