# AF-ablatie timing naar AF-duur: impact op aritmierecidief

*geplaatst 2025-06-03 · Atriumfibrilleren · 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 · https://hartvaat.nl/2025/06/03/af-ablatie-timing-naar-af-duur-impact-op-aritmierecidief/*

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.

## English: Impact of catheter ablation timing according to duration of atrial fibrillation history on arrhythmia recurrences and clinical outcomes: a meta-analysis.

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.

## Abstract (original, from the publication)

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.

Auteurs: Paschalis Karakasis, Stylianos Tzeis, Konstantinos Pamporis, Art Schuermans, Panagiotis Theofilis, Nikias Milaras, Dimitrios Tsiachris, Michael Efremidis, Antonios P Antoniadis, Nikolaos Fragakis

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Bron: 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, https://doi.org/10.1093/europace/euaf110. Bijgewerkt 2026-07-03T13:30:40Z. 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.