Atrial Fibrillation Recurrence-Free After Pulmonary Vein Isolation With and Without Non-Pulmonary Vein Trigger Ablation

Purpose: The success rate of Pulmonary Vein Isolation (PVI) depends on many factors. Non-pulmonary vein triggers are one of the factors of arrhythmia recurrence after catheter ablation. Whether PVI plus non-pulmonary vein trigger ablation improves the outcome of atrial fibrillation ablation is unclear. We, therefore, conducted a meta-analysis to compare the atrial fibrillation recurrence-free rate after PVI alone and PVI plus non-pulmonary vein trigger ablation.

Material and Methods: We independently searched the databases of MEDLINE and EMBASE from the inception to December 30, 2022. We included cohort studies that evaluate the atrial fibrillation recurrence-free rate after PVI with and without non-pulmonary vein trigger ablation. Data from each study were combined using the random-effects model to calculate pooled odds ratio (OR) with 95% confidence interval (CI).

Results: A total of 5 cohort studies involving 3,885 atrial fibrillation patients who underwent PVI alone and 1,277 patients who underwent PVI plus non-pulmonary vein trigger ablation was included in our meta-analysis. There was no statistical difference in atrial fibrillation recurrence-free rate between patients who underwent PVI alone and patients who underwent PVI plus non-pulmonary vein trigger ablation (pooled OR 1.632; 95% CI 0.699, 3.812; p=0.257; I2=93.7%).

Conclusions: Our meta-analysis indicated that the atrial fibrillation recurrence-free rate after PVI alone is not statistically different from PVI plus non-pulmonary vein trigger ablation. Larger studies are needed to clarify this outcome.