TY - JOUR
T1 - Longer diagnosis-to-ablation time is associated with recurrence of atrial fibrillation after catheter ablation—Systematic review and meta-analysis
AU - Pranata, Raymond
AU - Chintya, Veresa
AU - Raharjo, Sunu B.
AU - Yuniadi, Yoga
AU - Yamin, Muhammad
N1 - Publisher Copyright:
© 2019 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of the Japanese Heart Rhythm Society.
PY - 2020/4/1
Y1 - 2020/4/1
N2 - Background: Diagnosis-to-ablation time (DTAT) has been postulated to be one of the predictors of atrial fibrillation (AF) recurrence, and it is a “modifiable” risk factor unlike that of many electrocardiographic or echocardiographic parameters. This development may change our consideration for ablation. In this systematic review and meta-analysis, we aim to analyze the latest evidence on the importance of DTAT and whether they predict the AF recurrence after catheter ablation. Methods: We performed a comprehensive search on topics that assess diagnosis-to-ablation time (DTAT) and AF recurrence from inception up until August 2019 through PubMed, EuropePMC, Cochrane Central Database, and ClinicalTrials.gov. Results: There was a total of 3548 patients from six studies. Longer DTAT was associated with increased risk for AF recurrence in all studies included. Meta-analysis of these studies showed that DTAT had a hazard ratio (HR) of 1.19 [1.02, 1.39], P =.03; I2: 92% for AF recurrence. Upon sensitivity analysis by removing a study, HR became 1.24 [1.16, 1.32], P <.001; I2: 29%. Meta-analysis on DTAT time >3 years had HR 1.73 [1.54, 1.93], P <.001; I2: 45% for the recurrence of AF. Upon subgroup analysis of data that compared >6 years to <1 year, the HR was 1.93 [1.62, 2.29], P <.001; I2: 0%. Conclusion: Longer DTAT time is associated with an increased risk of AF recurrence. Hence, determining management at the earliest possible moment to avoid delay is of utmost importance.
AB - Background: Diagnosis-to-ablation time (DTAT) has been postulated to be one of the predictors of atrial fibrillation (AF) recurrence, and it is a “modifiable” risk factor unlike that of many electrocardiographic or echocardiographic parameters. This development may change our consideration for ablation. In this systematic review and meta-analysis, we aim to analyze the latest evidence on the importance of DTAT and whether they predict the AF recurrence after catheter ablation. Methods: We performed a comprehensive search on topics that assess diagnosis-to-ablation time (DTAT) and AF recurrence from inception up until August 2019 through PubMed, EuropePMC, Cochrane Central Database, and ClinicalTrials.gov. Results: There was a total of 3548 patients from six studies. Longer DTAT was associated with increased risk for AF recurrence in all studies included. Meta-analysis of these studies showed that DTAT had a hazard ratio (HR) of 1.19 [1.02, 1.39], P =.03; I2: 92% for AF recurrence. Upon sensitivity analysis by removing a study, HR became 1.24 [1.16, 1.32], P <.001; I2: 29%. Meta-analysis on DTAT time >3 years had HR 1.73 [1.54, 1.93], P <.001; I2: 45% for the recurrence of AF. Upon subgroup analysis of data that compared >6 years to <1 year, the HR was 1.93 [1.62, 2.29], P <.001; I2: 0%. Conclusion: Longer DTAT time is associated with an increased risk of AF recurrence. Hence, determining management at the earliest possible moment to avoid delay is of utmost importance.
KW - atrial fibrillation
KW - atrial fibrillation recurrence
KW - catheter ablation
KW - diagnosis-to-ablation time
KW - time-to-ablation
UR - http://www.scopus.com/inward/record.url?scp=85077388373&partnerID=8YFLogxK
U2 - 10.1002/joa3.12294
DO - 10.1002/joa3.12294
M3 - Article
AN - SCOPUS:85077388373
SN - 1880-4276
VL - 36
SP - 289
EP - 294
JO - journal of arrhythmia
JF - journal of arrhythmia
IS - 2
ER -