Meta-Analysis of Ablation of Atrial Flutter and Supraventricular Tachycardia

Peter Spector, Matthew R. Reynolds, Hugh Calkins, Manu Sondhi, Yingxin Xu, Amber Martin, Catherine J. Williams, Isabella Sledge

Research output: Contribution to journalArticle

Abstract

The purpose of this study was to perform a systematic review and meta-analysis to evaluate the safety and efficacy of radiofrequency ablation (RFA) of typical atrial flutter (AFL) and atrioventricular node-dependent supraventricular tachycardia (SVT) in adult patients. Medline and EMBASE were searched (1990 to 2007) for all study design trials of RFA. Data relating to single- and multiple-procedure success, arrhythmia recurrence, repeat ablation, adverse events, and death were extracted. For RFA in AFL, 18 primary studies with 22 treatment arms and 1,323 patients were identified. Single-procedure success for AFL was 91.7% (95% confidence interval [CI] 88.4% to 94.9%). Multiple-procedure success was 97.0% (95% CI 94.7% to 99.4%). Postablation arrhythmia was noted in 13.2% of patients (95% CI 7.5% to 18.9%), while repeat ablation was reported in 8% (95% CI 4.5% to 11.4%). For RFA of SVT, 39 primary studies with 49 treatment arms in 7,693 patients with accessory pathways and atrioventricular nodal reentrant tachycardia were identified. Single-procedure success for SVT was 93.2% (95% CI 90.8% to 95.5%). Multiple-procedure success was 94.6% (95% CI 92.4% to 96.9). Postablation arrhythmia was noted in 5.6% patients (95% CI 4.1% to 7.2%). Repeat ablation occurred in 6.5% (95% CI 4.7% to 8.3%). For AFL studies, all-cause mortality was 0.6%, and adverse events were reported in 0.5% of patients. For SVT studies, all-cause mortality was 0.1%, and adverse events were reported in 2.9% of patients. In conclusion, studies of RFA for the treatment of patients with AFL and SVT report high efficacy rates and low rates of complications.

Original languageEnglish (US)
Pages (from-to)671-677
Number of pages7
JournalThe American Journal of Cardiology
Volume104
Issue number5
DOIs
StatePublished - Sep 1 2009

Fingerprint

Atrial Flutter
Supraventricular Tachycardia
Meta-Analysis
Confidence Intervals
Cardiac Arrhythmias
Atrioventricular Nodal Reentry Tachycardia
Atrioventricular Node
Mortality
Therapeutics
Safety
Recurrence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Meta-Analysis of Ablation of Atrial Flutter and Supraventricular Tachycardia. / Spector, Peter; Reynolds, Matthew R.; Calkins, Hugh; Sondhi, Manu; Xu, Yingxin; Martin, Amber; Williams, Catherine J.; Sledge, Isabella.

In: The American Journal of Cardiology, Vol. 104, No. 5, 01.09.2009, p. 671-677.

Research output: Contribution to journalArticle

Spector, P, Reynolds, MR, Calkins, H, Sondhi, M, Xu, Y, Martin, A, Williams, CJ & Sledge, I 2009, 'Meta-Analysis of Ablation of Atrial Flutter and Supraventricular Tachycardia', The American Journal of Cardiology, vol. 104, no. 5, pp. 671-677. https://doi.org/10.1016/j.amjcard.2009.04.040
Spector, Peter ; Reynolds, Matthew R. ; Calkins, Hugh ; Sondhi, Manu ; Xu, Yingxin ; Martin, Amber ; Williams, Catherine J. ; Sledge, Isabella. / Meta-Analysis of Ablation of Atrial Flutter and Supraventricular Tachycardia. In: The American Journal of Cardiology. 2009 ; Vol. 104, No. 5. pp. 671-677.
@article{091fc31de20142bda4c479583a1cfc48,
title = "Meta-Analysis of Ablation of Atrial Flutter and Supraventricular Tachycardia",
abstract = "The purpose of this study was to perform a systematic review and meta-analysis to evaluate the safety and efficacy of radiofrequency ablation (RFA) of typical atrial flutter (AFL) and atrioventricular node-dependent supraventricular tachycardia (SVT) in adult patients. Medline and EMBASE were searched (1990 to 2007) for all study design trials of RFA. Data relating to single- and multiple-procedure success, arrhythmia recurrence, repeat ablation, adverse events, and death were extracted. For RFA in AFL, 18 primary studies with 22 treatment arms and 1,323 patients were identified. Single-procedure success for AFL was 91.7{\%} (95{\%} confidence interval [CI] 88.4{\%} to 94.9{\%}). Multiple-procedure success was 97.0{\%} (95{\%} CI 94.7{\%} to 99.4{\%}). Postablation arrhythmia was noted in 13.2{\%} of patients (95{\%} CI 7.5{\%} to 18.9{\%}), while repeat ablation was reported in 8{\%} (95{\%} CI 4.5{\%} to 11.4{\%}). For RFA of SVT, 39 primary studies with 49 treatment arms in 7,693 patients with accessory pathways and atrioventricular nodal reentrant tachycardia were identified. Single-procedure success for SVT was 93.2{\%} (95{\%} CI 90.8{\%} to 95.5{\%}). Multiple-procedure success was 94.6{\%} (95{\%} CI 92.4{\%} to 96.9). Postablation arrhythmia was noted in 5.6{\%} patients (95{\%} CI 4.1{\%} to 7.2{\%}). Repeat ablation occurred in 6.5{\%} (95{\%} CI 4.7{\%} to 8.3{\%}). For AFL studies, all-cause mortality was 0.6{\%}, and adverse events were reported in 0.5{\%} of patients. For SVT studies, all-cause mortality was 0.1{\%}, and adverse events were reported in 2.9{\%} of patients. In conclusion, studies of RFA for the treatment of patients with AFL and SVT report high efficacy rates and low rates of complications.",
author = "Peter Spector and Reynolds, {Matthew R.} and Hugh Calkins and Manu Sondhi and Yingxin Xu and Amber Martin and Williams, {Catherine J.} and Isabella Sledge",
year = "2009",
month = "9",
day = "1",
doi = "10.1016/j.amjcard.2009.04.040",
language = "English (US)",
volume = "104",
pages = "671--677",
journal = "American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - Meta-Analysis of Ablation of Atrial Flutter and Supraventricular Tachycardia

AU - Spector, Peter

AU - Reynolds, Matthew R.

AU - Calkins, Hugh

AU - Sondhi, Manu

AU - Xu, Yingxin

AU - Martin, Amber

AU - Williams, Catherine J.

AU - Sledge, Isabella

PY - 2009/9/1

Y1 - 2009/9/1

N2 - The purpose of this study was to perform a systematic review and meta-analysis to evaluate the safety and efficacy of radiofrequency ablation (RFA) of typical atrial flutter (AFL) and atrioventricular node-dependent supraventricular tachycardia (SVT) in adult patients. Medline and EMBASE were searched (1990 to 2007) for all study design trials of RFA. Data relating to single- and multiple-procedure success, arrhythmia recurrence, repeat ablation, adverse events, and death were extracted. For RFA in AFL, 18 primary studies with 22 treatment arms and 1,323 patients were identified. Single-procedure success for AFL was 91.7% (95% confidence interval [CI] 88.4% to 94.9%). Multiple-procedure success was 97.0% (95% CI 94.7% to 99.4%). Postablation arrhythmia was noted in 13.2% of patients (95% CI 7.5% to 18.9%), while repeat ablation was reported in 8% (95% CI 4.5% to 11.4%). For RFA of SVT, 39 primary studies with 49 treatment arms in 7,693 patients with accessory pathways and atrioventricular nodal reentrant tachycardia were identified. Single-procedure success for SVT was 93.2% (95% CI 90.8% to 95.5%). Multiple-procedure success was 94.6% (95% CI 92.4% to 96.9). Postablation arrhythmia was noted in 5.6% patients (95% CI 4.1% to 7.2%). Repeat ablation occurred in 6.5% (95% CI 4.7% to 8.3%). For AFL studies, all-cause mortality was 0.6%, and adverse events were reported in 0.5% of patients. For SVT studies, all-cause mortality was 0.1%, and adverse events were reported in 2.9% of patients. In conclusion, studies of RFA for the treatment of patients with AFL and SVT report high efficacy rates and low rates of complications.

AB - The purpose of this study was to perform a systematic review and meta-analysis to evaluate the safety and efficacy of radiofrequency ablation (RFA) of typical atrial flutter (AFL) and atrioventricular node-dependent supraventricular tachycardia (SVT) in adult patients. Medline and EMBASE were searched (1990 to 2007) for all study design trials of RFA. Data relating to single- and multiple-procedure success, arrhythmia recurrence, repeat ablation, adverse events, and death were extracted. For RFA in AFL, 18 primary studies with 22 treatment arms and 1,323 patients were identified. Single-procedure success for AFL was 91.7% (95% confidence interval [CI] 88.4% to 94.9%). Multiple-procedure success was 97.0% (95% CI 94.7% to 99.4%). Postablation arrhythmia was noted in 13.2% of patients (95% CI 7.5% to 18.9%), while repeat ablation was reported in 8% (95% CI 4.5% to 11.4%). For RFA of SVT, 39 primary studies with 49 treatment arms in 7,693 patients with accessory pathways and atrioventricular nodal reentrant tachycardia were identified. Single-procedure success for SVT was 93.2% (95% CI 90.8% to 95.5%). Multiple-procedure success was 94.6% (95% CI 92.4% to 96.9). Postablation arrhythmia was noted in 5.6% patients (95% CI 4.1% to 7.2%). Repeat ablation occurred in 6.5% (95% CI 4.7% to 8.3%). For AFL studies, all-cause mortality was 0.6%, and adverse events were reported in 0.5% of patients. For SVT studies, all-cause mortality was 0.1%, and adverse events were reported in 2.9% of patients. In conclusion, studies of RFA for the treatment of patients with AFL and SVT report high efficacy rates and low rates of complications.

UR - http://www.scopus.com/inward/record.url?scp=68849131994&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=68849131994&partnerID=8YFLogxK

U2 - 10.1016/j.amjcard.2009.04.040

DO - 10.1016/j.amjcard.2009.04.040

M3 - Article

VL - 104

SP - 671

EP - 677

JO - American Journal of Cardiology

JF - American Journal of Cardiology

SN - 0002-9149

IS - 5

ER -