4Ĭomplete PV isolation (PVI) by single-shot or point-by-point catheter ablation approach is the cornerstone of catheter ablation in AF patients. 3 In contrast, AF induced by pacing protocol during typical AFL ablation is a strong predictor for AF. 2 Pulmonary vein (PV) firing during AF episodes makes an essential contribution to initiating typical AFL. 1 The presence of AFL is documented in 20.6% of AF patients. Conclusion: This study suggested that prophylactic CTI ablation was an ineffective and inefficient approach in AF without documented typical atrial flutter patients.ĪF and atrial flutter (AFL) commonly coexist, and reveal a strong clinical interrelationship. Additional prophylactic CTI ablation to pulmonary vein isolation significantly increased the radio frequency application time (standardised mean difference 0.52 95% CI p=0.03). Prophylactic CTI ablation was associated with a higher recurrent AF rate (33.8% versus 27.1% risk difference 0.07 95% CI p=0.02). The risk of atrial tachyarrhythmias following a successful catheter ablation procedure was greater in the pulmonary vein isolation + CTI ablation group than pulmonary vein isolation alone group (34.8% versus 28.2% risk difference 0.08 95% CI p=0.04). Results: A total of 1,476 patients from four studies were included. The pooled effects were presented as the risk difference and standardised mean difference for dichotomous and continuous outcomes, respectively. The overall effects estimation was conducted using random effects models. Methods: A systematic review and meta-analysis study was conducted. The present study aimed to evaluate the role of prophylactic CTI ablation in this population. Background: The advantage of prophylactic cavotricuspid isthmus (CTI) ablation for AF patients without documented atrial flutter is still unclear.
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