Outcomes of Catheter Ablation With and Without Left Atrial Appendage Closure

In a meta-analysis published in the Anatolian Journal of Cardiology, researchers assessed the effectiveness of catheter ablation combined with left atrial appendage closure compared with catheter ablation alone. After the review, lead author An Wang and colleagues proposed that “the freedom from atrial arrhythmia rate and safety outcomes of catheter ablation combined with left atrial appendage closure are similar to those of catheter ablation alone.”

Additionally, the authors observed that “catheter ablation combined with left atrial appendage closure appears to have longer procedure and fluoroscopy times than catheter ablation alone.”

The final analysis included five studies with 699 total patients. Notably, the investigators “found no significant difference in the freedom from atrial arrhythmia rate” between the two treatment groups (risk ratio [RR] = 0.93; 95% confidence interval [CI], 0.83–1.04; p = 0.21). The mean procedure and mean fluoroscopy times in the combined treatment were significantly longer than in catheter ablation alone (standard mean difference = 1.26; 95% CI, 0.85–1.67; p <0.0001; and 1.19; 95% CI, 0.53–1.85; p = 0.0004). There were no significant differences between groups during follow-up with regards to perioperative complications (RR = 1.62; 95% CI, 0.99–2.63; p = 0.05), thromboembolic events (RR = 0.67; 95% CI, 0.15–3.11; p = 0.61), or bleeding events (RR = 0.67; 95% CI, 0.11–3.88; p = 0.65).

The authors presented their findings to inform the “controversial” topic of the effectiveness of combined treatment versus catheter ablation alone, ultimately concluded that the efficacy outcomes were comparable.