• Haobin Huang, Qinxue Wang, Jin Xu, Yanhu Wu, and Cheng Xu.
• Department of Cardiovascular Surgery, the First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
• J. Thorac. Cardiovasc. Surg. 2022 Mar 1; 163 (3): 980-993.

ObjectiveTo compare both the beneficial and adverse effects of catheter ablation (CA) and surgical ablation (SA) on patients with atrial fibrillation (AF).MethodsWe searched MEDLINE and 4 additional databases for randomized controlled trials that compared CA with SA. Following data extraction, we conducted a meta-analysis to estimate the efficacy and safety of CA relative to SA. The primary end point of this study was the absence of AF during a 12-month follow-up period without the use of antiarrhythmic drugs.ResultsSeven trials comparing SA with CA met the inclusion criteria for efficacy outcome assessments. Following the meta-analysis, we obtained a summary odds ratio (OR) of achieving success 1 year after CA relative to SA was 0.37:1 (95% confidence interval [CI], 0.20-0.69). The result was robust in the subgroup analysis. CA was associated with a greater incidence of femoral vascular complications (OR, 5.81; 95% CI, 1.03-32.71), but a lower incidence of pneumothorax (OR, 0.09; 95% CI, 0.01-0.74) than SA. Statistically significant differences in the other safety outcomes were not observed between CA and SA.ConclusionsSA confers a moderate advantage over CA in 1-year efficacy outcomes and may be safely performed by experienced surgeons.Copyright © 2020 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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