A Meta-analysis Of Efficacy Comparison Between Surgical Ablation And Catheter Ablation In The Treatment Of Atrial Fibrillation

Objective: To systematically review the effectiveness and safety ofsurgical ablation versus catheter ablation in patients with atrial fibrillation.Methods: A search was conducted across PubMed、Cochrane Library、CNKI、WanFang Data、CBM and VIP for the clinical controlled trials ofsurgical ablation versus catheter ablation in patients with atrial fibrillationfrom Juanary1,1991to Juanary1,2014. The references in the includedliterature were also retrieved. and then the extracted data were analyzed byusing RevMan5.2software.Results: Six qualified trials involving905atrial fibrillation patientswere included. The results of meta-analysis showed that:Surgical ablationhad a significantly higher freedom from atrial fibrillation compared withcatheter ablation(OR=2.46,95%CI1.82to3.31，P＜0.00001).Subgroupanalysis demonstrated that surgical ablation increased the rates of sinusrhythm maintenance in paroxysmal atrial fibrillation (OR=2.47,95%CI1.00to6.12，P=0.05)and in chronic atrial fibrillation(OR=2.54,95%CI1.62to3.96)，P＜0.0001). but the incidence rate of complications were higher for surgical ablation than for catheter ablation(OR=1.93,95%CI1.16to3.19，P=0.01).Conclusion: Surgical ablation is superior to catheter ablation inachieving long-term sinus rhythm maintenance in atrial fibrillation patients.but the incidence rate of complications were higher for surgical ablationthan for catheter ablation. Large sample, prospective randomized clinicaltrials are warranted to study the outcome.