Work

The impact of empirical superior vena cava isolation in addition to pulmonary vein isolation on outcomes in atrial fibrillation – Systematic review, meta-analysis, and meta-regression

Year: 2025

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: Background: Atrial tachyarrhythmia (ATa) recurrence remains high after pulmonary vein isolation (PVI), with the superior vena cava (SVC) being a common source of non-pulmonary vein foci. Objective: -regression analysis regarding the empirical SVC isolation (eSVCi) versus no eSVCi in atrial fibrillation (AF) ablation. Methods: A systematic review was conducted on studies comparing eSVCi to no eSVCi (PVI-only or adjunctive SVC isolation). The primary outcome was ATa recurrence, defined as AF/atrial flutter/atrial tachycardia lasting over 30 s after a blanking period. Secondary outcomes included procedural duration, fluoroscopic duration, and complications. Results: = 40.7 %). Subgroup analysis revealed eSVCi reduced ATa recurrence in observational studies but not in RCTs, and in initial ablations but not repeat procedures. eSVCi was beneficial in both PVI-only and adjunctive SVC isolation subgroups. Meta-regression showed the benefit of eSVCi was less in patients with non-paroxysmal AF (p = 0.044) and hypertension (p = 0.012). Procedural time, fluoroscopic time, and complications were similar between the two groups. Conclusion: eSVCi potentially reduce ATa recurrence compared to no eSVCi, without increasing complications or prolonging procedural times.

Source: IJC Heart & Vasculature

DOI: 10.1016/j.ijcha.2025.101662

Authors: Raymond Pranata, William Kamarullah, Giky Karwiky, Chaerul Achmad, Mohammad Iqbal

Institutions: Dr. Hasan Sadikin General Hospital, Padjadjaran University

Language: English

Topic: Atrial Fibrillation Management and Outcomes

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,330