Aims: This study aims to systematically evaluate the efficacy of ATP guided Pulmonary Vein Isolation (PVI) for the treatment of paroxysmal Atrial Fibrillation (AF) and persistent AF.
Methods: A systematic search was performed on PubMed, EMbase, the Cochrane Library and Medline for Randomized Controlled Trial (RCT) and Non-Randomized Controlled Trials (Non-RCT) of ATP guided PVI treatment efficacy in AF patients until February 2016. RevMan 5.3 was used for metaanalysis.
Results: Finally, 3 RCTs and 9 non-RCTs were included. There was no difference in postoperative freedom from AF for paroxysmal AF patients in 2 non-RCTs; and no difference in postoperative freedom from AF for paroxysmal and persistent AF patients in 4 non-RCTs. The overall meta-analysis results showed that AF recurrence rate was higher in ATP group than that in conventional PVI group (P<0.05). Two RCTs showed no difference in postoperative recovery rate of pulmonary vein conduction between the two groups. For 1 year postoperative freedom from AF, 2 RCTs showed no difference between ATP guided and conventional PVI groups. However, 1 year postoperative freedom from AF was significantly higher in ATP guided PVI group than that in conventional PVI group in 4 non-RCTs (P<0.001). The overall meta-analysis results also showed that 1 year postoperative freedom from AF was significantly higher in ATP guided PVI group than that in conventional PVI group (P<0.01).
Conclusions: ATP is safe and effective in identification of occult conduction in PVI.