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Updated: May 8, 2026

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

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Ablation of atrial fibrillation and risk of stroke: A meta-analysis

Rui Providencia1, Hussam Ali2, Sérgio Barra3

  • 1Institute of Health Informatics Research, University College London, London, United Kingdom; Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom.

Heart Rhythm
|May 21, 2025
PubMed

Insights

Catheter ablation significantly reduces stroke risk in patients with atrial fibrillation (AF) despite anticoagulant therapy. Further trials are needed to confirm this stroke protection benefit.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Interventions

Background:

  • Patients with atrial fibrillation (AF) face a persistent stroke risk even with anticoagulant treatment.
  • The additional stroke protection offered by catheter ablation in AF patients requires further investigation.

Purpose of the Study:

  • To evaluate the stroke-protective benefits of catheter ablation for atrial fibrillation (AF).

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials (RCTs) comparing catheter ablation to medical treatment in AF patients.
  • Data from 18 RCTs involving 5877 patients were pooled to calculate relative risks and number needed to treat.
  • Quality of evidence was assessed using GRADE, with subgroup analyses performed on various patient and study characteristics.

Main Results:

  • Catheter ablation demonstrated a significant reduction in stroke risk (RR 0.63; P = .006) with a number needed to treat of 78.7.
  • Moderate quality evidence showed low heterogeneity (I² = 0) across studies.
  • Subgroup analyses indicated consistent stroke risk reduction, except in trials with less than one year of follow-up.

Conclusions:

  • Pooled data from high-quality RCTs suggest catheter ablation offers significant stroke risk reduction in AF patients.
  • While promising, a definitive answer requires a dedicated confirmatory trial.
Abstract

Keywords:
ArrhythmiaParoxysmalPercutaneous interventionPersistent and strokeRhythm control

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