{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:13:32Z","timestamp":1777418012369,"version":"3.51.4"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T00:00:00Z","timestamp":1733961600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012317","name":"UCL","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012317","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100019573","name":"BHF","doi-asserted-by":"publisher","award":["AA\/18\/6\/34223"],"award-info":[{"award-number":["AA\/18\/6\/34223"]}],"id":[{"id":"10.13039\/501100019573","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"NIHR","doi-asserted-by":"publisher","award":["NIHR129463"],"award-info":[{"award-number":["NIHR129463"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"NIHR","doi-asserted-by":"publisher","award":["UKRI\/ERC\/HORIZON 10103153"],"award-info":[{"award-number":["UKRI\/ERC\/HORIZON 10103153"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014013","name":"UK Research and Innovation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014013","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100018693","name":"UK government\u2019s Horizon Europe","doi-asserted-by":"publisher","award":["EP\/Z000211\/1"],"award-info":[{"award-number":["EP\/Z000211\/1"]}],"id":[{"id":"10.13039\/100018693","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Cavotricuspid isthmus (CTI) ablation is the current ablation treatment for typical atrial flutter (AFL). However, post-ablation atrial tachyarrhythmias, mostly in the form of atrial fibrillation (AF), are frequently observed after CTI ablation. We aimed to evaluate the effectiveness and safety of concomitant or isolated pulmonary vein isolation (PVI) in patients with typical AFL scheduled for ablation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Electronic databases (PubMED, EMBASE, Clinicaltrials.gov) were searched through July, 2024. Randomized controlled trials (RCTs) were eligible if comparing PVI \u00b1 CTI ablation vs. CTI alone. The primary outcomes were any sustained atrial arrhythmia, typical AFL relapse, and AF. Secondary outcomes were need for redo-ablation or antiarrhythmic drugs. Random-effects and fixed-effects meta-analyses were undertaken for each individual outcome. Seven RCTs, with a total of 902 patients, were included. Comparing to CTI ablation alone, PVI \u00b1 CTI was more effective in preventing atrial tachyarrhythmias [risk ratio (RR) = 0.57, 95% CI: 0.41\u20130.79, P = 0.0007, I2 = 50%, number needed to treat (NNT) = 4.1]. The results were driven mainly by a reduction of new onset\/recurrent AF (RR = 0.41, 95% CI: 0.27\u20130.61, P &amp;lt; 0.0001, I2 = 0%, NNT = 3.3), whereas there were no differences in typical AFL relapse (RR = 1.52, 95% CI: 0.63\u20133.66, P = 0.35, I2 = 9%). Major complication rate was low and comparable across groups, although uncomplicated pericardial effusion was higher in PVI \u00b1 CTI (1.8% vs. 0.0%, P = 0.04). Results were comparable for the sub-analysis of PVI alone vs. CTI ablation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In patients with typical AFL, PVI \u00b1 CTI ablation is more effective than CTI alone in reducing the atrial tachyarrhythmias and subsequent AF during follow-up, without affecting major complications rate. These results set the rationale for a well-designed, larger-scale RCT comparing both strategies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjopen\/oeae102","type":"journal-article","created":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T22:51:42Z","timestamp":1734043902000},"source":"Crossref","is-referenced-by-count":1,"title":["Impact of pulmonary vein isolation on atrial arrhythmias in patients with typical atrial flutter: systematic review and meta-analysis of randomized clinical trials"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6894-648X","authenticated-orcid":false,"given":"Daniel A","family":"Gomes","sequence":"first","affiliation":[{"name":"Department of Cardiology, Hospital de Santa Cruz, Unidade Local de Sa\u00fade de Lisboa Ocidental , 2790-134 Carnaxide ,","place":["Portugal"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita","family":"Reis 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,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8401-4033","authenticated-orcid":false,"given":"Peter","family":"Calvert","sequence":"additional","affiliation":[{"name":"Liverpool Heart & Chest Hospital NHS Foundation Trust , Liverpool L14 3PE ,","place":["UK"]},{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool , Liverpool L69 7TX ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1327-0424","authenticated-orcid":false,"given":"Amand Floriaan","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science, University College London , London WC1E 6DD ,","place":["UK"]},{"name":"Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centres, University of Amsterdam , 1105 AZ Amsterdam ,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhiraj","family":"Gupta","sequence":"additional","affiliation":[{"name":"Liverpool Heart & Chest Hospital NHS Foundation Trust , Liverpool L14 3PE ,","place":["UK"]},{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool , Liverpool L69 7TX ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1280-7042","authenticated-orcid":false,"given":"Serge","family":"Boveda","sequence":"additional","affiliation":[{"name":"Clinique Pasteur, Heart Rhythm Management Department , 31300 Toulouse ,","place":["France"]},{"name":"Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel , 1090 Jette ,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Adrag\u00e3o","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital de Santa Cruz, 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