{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T12:56:08Z","timestamp":1791982568149,"version":"4.4.0"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,7,7]],"date-time":"2020-07-07T00:00:00Z","timestamp":1594080000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pulmonary vein isolation (PVI) is the mainstay of catheter ablation (CA) for paroxysmal atrial fibrillation (AF). However, for persistent and long\u2010standing persistent AF, there are no established strategies to improve the success rate of CA. Despite studies indicating that prophylactic cavotricuspid isthmus (CTI) ablation provides no or limited incremental benefit in patients with AF, it is still routinely performed worldwide.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>We sought to examine whether CTI ablation for AF is associated with improvement in recurrence of all\u2010atrial arrhythmias, compared with PVI alone in patients with and without typical atrial flutter (AFL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review of PubMed, Cochrane, and Embase was performed for clinical studies including AF patients, reporting outcomes of CTI\u2009+\u2009PVI versus PVI alone. The primary efficacy endpoint was recurrence of all\u2010atrial arrhythmias.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five studies comprising 1400 patients undergoing CTI\u2009+\u2009PVI versus PVI alone were included; 1110 patients had AF without AFL, and 290 patients had coexistent AF and AFL. After a mean follow\u2010up of 14.4\u2009\u00b1\u20094.8 months, CTI\u2009+\u2009PVI was not associated with improvement in recurrence of all\u2010atrial arrhythmias when compared with PVI alone (risk ratio [RR]: 1.29; 95% confidence interval [CI]: 0.93\u20131.79;<jats:italic>p<\/jats:italic>\u2009=\u2009.13). In the subgroup analysis, there were no differences between both groups in patients with AF without AFL (RR: 1.55; 95% CI: 0.96\u20132.48; <jats:italic>p<\/jats:italic>\u2009=\u2009.07), and in patients with AF and AFL (RR: 0.91; 95% CI: 0.6\u20131.39; <jats:italic>p<\/jats:italic>\u2009=\u2009.68).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In AF patients, irrespective of the presence of typical AFL, additional CTI ablation is not associated with improvement in recurrence of all\u2010atrial arrhythmias, compared with PVI alone.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.14614","type":"journal-article","created":{"date-parts":[[2020,6,12]],"date-time":"2020-06-12T14:57:07Z","timestamp":1591973827000},"page":"1987-1995","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Cavotricuspid isthmus line in patients undergoing catheter ablation of atrial fibrillation with or without history of typical atrial flutter: A meta\u2010analysis"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6420-8669","authenticated-orcid":false,"given":"Jorge","family":"Romero","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Cardiac Arrhythmia Center Montefiore\u2010Einstein Center for Heart and Vascular Care  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6416-5910","authenticated-orcid":false,"given":"Kavisha","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Cardiac Arrhythmia Center Montefiore\u2010Einstein Center for Heart and Vascular Care  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3962-1248","authenticated-orcid":false,"given":"David","family":"Briceno","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Cardiac Arrhythmia Center Montefiore\u2010Einstein Center for Heart and Vascular Care  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1492-2693","authenticated-orcid":false,"given":"Dhanunjaya","family":"Lakkireddy","sequence":"additional","affiliation":[{"name":"Kansas City Heart Rhythm Institute HCA Midwest Health  Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7129-5550","authenticated-orcid":false,"given":"Mohamed","family":"Gabr","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Cardiac Arrhythmia Center Montefiore\u2010Einstein Center for Heart and Vascular Care  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0887-1700","authenticated-orcid":false,"given":"Juan C.","family":"Diaz","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Cardiac Arrhythmia Center Montefiore\u2010Einstein Center for Heart and Vascular Care  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5417-9777","authenticated-orcid":false,"given":"Isabella","family":"Alviz","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Cardiac Arrhythmia Center Montefiore\u2010Einstein Center for Heart and Vascular Care  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalvert","family":"Polanco","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Cardiac Arrhythmia Center Montefiore\u2010Einstein Center for Heart and Vascular Care  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico G.","family":"Della Rocca","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute at St. David's Medical Center  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prasant","family":"Mohanty","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute at St. David's Medical Center  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6601-944X","authenticated-orcid":false,"given":"Sanghamitra","family":"Mohanty","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute at St. David's Medical Center  Austin Texas 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