{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T06:48:14Z","timestamp":1781765294237,"version":"3.54.5"},"reference-count":30,"publisher":"Sociedade Brasileira de Cardiologia","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Bras. Cardiol."],"abstract":"<jats:p>Resumo  Fundamento  Em pacientes com fibrila\u00e7\u00e3o atrial (FA) persistente, a realiza\u00e7\u00e3o do isolamento da parede posterior (IPP) al\u00e9m do isolamento das veias pulmonares (IVP) \u00e9 controversa.  Objetivo  Comparar IVP mais IPP versus IVP exclusivo em pacientes com FA persistente.  M\u00e9todos  Trata-se de uma revis\u00e3o sistem\u00e1tica conduzida nas bases de dados PubMed (MEDLINE), Embase, LILACS, CENTRAL (Cochrane Library), e Clinicaltrials.gov por ensaios cl\u00ednicos randomizados comparando IVP + IPP e IVP exclusivo e FA persistente. Os desfechos foram (i) recorr\u00eancia de FA; (ii) recorr\u00eancia de arritmias atriais, isto \u00e9, FA, taquicardia atrial, ou flutter atrial); (iii) complica\u00e7\u00f5es cl\u00ednicas importantes (isto \u00e9, derrame ou tamponamento peric\u00e1rdico; disfun\u00e7\u00e3o do n\u00f3 sinusal ou f\u00edstula atrioesof\u00e1gica); (iv) tempo m\u00e9dio de abla\u00e7\u00e3o. O risco de vi\u00e9s e a qualidade da evid\u00eancia foram avaliados usando a ferramenta Cochrane de avalia\u00e7\u00e3o de risco de vi\u00e9s (RoB 2.0) e o GRADE, respectivamente. A signific\u00e2ncia estat\u00edstica foi estabelecida em 5%, e an\u00e1lises por subgrupos e de sensibilidade foram realizadas.  Resultados  Foram inclu\u00eddos oito estudos e 1119 pacientes, dos quais 561 se submeteram a IVP+IPP. Durante o seguimento (12-24 meses), a recorr\u00eancia de FA foi significativamente diminu\u00edda com IPP adjuvante (RR 0,66; IC 95%; 0,44-0,98). O composto de arritmias atriais recorrentes n\u00e3o difere significativamente (RR 0,83, IC 95% 0,65- 1,06). As complica\u00e7\u00f5es cl\u00ednicas maiores (RR 0,81, IC95% 0,42-1,58) foram similares, e o IVP exclusivo foi associado a um tempo m\u00e9dio mais curto de procedimento (diferen\u00e7a m\u00e9dia -23,37 minutos, IC 95% -30,23, -16,50).  Conclus\u00e3o  O IPP adjuvante parece efetivo em melhorar FA recorrente, mas n\u00e3o a recorr\u00eancia de todas as arritmias atriais. O tempo de procedimento foi mais longo com IVP + IPP sem mudan\u00e7a significativa na seguran\u00e7a global. Mais estudos s\u00e3o necess\u00e1rios para investigar os benef\u00edcios em longo prazo.<\/jats:p>","DOI":"10.36660\/abc.20240472","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T13:59:41Z","timestamp":1738591181000},"source":"Crossref","is-referenced-by-count":1,"title":["Efic\u00e1cia e Seguran\u00e7a do Isolamento Adjuvante da Parede Posterior em Pacientes com Fibrila\u00e7\u00e3o Atrial Persistente: Uma Revis\u00e3o Sistem\u00e1tica e Metan\u00e1lise"],"prefix":"10.36660","volume":"122","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6926-0850","authenticated-orcid":false,"given":"Jo\u00e3o Vitor Levindo Coelho","family":"Novaes","sequence":"first","affiliation":[{"name":"Funda\u00e7\u00e3o Educacional Lucas Machado,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David de P\u00e1dua","family":"Brasil","sequence":"additional","affiliation":[{"name":"Universidade Federal de Lavras,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5895-9668","authenticated-orcid":false,"given":"Flavia Maria de Freitas","family":"Faria","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Educacional Lucas Machado,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isadora Soares Bicalho","family":"Garcia","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Educacional Lucas Machado,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8359-4548","authenticated-orcid":false,"given":"Camila Ribeiro","family":"Pimenta","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Educacional Lucas Machado,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0487-0500","authenticated-orcid":false,"given":"Nathalia Sernizon","family":"Guimar\u00e3es","sequence":"additional","affiliation":[{"name":"Universidade Federal de Minas Gerais,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8171-3920","authenticated-orcid":false,"given":"Marcus Vinicius Bolivar","family":"Malachias","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Educacional Lucas Machado,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"22636","published-online":{"date-parts":[[2025]]},"reference":[{"issue":"11","key":"ref1","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1093\/europace\/euw295","article-title":"2016 ESC Guidelines for the Management of Atrial Fibrillation Developed in Collaboration with EACTS","volume":"18","author":"Kirchhof P","year":"2016","journal-title":"Europace"},{"issue":"7","key":"ref2","doi-asserted-by":"crossref","first-page":"1857","DOI":"10.1111\/jce.14298","article-title":"Persistent Atrial 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