Sixty-three studies were included in the RFA review (n=8,789): nine RCTs; 11 prospective comparative studies; 31 prospective single-arm studies; and 12 retrospective series. Seven RCTs had a Jadad score of 1 or 2 and two had a score of 3 or more. Nineteen studies provided level I or II evidence; others provided level III or IV evidence. Mean follow-up was 14 months (range two to 12 months).
Patients off AAD therapy: Single procedure success rate of catheter ablation (n=2,800, 31 arms) was 57% (95% CI 50% to 64%). Multiple/uncertain number procedure success rate (n=3,481; 34 arms) was 71% (95% CI 65% to 77%)
Patients on AAD therapy: Single procedure success rate of catheter ablation (n=4,786, 52 arms) was 72% (95% CI not reported). Multiple/uncertain number procedure success rate (n=3,562, 42 arms) was 77% (95% CI 73% to 81%).
Stratified analyses found that the outcomes of procedure and fluoroscopy times varied by technique. Procedure approach and use of additional technology did not show any major differences (further details were in the report).
Major complications occurred in 4.9% of patients.
Thirty-four studies were included in the AAD review (n=6,589): 24 RCTs; one non-randomised comparative study; and nine single-arm trials. Jadad scores were not reported. Twenty studies provided level I evidence, five gave level II and nine level III and IV. Mean follow-up was 12 months (range one to 48 months).
The overall success rate for all drug treatment groups (n=3,180, 32 arms) was 52% (95% CI 47% to 57%). Treatment success in the placebo arms (n=655, eight arms) was 24.9% (95% CI 15% to 34%). Further results for individual drugs were detailed in the report.
Adverse events occurred in 30% of patients; these were less severe than those seen with RFA.
The authors reported that there was significant heterogeneity of efficacy outcomes between RFA and AAD studies, but no details of statistics were reported