The impact of catheter ablation in congenital heart disease and atrial fibrillation: An updated meta-analysis.

BACKGROUND

Catheter ablation (CA) is a well-established therapy for Atrial Fibrillation (AF). However, the impact of CA on patients with AF and Congenital Heart Disease (CHD) remains unclear. Therefore, we performed a meta-analysis evaluating the safety and efficacy of CA in patients with CHD and AF.

METHODS

PubMed, Embase, Cochrane, and Clinical Trials databases were searched for studies evaluating the use of CA in patients with CHD and AF. The search included all records from the beginning of the database to September 2025. Our primary endpoints were AF recurrence and periprocedural complications. We reported the endpoints in proportion (%) and 95% confidence intervals (95% CI). Additionally, a prespecified subanalysis of Atrial Septal Defects (ASD) was performed.

RESULTS

We included 38 studies, comprising 1,657 patients, of whom 30.2% were female, with a mean age of 55.63 years. ASD was present in 31.6% of patients. The follow-up period ranged from 6 to 49 months. The recurrence rate of AF over a mean follow-up of 24.1 months was 27% (95% CI: 19.0 to 35.0%), and up to 12 months was 19% (95% CI: 14.0 to 24.0%). Moreover, there was a low periprocedural complication rate of 5.0% (95% CI: 2.0% to 7.0%). Our prespecified subanalysis for the ASD cohort had an AF recurrence of 18.0% (95% CI: 10 to 27.0%).

CONCLUSION

Our findings suggest that CA in patients with CHD and AF is effective and safe, with results similar to the general population.