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Background: In this systematic review and meta‐analysis, we aimed to validate the predictive role of atrial fibrillation (AF) termination in long‐term arrhythmia recurrence. Method: Our search encompassed databases including MEDLINE, EMBASE, PubMed, and the Cochrane Library up to August 1, 2021. Three independent reviewers conducted screening and data extraction. The data included ablation strategy, recurrence mode, AF termination mode, numbers of patients, and recurrence cases in the termination and nontermination groups. The primary endpoint was the recurrence of atrial arrhythmia at long‐term follow‐up (≥ 12 months). Results: Our analysis included 22 publications, with 11 prospective studies being eligible for further meta‐analysis. Among these, 14 studies reported significantly lower rates of arrhythmia recurrence in the AF termination group compared to the nontermination group. Among seven studies involving 1114 patients that examined single procedure outcomes, the pooled estimated effect was RR 0.78 (95% CI 0.68–1.90) with an I2 value of 57%. Subgroup analysis focusing on termination mode as sinus rhythm yielded a pooled estimated effect of RR 0.74 (95% CI 0.59–0.92) with an I2 value of 47%. Additionally, analysis of seven studies involving 1433 patients for repeat procedures demonstrated a significant preference for the AF termination group (RR 0.83, 95% CI 0.71–0.97, I2 = 84%). Subgroup analysis indicated reduced heterogeneity when the termination mode was sinus rhythm (RR 0.68, 95% CI 0.51–0.90, I2 = 57%). Conclusion: Our study establishes that AF termination serves as an effective predictor for the success of persistent AF ablation procedures. This finding holds potential implications for clinical practice and contributes to our understanding of long‐term arrhythmia recurrence in the context of AF termination. [ABSTRACT FROM AUTHOR]

Background: There is limited available data regarding the impact of cycle length (CL) prolongation when converting atrial fibrillation (AF) to organized atrial tachycardia (AT) and its effect on clinical outcomes. Methods and Method: We retrospectively screened and included a cohort of 132 patients with persistent or long‐standing persistent AF who underwent circumferential pulmonary vein isolation (CPVI) and left atrial substrate modification (LASM) between January 2015 and October 2019. In all 132 consecutive patients, persistent AF was successfully converted into organized AT. For cases with recurrence after a 3‐month blanking period, a repeat procedure was conducted. Results: We observed a notable prolongation in CL after ablation (average increase of 56.6 ± 30 ms). Following a median follow‐up duration of 9.5 ± 5.1 months, 27 patients experienced recurrence. Through receiver operating curve (ROC) analysis, a prolonged CL cut‐off of 42.5 ms was identified, with a specificity of 71% and a sensitivity of 59.4%. Patients were categorized into two groups: those with CL less than 42.5 ms (group A, n = 48) and those with CL more than 42.5 ms (group B, n = 84). The Kaplan–Meier survival curves demonstrated a significantly higher recurrence‐free rate after catheter ablation in group B compared to group A (p = 0.002). Conclusions: Upon termination of persistent AF into AT during ablation, it was found that CL prolongation beyond 42.5 ms was associated with improved freedom from arrhythmia. [ABSTRACT FROM AUTHOR]