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Posterior wall isolation (PWI) is an emerging approach in atrial fibrillation (AF) ablation, yet its efficacy remains controversial. This is the first meta‐analysis of randomized controlled trials (RCT) to evaluate the efficacy of PWI in AF ablation.

To assess the efficacy of PWI in reducing atrial arrhythmia recurrence following initial AF ablation at long‐term follow‐ups when compared to conventional methods.

We conducted a literature search from inception through September 2021 in EMBASE and MEDLINE databases. We included RCTs that compared outcomes in PWI and conventional approaches of AF ablation. Data from each study were combined using the random‐effects, generic inverse variance method of DerSimonian and Laird to calculate odds ratio (OR), and 95% confidence interval (CI).

Eight RCT from 2009 to 2020, including 1024 AF patients, were included. PWI …