Meta-analysis of medical management versus catheter ablation for atrial fibrillation

Mao, Yin-Jun; Wang, Hang; Chen, Jianxing; Huang, Pinfang

doi:10.31083/j.rcm.2020.03.60

Cited by 9 publications

(15 citation statements)

References 62 publications

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“…Additionally, Mao et al 25 18 reported no statistically significant difference in procedure success rates after cryoablation between patients with paroxysmal AF and persistent AF (52% vs. 41%, p = .36).…”

Section: Publication Bias and Sensitivity Analysismentioning

confidence: 96%

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Cryoballoon ablation for atrial fibrillation in patients with heart failure and reduced left ventricular ejection fraction: A systematic review and meta‐analysis

Taha,

Hendi,

Elwekel

et al. 2023

Clinical Cardiology

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The coexistence of atrial fibrillation (AF) with heart failure (HF) is prevalent, leading to severe complications. This review aimed to investigate the success rate and efficacy of cryoballoon ablation (CBA) by measuring the improvement in the New York Heart Association (NYHA) classification and the effect on the left ventricular systolic function in patients with AF accompanied by heart failure with reduced ejection fraction (HFrEF). Electronic databases search included PubMed, Web of Science, and Scopus in January 2023. Outcomes addressed the following: left ventricular ejection fraction (LVEF) improvement, AF recurrence, NYHA classification improvement, and mortality. STATA 17.0 software was used for data analysis. The effect size for the studies was a standard mean difference (SMD) with a 95% confidence interval (CI) for outcomes. Proportion analysis with 95% CI was used for freedom from early AF and AF after 2 years and all‐cause death. We included six studies, including 1699 HF patients with 365 HFrEF patients. The SMD of postoperative LVEF compared to preoperative LVEF in HFrEF was 0.99 ([95% CI: 0.60, 1.39], p = .00), and for NYHA was −1.12 ([95% CI: −1.36, −0.87], p = .00). The analysis results in HFrEF patients for freedom from AF after 1 year was 65% ([95% CI: 0.55, 0.75], and after 2 years was 39% ([95% CI: 0.10, 0.67]). Proportional analysis was conducted for all‐cause death, resulting in 3% mortality ([95% CI: −0.01, 0.07]). Cryoablation of AF accompanied by HFrEF appeared safe as it reduced AF recurrence and enhanced clinical outcomes.

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Section: Publication Bias and Sensitivity Analysismentioning

confidence: 96%

“…However, all studies included in the AlTurki review were randomized controlled trials, different from our approach, and used mainly single-arm studies. Mao et al 25 supported using CA to reduce mortality.…”

Section: Publication Bias and Sensitivity Analysismentioning

confidence: 99%

Cryoballoon ablation for atrial fibrillation in patients with heart failure and reduced left ventricular ejection fraction: A systematic review and meta‐analysis

Taha,

Hendi,

Elwekel

et al. 2023

Clinical Cardiology

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“…Catheter ablation, surgical ablation, and hybrid therapy have all been proposed as treatments for AF, but they vary in efficacy and accessibility. In recent years, transvenous catheter ablation of pulmonary vein isolation (PVI) has been the treatment of choice for symptomatic patients who require rhythm control and fail antiarrhythmic drug therapy (30)(31)(32)(33).…”

Section: Catheter and Surgical Ablationmentioning

confidence: 99%

Nano drugs delivery system: A novel promise for the treatment of atrial fibrillation

Wang

Tong

et al. 2022

Front. Cardiovasc. Med.

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Atrial fibrillation (AF) is one of the most common sustained tachyarrhythmias worldwide, and its prevalence is positively correlated with aging. AF not only significantly reduces the quality of life of patients but also causes a series of complications, such as thromboembolism, stroke, and heart failure, increases the average number of hospitalizations of patients, and places a huge economic burden on patients and society. Traditional drug therapy and ablation have unsatisfactory success rates, high recurrence rates, and the risk of serious complications. Surgical treatment is highly traumatic. The nano drug delivery system has unique physical and chemical properties, and in the application of AF treatment, whether it is used to assist in enhancing the ablation effect or for targeted therapy, it provides a safer, more effective and more economical treatment strategy.

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“…However, there is still recurrence or thromboembolic events (TEs) in patients with AF after CA. 6 Thromboembolic complications are the main cause of death and disability in AF. 7 Although anticoagulant therapy reduces the incidence of thromboembolism, 8 it also has its limitations.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Catheter Ablation Combined with Left Atrial Appendage Closure in the Treatment of Atrial Fibrillation: A Systematic Review and Meta-Analysis

Wang

Jiang²,

Xie

et al. 2022

Anatolian J Cardiol

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Background Catheter ablation combined with left atrial appendage closure is effective in treating atrial fibrillation. However, the effectiveness of this combined treatment compared with catheter ablation alone is still controversial. Methods We searched studies in databases, including The Cochrane Library, PubMed, EMBASE, and Web of Science, that compared catheter ablation combined with left atrial appendage closure and catheter ablation alone in the treatment of atrial fibrillation. These studies reported at least one of the following outcomes: the freedom from atrial arrhythmia rate, the procedure time, the fluoroscopy time, perioperative complications, thromboembolic events, and bleeding events during follow-up. The risk ratio and standard mean difference with 95% CI were analyzed by the random-effects model. Results Five studies involving 699 people were included in our meta-analysis. We found no significant difference in the freedom from atrial arrhythmia rate (risk ratio = 0.93, 95% CI = 0.83-1.04, I 2 = 0%, P = .21) between the 2 groups. Catheter ablation combined with left atrial appendage closure showed significantly longer procedure and fluoroscopy times than catheter ablation alone (standard mean difference = 1.26, 95% CI = 0.85-1.67, P < .00001 and standard mean difference = 1.19, 95% CI = 0.53-1.85, P = .0004, respectively). With regard to safety outcomes, no significant differences were observed in perioperative complications (RR = 1.62, 95% CI = 0.99-2.63, I 2 = 0%, P = .05), thromboembolic events (RR = 0.67, 95% CI = 0.15-3.11, I 2 = 0%, P = .61), or bleeding events (RR = 0.67, 95% CI = 0.11-3.88, P = .65) between the 2 groups during follow-up. Conclusion The freedom from atrial arrhythmia rate and safety outcomes of catheter ablation combined with left atrial appendage closure are similar to those of catheter ablation alone. Catheter ablation combined with left atrial appendage closure appears to have longer procedure and fluoroscopy times than catheter ablation alone.

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Meta-analysis of medical management versus catheter ablation for atrial fibrillation

Cited by 9 publications

References 62 publications

Cryoballoon ablation for atrial fibrillation in patients with heart failure and reduced left ventricular ejection fraction: A systematic review and meta‐analysis

Cryoballoon ablation for atrial fibrillation in patients with heart failure and reduced left ventricular ejection fraction: A systematic review and meta‐analysis

Nano drugs delivery system: A novel promise for the treatment of atrial fibrillation

Efficacy and Safety of Catheter Ablation Combined with Left Atrial Appendage Closure in the Treatment of Atrial Fibrillation: A Systematic Review and Meta-Analysis

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