The Long-Term Outcomes of Ablation With Vein of Marshall Ethanol Infusion vs. Ablation Alone in Patients With Atrial Fibrillation: A Meta-Analysis

Li, Feng; Sun, Jin-Yu; Wu, Li-Da; Zhang, Lei; Qu, Qiang; Wang, Chao; Qian, Lingling; Wang, Ruxing

doi:10.3389/fcvm.2022.871654

Cited by 15 publications

(12 citation statements)

References 42 publications

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“…[20] with twenty-six studies including a total of 57,993 patients suggested that male gender, chronice kidney disease, previous myocardial infarction, native QRS duration, and paced QRS duration were identified to be the most important risk factors for pacing induced cardiomyopathy. Moreover, our previous studies also revealed that high-volume center (also meant a high sample size for a key technique) representing a relatively advanced operational team, was significantly associated with a better effacacy and comparable safety[7, 21]. Whereas, very few studies have reported the potential risk factors for the potential pacing induced new-onset AF.…”

Section: Discussionmentioning

confidence: 99%

Conduction system pacing is superior to reduce the new-onset atrial fibrillation risk compared with right ventricular pacing: insights from pooled clinical evidence

Li,

Zhang,

Peng

et al. 2024

Preprint

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BackgroundConduction system pacing (CSP) has been reported to improve clinical outcomes in comparison of right ventricular pacing (RVP). However, the performance between CSP and RVP on the risk of new-onset atrial fibrillation (AF) remains elusive.MethodsFour online databases were systematically searched up to December 1st2023. Studies comprising the rate/risk of new-onset AF between CSP and RVP group were included. Subgroup analysis was performed to screen the potential determinants for the new-onset AF risk for CSP therapy. Moreover, the pooled risk of new-onset AF based on ventricular pacing burden (Vp) between CSP and RVP group were evaluated.ResultsA total of five studies including 1,491 patients requiring pacing therapy were eligible. The pooled new-onset AF rates for CSP and RVP group were 0.09 and 0.26, respectively. Compared with RVP group, CSP group showed a lower pooled risk (risk ratio [RR] 0.38,P=0.000) and adjusted risk (hazard ratio [HR] 0.33,P=0.000) of new-onset AF. Meanwhile, a significant intervention-covariate interaction for the adjusted risk of new-onset AF between CSP and RVP group was identified with Vp < 20% and Vp ≥ 20%.ConclusionsOur study suggests that CSP is superior to reduce the new-onset atrial fibrillation risk compared with RVP. The Vp ≥ 20% may be the key determinant on the lower risk of new-onset AF with CSP therapy.

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Section: Discussionmentioning

confidence: 99%

Conduction system pacing is superior to reduce the new-onset atrial fibrillation risk compared with right ventricular pacing: insights from pooled clinical evidence

Li,

Zhang,

Peng

et al. 2024

Preprint

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“…Furthermore, a randomized study demonstrated reduced rates of recurrent AT (and AF) on follow-up in those receiving adjunct VoM ethanol infusion during ablation for persistent AF (41), with peri-mitral block identified as a significant determinant of outcome (42). A recently published meta-analysis of the technique confirmed these findings with greater freedom from recurrent AT and AF with adjunct VoM ethanol infusion compared with ablation alone in patients with AF (43). Epicardial connections across roof lines utilizing the septopulmonary bundle, which again may be insulated by fat, have been demonstrated to be a common cause of failure to achieve roof line block (44).…”

Section: Epicardial Connections and Novel Techniquesmentioning

confidence: 91%

Atrial tachycardia occurring after a prior atrial fibrillation ablation procedure: Does non-inducibility matter?

O’Neill

Becker

Smet

et al. 2022

Front. Cardiovasc. Med.

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Recurrent atrial tachycardia (AT) is a common phenomenon after catheter ablation for AF, particularly in the setting of additional substrate ablation, with many studies demonstrating gap-related macro re-entrant AT (predominantly mitral and roof dependent) to be the dominant mechanism. Although multiple inducible ATs after ablation of the clinical AT are commonly described at repeat procedures, the optimal ablation strategy, and procedural endpoints are unclear in this setting. A recent randomized study addressing the question of non-inducibility as a procedural endpoint demonstrated no additional benefits to the ablation of all induced, non-clinical ATs, but it was limited by small numbers and high rates of non-inducibility. Nevertheless, once ablation of the clinical AT has been successfully performed, ensuring durable linear block and PV isolation may be sufficient for the prevention of further AT. Durable linear block, particularly at the mitral isthmus, is difficult to achieve but may be facilitated by the real-time evaluation of lesion quality and contiguity and the novel technique of vein of Marshall ethanol infusion. Large-scale, randomized trials are needed, nonetheless, to fully assess the optimal ablation strategy in the setting of recurrent AT post-AF ablation.

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“…A subgroup analysis was also performed according to our previous reported methods 13 . A total of seven confounding factors were screened, including study region (Asian and non‐Asian), numbers of patients with diabetes (≥10 000 and < 10 000), age (≥60 years and < 60 years), gender (≥50% male and <50% male), types of diabetes (type 2 diabetes and type 1 diabetes), adjustment of diabetes duration (Yes and No), adjustment of baseline HbA1c (Yes and No), and follow‐up time (≥5 years and <5 years).…”

Section: Methodsmentioning

confidence: 99%

Higher glucose fluctuation is associated with a higher risk of cardiovascular disease: Insights from pooled results among patients with diabetes

Zhang

Shen

et al. 2023

Journal of Diabetes

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Background The relationship between glucose fluctuation and the risk of cardiovascular disease (CVD) in patients with diabetes remains elusive. Glycated hemoglobin (HbA1c) variability is a key parameter of glucose fluctuation. Methods PubMed, Cochrane Library, Web of Science, and Embase were searched up to 1 July 2022. Studies reporting associations of HbA1c variability (HbA1c‐SD), coefficient of variation of HbA1c (HbA1c‐CV), and HbA1c variability score [HVS] with the risk of CVD among patients with diabetes were included. We used three different insights (a high‐low value meta‐analysis, a study‐specific meta‐analysis, and a non‐linear dose–response meta‐analysis) to explore the relationship between HbA1c variability and CVD risk. A subgroup analysis was also performed to screen the potential confounding factors. Results A total of 14 studies with 254 017 patients with diabetes were eligible. The highest HbA1c variability was significantly associated with increased risks of CVD (HbA1c‐SD, risk ratio [RR] 1.45; HbA1c‐CV, RR 1.74; HVS, RR 2.46; all p < .001) compared to the lowest HbA1c variability. The RRs of CVD for per HbA1c variability were significantly >1 (all p < .001). The subgroup analysis for per HbA1c‐SD found a significant exposure‐covariate interaction in the types of diabetes ( p = .003 for interaction). The dose–response analysis showed a positive association between HbA1c‐CV and CVD risk ( P for nonlinearity <.001). Conclusions Our study suggests that the higher glucose fluctuation is significantly associated with the higher CVD risk in diabetes patients based on HbA1c variability. The CVD risk associated with per HbA1c‐SD might be higher among patients type 1 diabetes than patients with type 2 diabetes.

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The Long-Term Outcomes of Ablation With Vein of Marshall Ethanol Infusion vs. Ablation Alone in Patients With Atrial Fibrillation: A Meta-Analysis

Cited by 15 publications

References 42 publications

Conduction system pacing is superior to reduce the new-onset atrial fibrillation risk compared with right ventricular pacing: insights from pooled clinical evidence

Conduction system pacing is superior to reduce the new-onset atrial fibrillation risk compared with right ventricular pacing: insights from pooled clinical evidence

Atrial tachycardia occurring after a prior atrial fibrillation ablation procedure: Does non-inducibility matter?

Higher glucose fluctuation is associated with a higher risk of cardiovascular disease: Insights from pooled results among patients with diabetes

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