Clinical outcomes after ablation and pacing therapy for atrial fibrillation - A meta-analysis

Article

关键词: QUALITY-OF-LIFE;    RADIOFREQUENCY CATHETER ABLATION;    ATRIOVENTRICULAR JUNCTION ABLATION;    LEFT-VENTRICULAR FUNCTION;    HIS-BUNDLE ABLATION;    CARDIAC-PERFORMANCE;    PHARMACOLOGICAL TREATMENT;    HEART-FAILURE;    SUDDEN-DEATH;    PACEMAKER;   

DOI  :  10.1161/01.CIR.101.10.1138

来源: SCIE

【 摘 要 】

Background-Radiofrequency ablation of the atrioventricular node and permanent pacing are used for symptomatic relief in patients with medically refractory atrial fibrillation. In this study, meta-analysis was used to clarify clinical outcomes and survival after ablation and pacing therapy using data from the published literature. Methods and Results-We used 21 studies with a total of 1181 patients in the meta-analysis. All patients had medically refractory atrial tachyarrhythmias, primarily atrial fibrillation (97%). Nineteen measures of clinical outcome, encompassing quality of life, ventricular function, exercise duration, and healthcare use, were derived from the studies. The meta-analysis demonstrated significant improvement after ablation and pacing therapy in all outcome measures except fractional shortening, which demonstrated a trend toward improvement (P=0.08). Ejection fraction did show significant improvement (P<0.001). The calculated 1-year total and sudden death mortality rates after ablation and pacing therapy were 6.3% and 2.0%, respectively. Conclusions-Ablation and pacing therapy improves a broad range of clinical outcomes for patients with medically refractory atrial fibrillation. The calculated 1-year mortality rates after this therapy are low and comparable with medical therapy.

【 授权许可】

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