Catheter ablation vs medical therapy for treatment of atrial fibrillation patients with heart failure with preserved ejection fraction: a systematic review and meta-analysis
| العنوان: | Catheter ablation vs medical therapy for treatment of atrial fibrillation patients with heart failure with preserved ejection fraction: a systematic review and meta-analysis |
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| المؤلفون: | H Jiang, H Y Su, V H Tan, C Yeo |
| المصدر: | European Heart Journal. 44 |
| بيانات النشر: | Oxford University Press (OUP), 2023. |
| سنة النشر: | 2023 |
| مصطلحات موضوعية: | Cardiology and Cardiovascular Medicine |
| الوصف: | Funding Acknowledgements Type of funding sources: None. Introduction Catheter ablation (CA) is used as a treatment option in selected patients with atrial fibrillation (AF) and heart failure with reduced ejection fraction (HFrEF) as studies have shown that it reduces heart failure (HF) hospitalization, improves survival, and reduces rates of AF recurrence when compared to medical therapy. However, it is not known whether this benefit persists in patients with heart failure with preserved ejection fraction (HFpEF). Purpose The aim of this meta-analysis is to compare CA versus medical therapy in patients with AF and HFpEF Methods MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials were searched from August 2012 to August 2022. All randomized controlled trials (RCTs), propensity score matched (PSM) studies, and observational studies including conference abstracts providing outcomes in patients with HFpEF and AF after CA were included. Outcomes examined include all-cause mortality, HF hospitalizations, and AF recurrence. A random-effects model using R statistical software was used to calculate odds ratios (OR) and 95% confidence intervals (CI). Results Of 3151 studies screened, 8 studies (1 RCT, 4 PSM, 3 observational) were included with a pooled population of 2171 and 24087 patients with AF and HFpEF who underwent CA and medical therapy respectively. There were no significant differences in baseline age (70.6 vs 70.7, p = 0.16), proportion of hypertension (85.0% vs 86.4%, p = 0.58), diabetes (33.8% vs 35.8%, p = 0.39), coronary artery disease (40.2% vs 41.8%, p = 0.06), or men (42.3 vs 36.6%, p = 0.42). After a mean weighted follow-up of 9.45 months, there was no significant difference in all-cause mortality (OR 0.77 [0.47-1.26], p = 0.07), HF hospitalizations (OR 0.44 [0.18-1.08], p = 0.22), but a significantly lower rate of AF recurrence (OR 0.22 [0.09-0.54], p = 0.001) associated with CA. Conclusion In patient with HFpEF, CA significantly reduced AF recurrence compared with medical therapy but with no difference in mortality or HF hospitalization. CA continues to have an important role to play in treatment of AF even in HFpEF patients. |
| تدمد: | 1522-9645 0195-668X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::aef9eb5808eb9cf5ddcbbe84934f90b0 https://doi.org/10.1093/eurheartj/ehac779.020 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi...........aef9eb5808eb9cf5ddcbbe84934f90b0 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15229645 0195668X |
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