Impact of atrial fibrillation catheter ablation on mortality, stroke, and heart failure hospitalizations: A meta-analysis.
J Cardiovasc Electrophysiol
; 31(5): 1040-1047, 2020 05.
Article
em En
| MEDLINE
| ID: mdl-32115777
ABSTRACT
BACKGROUND:
The impact of atrial fibrillation catheter ablation (AFCA) on hard clinical endpoints remains controversial.OBJECTIVE:
Our aim was to conduct a random-effect model meta-analysis on efficacy data from high-quality large matched database/registry studies and randomized clinical trials. We compared long-term all-cause mortality, stroke, and hospitalization for heart failure in patients undergoing AFCA vs patients treated with medical therapy alone (rhythm and/or rate control medications) in a general AF population. METHODS ANDRESULTS:
PubMed/MEDLINE and Embase databases were screened and a total of nine studies were selected (one randomized clinical trial-CABANA-and eight large matched population studies). A total of 241 372 patients (27 711 in the ablation group, 213 661 in the nonablation group) were included. After a median follow-up of 3.5 years, AFCA decreased the risk of mortality (hazard ratio [HR], 0.62; 95% confidence interval [CI], 0.54-0.72; I2 = 54%; number needed to treat [NNT] = 28), stroke (HR, 0.63; 95% CI, 0.56-0.70; I2 = 23%; NNT = 59) and hospitalization for heart failure (HR, 0.64; 95% CI, 0.51-0.80; I2 = 28%; NNT = 33) compared with AF patients treated with medical therapy alone.CONCLUSION:
Based on the currently available efficacy and effectiveness evidence, AFCA significantly reduces the risk of death, stroke, and hospitalization compared with medical therapy alone.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fibrilação Atrial
/
Ablação por Cateter
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Acidente Vascular Cerebral
/
Frequência Cardíaca
/
Antiarrítmicos
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Cardiovasc Electrophysiol
Assunto da revista:
ANGIOLOGIA
/
CARDIOLOGIA
/
FISIOLOGIA
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Itália