Impact of the left common ostium following pulmonary vein isolation in AF: Systematic review and meta-analysis.
J Arrhythm
; 38(3): 287-298, 2022 Jun.
Article
in En
| MEDLINE
| ID: mdl-35785389
ABSTRACT
Purpose:
Pulmonary vein isolation (PVI) through catheter ablation is the basis for the treatment of atrial fibrillation (AF). The left common ostium (LCO) is a high prevalence anatomical variation and has conflicting results in the effects on the prognosis following ablation. We undertook a systematic review and meta-analysis of studies that compared the arrhythmia recurrence rate after radiofrequency ablation or cryoablation balloon between patients with normal pattern pulmonary vein and patients with LCO. Methods andResults:
Results were pooled using a fixed or random effect, at the discretion of heterogeneity (>25%), in addition, we associated subgroup analysis in these cases and when clinically indicated. Fourteen non-randomized studies totaling 3278 patients were included. In analyses using the two energies all patients OR 1.01 (95% CI 0.84-1.23; P = .90, I 2 = 67%) and excluding patients with any type of persistent AF (PeAF) and those submitted to linear atrial lesion (LAL) OR 0.80 (95% CI 0.52-1.22; P = .30, I 2 = 71%). Using CRYO all patients OR 1.34 (95% CI 1.03-1.74; P = .03, I 2 = 0%). Using RF all patients-OR 0.55 (95% CI 0.32-0.95; P = .03, I 2 = 49%); excluding studies with long duration PeAF and the performance of LAL concomitant-OR 0.45 (95% CI 0.23-0.91; P = .03, I 2 = 44%).Conclusion:
The results suggest a better prognosis in patients with LCO, submitted to PVI without additional LAL under RF energy in paroxysmal AF and short-duration PeAF. In patients undergoing CRYO, the presence of LCO suggests a worse prognosis.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Type of study:
Clinical_trials
/
Risk_factors_studies
/
Systematic_reviews
Language:
En
Journal:
J Arrhythm
Year:
2022
Document type:
Article