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Zwimpfer L, Aeschbacher S, Krisai P, Coslovsky M, Springer A, Paladini RE, Girod M, Hufschmid J, Knecht S, Badertscher P, Beer JH, Bonati LH, Zuern CS, Roten L, Reichlin T, Sticherling C, Conen D, Osswald S, Kühne M. Neurocognitive function in patients with atrial fibrillation undergoing pulmonary vein isolation. Front Cardiovasc Med 2022; 9:1000799. [PMID: 36505379 PMCID: PMC9732530 DOI: 10.3389/fcvm.2022.1000799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/11/2022] [Indexed: 11/27/2022] Open
Abstract
Background Atrial fibrillation (AF) is associated with cognitive dysfunction. However, neurocognitive function in AF patients undergoing pulmonary vein isolation (PVI) has not been well studied. The aim of this analysis is to compare neurocognitive function in patients who did or did not undergo PVI. Materials and methods We used data from the Swiss Atrial Fibrillation Cohort study (Swiss-AF), a prospective, observational, multicenter study in Switzerland. Patients with documented AF were enrolled and data of 1,576 patients without history of PVI and with complete information on PVI status and neurocognitive function were used. Information on PVI was collected at baseline and during 1 year of follow-up. Neurocognitive testing was performed at baseline and after 1 year of follow-up, using the Montreal Cognitive Assessment (MoCA), trail making test (TMT) A and B, digit symbol substitution test (DSST) and semantic fluency test (SFT). To investigate the association of PVI with neurocognitive function, we use propensity score matching (1:3) and inverse probability of treatment weighting (IPTW). Results The mean age of this population was 74 ± 8 years, 27.1% were women. Overall, 88 (5.5%) patients underwent PVI during 1 year of follow-up. Using ITPW (n = 1576), PVI was weakly associated with the MoCA score after adjusting for time since PVI, baseline MoCA score and other covariates (β (95%CI) 1.19 (0.05; 2.32), p = 0.04). In the propensity matched comparison (n = 352), there was no significant association between PVI and the MoCA score (β (95%CI) 1.04 (-0.19; 2.28), p = 0.1). There were no significant associations between PVI and cognitive function when using the TMT A and B, DSST or SFT independent of the method used. Conclusion In this population of AF patients, there was no consistent evidence of an association between PVI and neurocognitive function. Clinical trial registration [https://clinicaltrials.gov/], identifier [NCT02105844].
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Affiliation(s)
- Leon Zwimpfer
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland
| | - Stefanie Aeschbacher
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland
| | - Philipp Krisai
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland
| | - Michael Coslovsky
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland,Department of Clinical Research, University Hospital Basel, Basel, Switzerland
| | - Anne Springer
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland
| | - Rebecca E. Paladini
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland
| | - Marc Girod
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland
| | - Janik Hufschmid
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland
| | - Sven Knecht
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland
| | - Patrick Badertscher
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland
| | - Jürg H. Beer
- Department of Medicine, Cantonal Hospital of Baden and Molecular Cardiology, University Hospital of Zürich, Zürich, Switzerland
| | - Leo H. Bonati
- Department of Clinical Research, University Hospital Basel, Basel, Switzerland,Reha Rheinfelden, Department of Neurology, University Hospital Basel, University of Basel, Basel, Switzerland,Department of Neurology and Stroke Center, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Christine S. Zuern
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland
| | - Laurent Roten
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Tobias Reichlin
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christian Sticherling
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland
| | - David Conen
- Population Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - Stefan Osswald
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland
| | - Michael Kühne
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland,*Correspondence: Michael Kühne,
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Hafkamp FJ, Tio RA, Otterspoor LC, de Greef T, van Steenbergen GJ, van de Ven ART, Smits G, Post H, van Veghel D. Optimal effectiveness of heart failure management - an umbrella review of meta-analyses examining the effectiveness of interventions to reduce (re)hospitalizations in heart failure. Heart Fail Rev 2022; 27:1683-1748. [PMID: 35239106 PMCID: PMC8892116 DOI: 10.1007/s10741-021-10212-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 12/11/2022]
Abstract
Heart failure (HF) is a major health concern, which accounts for 1-2% of all hospital admissions. Nevertheless, there remains a knowledge gap concerning which interventions contribute to effective prevention of HF (re)hospitalization. Therefore, this umbrella review aims to systematically review meta-analyses that examined the effectiveness of interventions in reducing HF-related (re)hospitalization in HFrEF patients. An electronic literature search was performed in PubMed, Web of Science, PsycInfo, Cochrane Reviews, CINAHL, and Medline to identify eligible studies published in the English language in the past 10 years. Primarily, to synthesize the meta-analyzed data, a best-evidence synthesis was used in which meta-analyses were classified based on level of validity. Secondarily, all unique RCTS were extracted from the meta-analyses and examined. A total of 44 meta-analyses were included which encompassed 186 unique RCTs. Strong or moderate evidence suggested that catheter ablation, cardiac resynchronization therapy, cardiac rehabilitation, telemonitoring, and RAAS inhibitors could reduce (re)hospitalization. Additionally, limited evidence suggested that multidisciplinary clinic or self-management promotion programs, beta-blockers, statins, and mitral valve therapy could reduce HF hospitalization. No, or conflicting evidence was found for the effects of cell therapy or anticoagulation. This umbrella review highlights different levels of evidence regarding the effectiveness of several interventions in reducing HF-related (re)hospitalization in HFrEF patients. It could guide future guideline development in optimizing care pathways for heart failure patients.
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Affiliation(s)
| | - Rene A. Tio
- Netherlands Heart Network, Veldhoven, The Netherlands
- Catharina Hospital, Eindhoven, The Netherlands
| | - Luuk C. Otterspoor
- Netherlands Heart Network, Veldhoven, The Netherlands
- Catharina Hospital, Eindhoven, The Netherlands
| | - Tineke de Greef
- Netherlands Heart Network, Veldhoven, The Netherlands
- Catharina Hospital, Eindhoven, The Netherlands
| | | | - Arjen R. T. van de Ven
- Netherlands Heart Network, Veldhoven, The Netherlands
- St. Anna Hospital, Geldrop, The Netherlands
| | - Geert Smits
- Netherlands Heart Network, Veldhoven, The Netherlands
- Primary care group Pozob, Veldhoven, The Netherlands
| | - Hans Post
- Netherlands Heart Network, Veldhoven, The Netherlands
- Catharina Hospital, Eindhoven, The Netherlands
| | - Dennis van Veghel
- Netherlands Heart Network, Veldhoven, The Netherlands
- Catharina Hospital, Eindhoven, The Netherlands
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3
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Girod M, Coslovsky M, Aeschbacher S, Sticherling C, Reichlin T, Roten L, Rodondi N, Ammann P, Auricchio A, Moschovitis G, Kobza R, Badertscher P, Knecht S, Krisai P, Marugg A, Aebersold H, Hennings E, Serra-Burriel M, Schwenkglenks M, Zuern CS, Bonati LH, Conen D, Osswald S, Kühne M. Association of pulmonary vein isolation and major cardiovascular events in patients with atrial fibrillation. Clin Res Cardiol 2022; 111:1048-1056. [PMID: 35403852 PMCID: PMC9424150 DOI: 10.1007/s00392-022-02015-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 03/23/2022] [Indexed: 12/02/2022]
Abstract
Background Patients with atrial fibrillation (AF) face an increased risk of adverse cardiovascular events. Evidence suggests that early rhythm control including AF ablation may reduce this risk. Methods To compare the risks for cardiovascular events in AF patients with and without pulmonary vein isolation (PVI), we analysed data from two prospective cohort studies in Switzerland (n = 3968). A total of 325 patients who had undergone PVI during a 1-year observational period were assigned to the PVI group. Using coarsened exact matching, 2193 patients were assigned to the non-PVI group. Outcomes were all-cause mortality, hospital admission for acute heart failure, a composite of stroke, transient ischemic attack and systemic embolism (Stroke/TIA/SE), myocardial infarction (MI), and bleedings. We calculated multivariable adjusted Cox proportional-hazards models. Results Overall, 2518 patients were included, median age was 66 years [IQR 61.0, 71.0], 25.8% were female. After a median follow-up time of 3.9 years, fewer patients in the PVI group died from any cause (incidence per 100 patient-years 0.64 versus 1.87, HR 0.39, 95%CI 0.19–0.79, p = 0.009) or were admitted to hospital for acute heart failure (incidence per 100 patient-years 0.52 versus 1.72, HR 0.44, 95%CI 0.21–0.95, p = 0.035). There was no significant association between PVI and Stroke/TIA/SE (HR 0.94, 95%CI 0.52–1.69, p = 0.80), MI (HR 0.43, 95%CI 0.11–1.63, p = 0.20) or bleeding (HR 0.75, 95% CI 0.50–1.12, p = 0.20). Conclusions In our matched comparison, patients in the PVI group had a lower incidence rate of all-cause mortality and hospital admission for acute heart failure compared to the non-PVI group. ClinicalTrials.gov Identifier NCT02105844, April 7th 2014. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1007/s00392-022-02015-0.
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Affiliation(s)
- Marc Girod
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland
- Department of Cardiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Michael Coslovsky
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland
- Department of Cardiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
- Clinical Trial Unit Basel, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
| | - Stefanie Aeschbacher
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland
- Department of Cardiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Christian Sticherling
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland
- Department of Cardiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Tobias Reichlin
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Laurent Roten
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nicolas Rodondi
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Department of General Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Peter Ammann
- Department of Cardiology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Angelo Auricchio
- Division of Cardiology, Institute Cardiocentro Ticino, Lugano, Switzerland
| | - Giorgio Moschovitis
- Division of Cardiology, Ente Ospedaliero Cantonale, Regional Hospital of Lugano, Lugano, Switzerland
| | - Richard Kobza
- Department of Cardiology, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Patrick Badertscher
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland
- Department of Cardiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Sven Knecht
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland
- Department of Cardiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Philipp Krisai
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland
- Department of Cardiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Andrea Marugg
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland
- Department of Cardiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Helena Aebersold
- Epidemiology, Biostatistics, and Prevention Institute, University of Zürich, Zürich, Switzerland
| | - Elisa Hennings
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland
- Department of Cardiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Miquel Serra-Burriel
- Epidemiology, Biostatistics, and Prevention Institute, University of Zürich, Zürich, Switzerland
| | - Matthias Schwenkglenks
- Epidemiology, Biostatistics, and Prevention Institute, University of Zürich, Zürich, Switzerland
- Institute of Pharmaceutical Medicine, University of Basel, Basel, Switzerland
| | - Christine S Zuern
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland
- Department of Cardiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Leo H Bonati
- Department of Neurology and Stroke Center, University Hospital Basel, University of Basel, Basel, Switzerland
| | - David Conen
- Population Health Research Institute, McMaster University, Hamilton, Canada
| | - Stefan Osswald
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland
- Department of Cardiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Michael Kühne
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland.
- Department of Cardiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
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Abstract
AF and heart failure (HF) commonly coexist. Left atrial ablation is an effective treatment to maintain sinus rhythm (SR) in patients with AF. Recent evidence suggests that the use of ablation for AF in patients with HF is associated with an improved left ventricular ejection fraction and lower death and HF hospitalisation rates. We performed a systematic search of world literature to analyse the association in more detail and to assess the utility of AF ablation as a non-pharmacological tool in the treatment of patients with concomitant HF.
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Affiliation(s)
| | - Magdi Saba
- St George's, University of London, London, UK
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5
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Shi S, Jia Q, Shi J, Shi S, Yuan G, Hu Y. The efficacy and safety of amiodarone combined with beta-blockers in the maintenance of sinus rhythm for atrial fibrillation: A protocol for systematic review and network meta-analysis. Medicine (Baltimore) 2020; 99:e22368. [PMID: 32957413 PMCID: PMC7505403 DOI: 10.1097/md.0000000000022368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 08/22/2020] [Accepted: 08/26/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The high recurrence rate of atrial fibrillation (AF) after recovering sinus rhythm has always been a clinical problem. Despite the established and widespread use of antiarrhythmic drugs, which one is better for maintaining sinus rhythm is still controversial. This study aims to summarize the randomized controlled trials (RCTs) of amiodarone combined with beta blockers to maintain sinus rhythm in AF, and to determine an effective and safe intervention for the prevention of AF recurrence through network meta-analysis (NMA). METHODS AND ANALYSIS A comprehensive search of the RCTs comparing amiodarone with different beta-blockers to maintain sinus rhythm of AF patients will be conducted from the inception to December 2019 in the Cochrane Library, PubMed, Web of Science, EMBASE, Chinese Biomedical Literature Database (SinoMed), Chinese National Knowledge Infrastructure (CNKI), and WanFang database. The primary outcomes will be the recurrence of AF and frequency of embolization complications. The secondary outcomes will be the symptom improvements and adverse events. Risk of bias assessment of the included RCTs will be conducted according to the Cochrane collaboration's risk of bias tool. Pairwise meta-analyses and Bayesian network meta-analyses will be performed for all related outcome measures. GRADE will be used to evaluate the quality of evidence. RESULTS The results of this NMA will be published in a peer-reviewed journal. CONCLUSION This NMA may provide more recommendations for patients and researchers, such as which treatment is better for a particular case of AF, and what may be the hotspots for the future studies. PROSPERO REGISTRATION NUMBER The protocol for this NMA has been registered on PROSPERO under the number CRD42020164438.
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Affiliation(s)
- Shuqing Shi
- Cardiovascular Department, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Qiulei Jia
- Cardiovascular Department, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Jingjing Shi
- Cardiovascular Department, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Shuai Shi
- Cardiovascular Department, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Guozhen Yuan
- Cardiovascular Department, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuanhui Hu
- Cardiovascular Department, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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6
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Packer M. Methodological and Clinical Heterogeneity and Extraction Errors in Meta-Analyses of Catheter Ablation for Atrial Fibrillation in Heart Failure. J Am Heart Assoc 2019; 8:e013779. [PMID: 31625420 PMCID: PMC6898828 DOI: 10.1161/jaha.119.013779] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background Meta‐analyses are expected to follow a standardized process, and thus, they have become highly formulaic, although there is little evidence that such regimentation yields high‐quality results. Methods and Results This article describes the results of a critical examination of 14 published meta‐analyses of catheter ablation for atrial fibrillation in heart failure that were based on a nearly identical core set of 4 to 6 primary trials. Methodological issues included (1) the neglect of primary data or the failure to report any primary data; (2) the inaccurate recording of the number of randomized patients; (3) the lack of attention to data missingness or baseline imbalances; (4) the failure to contact investigators of primary trials for additional data; (5) the incorrect extraction of data, the misidentification of events, and the assignment of events to the wrong treatment groups; (6) the calculation of summary estimates based on demonstrably heterogenous data, methods of differing reliability, or unrelated end points; and (7) the development of conclusions based on sparse numbers of events or overly reliant on the results of 1 dominant trial. Conclusions These findings reinforce existing concerns about the methodological validity of meta‐analyses and their current status in the hierarchy of medical evidence, and they raise new questions about the process by which meta‐analyses undergo peer review by medical journals.
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Affiliation(s)
- Milton Packer
- Baylor Heart and Vascular Institute Baylor University Medical Center Dallas TX.,Imperial College London United Kingdom
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Moschonas K, Nabeebaccus A, Okonko DO, McDonagh TA, Murgatroyd FD, Dhillon P, Scott PA. The impact of catheter ablation for atrial fibrillation in heart failure. J Arrhythm 2019; 35:33-42. [PMID: 30805042 PMCID: PMC6373662 DOI: 10.1002/joa3.12115] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 07/30/2018] [Accepted: 08/01/2018] [Indexed: 01/20/2023] Open
Abstract
Atrial fibrillation (AF) commonly co‐exists with systolic heart failure (SHF) and its presence is associated with a worse prognosis. Despite this, a rhythm control approach using antiarrhythmic drugs (AADs) to reduce AF burden has demonstrated no prognostic benefit. Catheter ablation (AFA) is more effective than AADs at reducing AF burden. We performed a meta‐analysis to evaluate the impact of AFA on outcomes in SHF. Electronic databases were systematically searched. We included only randomized controlled trials that examined the impact of AFA on clinical outcomes in patients with SHF (LVEF <50%). We included studies with any ablation strategy that incorporated pulmonary vein isolation and any control group. Seven studies (n = 858) were included with a mean follow‐up of 6‐38 months. In comparison to controls, AFA was associated with significant reductions in all‐cause mortality (relative risk [RR] 0.52, P = 0.0009) and unplanned or heart failure hospitalization (RR 0.58, P < 0.00001). Compared to controls, AFA was also associated with significant improvements in LVEF (mean difference 6.30%, P < 0.00001), Minnesota Living with Heart Failure Questionnaire score (mean difference 9.58, P = 0.0003), 6‐minute walk distance (mean difference 31.78 m, P = 0.003) and VO2 max (mean difference 3.17, P = 0.003). However, major procedure‐related complications occurred in 2.4%‐15% of ablation patients. In patients with AF and SHF, catheter ablation has significant benefits. Further work is needed to establish the role of ablation in the routine treatment of SHF patients with AF. We performed a meta‐analysis evaluating the impact of catheter ablation in patients with atrial fibrillation and systolic heart failure. A total of 858 patients were included across seven studies. Compared to controls, ablation was associated with lower all‐cause mortality and hospitalizations, higher LVEF, and improved symptoms and physiologic parameters.
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Affiliation(s)
| | - Adam Nabeebaccus
- Department of Cardiology King's College Hospital NHS Foundation Trust London UK.,King's College London London UK
| | - Darlington O Okonko
- Department of Cardiology King's College Hospital NHS Foundation Trust London UK.,King's College London London UK
| | - Theresa A McDonagh
- Department of Cardiology King's College Hospital NHS Foundation Trust London UK.,King's College London London UK
| | - Francis D Murgatroyd
- Department of Cardiology King's College Hospital NHS Foundation Trust London UK.,King's College London London UK
| | - Para Dhillon
- Department of Cardiology King's College Hospital NHS Foundation Trust London UK.,King's College London London UK
| | - Paul A Scott
- Department of Cardiology King's College Hospital NHS Foundation Trust London UK.,King's College London London UK
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