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Diemberger I, Imberti JF, Spagni S, Rapacciuolo A, Curcio A, Attena E, Amadori M, De Ponti R, D’Onofrio A, Boriani G. Drug management of atrial fibrillation in light of guidelines and current evidence: an Italian Survey on behalf of Italian Association of Arrhythmology and Cardiac Pacing. J Cardiovasc Med (Hagerstown) 2023; 24:430-440. [PMID: 37222631 PMCID: PMC10319250 DOI: 10.2459/jcm.0000000000001501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/10/2023] [Accepted: 04/30/2023] [Indexed: 05/25/2023]
Abstract
AIM Atrial fibrillation is a multifaceted disease requiring personalized treatment, in accordance with current ESC guidelines. Despite a wide range of literature, we still have various aspects dividing the opinion of the experts in rate control, rhythm control and thromboembolic prophylaxis. The aim of this survey was to provide a country-wide picture of current practice regarding atrial fibrillation pharmacological management according to a patient's characteristics. METHODS Data were collected using an in-person survey that was administered to members of the Italian Association of Arrhythmology and Cardiac Pacing. RESULTS We collected data from 106 physicians, working in 72 Italian hospitals from 15 of 21 regions. Our work evidenced a high inhomogeneity in atrial fibrillation management regarding rhythm control, rate control and thromboembolic prophylaxis in both acute and chronic patients. This element was more pronounced in settings in which literature shows a lack of evidence and, consequently, the indications provided by the guidelines are weak or absent. CONCLUSION This National survey evidenced a high inhomogeneity in current approaches adopted for atrial fibrillation management by a sample of Italian cardiologist experts in arrhythmia management. Further studies are needed to explore if these divergences are associated with different long-term outcomes.
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Affiliation(s)
- Igor Diemberger
- Institute of Cardiology, Department of Medical and Surgical Sciences, University of Bologna, Policlinico S.Orsola-Malpighi, Bologna
- IRCCS Policlinico di S.Orsola, U.O.C. di Cardiologia
- Pharmacologic Area of AIAC (Associazione Italiana Aritmologia e Cardiostimolazione), Rome
| | - Jacopo Francesco Imberti
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia
- Pharmacologic Area of AIAC (Associazione Italiana Aritmologia e Cardiostimolazione), Rome
| | - Stefano Spagni
- Institute of Cardiology, Department of Medical and Surgical Sciences, University of Bologna, Policlinico S.Orsola-Malpighi, Bologna
| | - Antonio Rapacciuolo
- Department of Advanced Biomedical Science, University of Naples Federico II, Corso Umberto I 40, Naples
- Pharmacologic Area of AIAC (Associazione Italiana Aritmologia e Cardiostimolazione), Rome
| | - Antonio Curcio
- Pharmacologic Area of AIAC (Associazione Italiana Aritmologia e Cardiostimolazione), Rome
- Department of Medical and Surgical Sciences, University ‘Magna Graecia’ of Catanzaro, Catanzaro
| | - Emilio Attena
- Pharmacologic Area of AIAC (Associazione Italiana Aritmologia e Cardiostimolazione), Rome
- Cardiology Unit, Roccadaspide Hospital, ASL Salerno
| | - Martina Amadori
- Institute of Cardiology, Department of Medical and Surgical Sciences, University of Bologna, Policlinico S.Orsola-Malpighi, Bologna
| | - Roberto De Ponti
- Cardiovascular Department, Circolo Hospital, Università degli Studi dell’Insubria
| | - Antonio D’Onofrio
- Departmental Unit of Electrophysiology, Evaluation and Treatment of Arrhythmias, Monaldi Hospital, Naples, Italy
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena
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Massaro G, Spadotto A, Canovi L, Martignani C, Ziacchi M, Angeletti A, Galie N, Boriani G, Biffi M, Diemberger I. Prognostic value of renal failure in patients undergoing transvenous lead extraction: single centre experience and systematic review of the literature. Expert Rev Med Devices 2022; 19:905-913. [DOI: 10.1080/17434440.2022.2151360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Giulia Massaro
- Cardiology Unit, Cardio-Thoracic-Vascular Building, S.Orsola-Malpighi Policlinic, University of Bologna, Bologna, Italy
- Cardiology Division, IRCCS AOU di Bologna, Bologna, Italy
| | - Alberto Spadotto
- Cardiology Unit, Cardio-Thoracic-Vascular Building, S.Orsola-Malpighi Policlinic, University of Bologna, Bologna, Italy
- Cardiology Division, IRCCS AOU di Bologna, Bologna, Italy
| | - Luca Canovi
- Cardiovascular Institute, Ferrara University Hospital, Cona, Ferrara, Italy
| | - Cristian Martignani
- Cardiology Unit, Cardio-Thoracic-Vascular Building, S.Orsola-Malpighi Policlinic, University of Bologna, Bologna, Italy
- Cardiology Division, IRCCS AOU di Bologna, Bologna, Italy
| | - Matteo Ziacchi
- Cardiology Unit, Cardio-Thoracic-Vascular Building, S.Orsola-Malpighi Policlinic, University of Bologna, Bologna, Italy
- Cardiology Division, IRCCS AOU di Bologna, Bologna, Italy
| | - Andrea Angeletti
- Cardiology Unit, Cardio-Thoracic-Vascular Building, S.Orsola-Malpighi Policlinic, University of Bologna, Bologna, Italy
- Cardiology Division, IRCCS AOU di Bologna, Bologna, Italy
| | - Nazzareno Galie
- Cardiology Unit, Cardio-Thoracic-Vascular Building, S.Orsola-Malpighi Policlinic, University of Bologna, Bologna, Italy
- Cardiology Division, IRCCS AOU di Bologna, Bologna, Italy
| | - Giuseppe Boriani
- Cardiology Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Mauro Biffi
- Cardiology Unit, Cardio-Thoracic-Vascular Building, S.Orsola-Malpighi Policlinic, University of Bologna, Bologna, Italy
- Cardiology Division, IRCCS AOU di Bologna, Bologna, Italy
| | - Igor Diemberger
- Cardiology Unit, Cardio-Thoracic-Vascular Building, S.Orsola-Malpighi Policlinic, University of Bologna, Bologna, Italy
- Cardiology Division, IRCCS AOU di Bologna, Bologna, Italy
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Canaud B, Kooman J, Maierhofer A, Raimann J, Titze J, Kotanko P. Sodium First Approach, to Reset Our Mind for Improving Management of Sodium, Water, Volume and Pressure in Hemodialysis Patients, and to Reduce Cardiovascular Burden and Improve Outcomes. FRONTIERS IN NEPHROLOGY 2022; 2:935388. [PMID: 37675006 PMCID: PMC10479686 DOI: 10.3389/fneph.2022.935388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/07/2022] [Indexed: 09/08/2023]
Abstract
New physiologic findings related to sodium homeostasis and pathophysiologic associations require a new vision for sodium, fluid and blood pressure management in dialysis-dependent chronic kidney disease patients. The traditional dry weight probing approach that has prevailed for many years must be reviewed in light of these findings and enriched by availability of new tools for monitoring and handling sodium and water imbalances. A comprehensive and integrated approach is needed to improve further cardiac health in hemodialysis (HD) patients. Adequate management of sodium, water, volume and hemodynamic control of HD patients relies on a stepwise approach: the first entails assessment and monitoring of fluid status and relies on clinical judgement supported by specific tools that are online embedded in the HD machine or devices used offline; the second consists of acting on correcting fluid imbalance mainly through dialysis prescription (treatment time, active tools embedded on HD machine) but also on guidance related to diet and thirst management; the third consist of fine tuning treatment prescription to patient responses and tolerance with the support of innovative tools such as artificial intelligence and remote pervasive health trackers. It is time to come back to sodium and water imbalance as the root cause of the problem and not to act primarily on their consequences (fluid overload, hypertension) or organ damage (heart; atherosclerosis, brain). We know the problem and have the tools to assess and manage in a more precise way sodium and fluid in HD patients. We strongly call for a sodium first approach to reduce disease burden and improve cardiac health in dialysis-dependent chronic kidney disease patients.
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Affiliation(s)
- Bernard Canaud
- School of Medicine, Montpellier University, Montpellier, France
- Global Medical Office, Freseenius Medical Care (FMC)-France, Fresnes, France
| | - Jeroen Kooman
- Maastricht University Maastricht Medical Center (UMC), Maastricht University, Maastricht, Netherlands
| | - Andreas Maierhofer
- Global Research Development, Fresenius Medical Care (FMC) Deutschland GmbH, Bad Homburg, Germany
| | - Jochen Raimann
- Research Division, Renal Research Institute, New York, NY, United States
| | - Jens Titze
- Cardiovascular and Metabolic Disease Programme, Duke-National University Singapore (NUS) Medical School, Singapore, Singapore
| | - Peter Kotanko
- Research Division, Renal Research Institute, New York, NY, United States
- Nephrology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Boriani G, Iacopino S, Arena G, Pieragnoli P, Verlato R, Manfrin M, Molon G, Rovaris G, Curnis A, Perego GB, Dello Russo A, Landolina M, Vitolo M, Tondo C. Chronic Kidney Disease with Mild and Mild to Moderate Reduction in Renal Function and Long-Term Recurrences of Atrial Fibrillation after Pulmonary Vein Cryoballoon Ablation. J Cardiovasc Dev Dis 2022; 9:jcdd9050126. [PMID: 35621837 PMCID: PMC9147782 DOI: 10.3390/jcdd9050126] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/01/2022] [Accepted: 04/14/2022] [Indexed: 02/01/2023] Open
Abstract
The aim of this research was to evaluate if patients with chronic kidney disease (CKD) and mild or mild to moderate depression of renal function have an increased risk of atrial fibrillation (AF) recurrences after cryoballoon (CB) ablation. We performed a retrospective analysis of AF patients undergoing pulmonary vein isolation (PVI) by CB. The cohort was divided according to the KDIGO CKD-EPI classification into a (1) normal, (2) mildly decreased, or (3) mild to moderate reduction in estimated glomerular filtration rate (eGFR). Freedom from AF recurrences was the primary endpoint. A total of 1971 patients were included (60 ± 10 years, 29.0% females, 73.6% paroxysmal AF) in the study. Acute success and complication rates were 99.2% and 3.7%, respectively, with no significant differences among the three groups. After a follow-up of 24 months, AF recurrences were higher in the mildly and mild to moderate CKD groups compared to the normal kidney function group (23.4% vs. 28.3% vs. 33.5%, p < 0.05). Mild to moderate CKD was an independent predictor of AF recurrences after the blanking period (hazard ratio:1.38, 95% CI 1.02−1.86, p = 0.037). In conclusion, a multicenter analysis of AF patients treated with cryoablation revealed mild to moderate reductions in renal functions were associated with a higher risk of AF recurrences. Conversely, the procedural success and complication rates were similar in patients with normal, mildly reduced, or mild to moderate reduction in eGFR.
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Affiliation(s)
- Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41121 Modena, Italy;
- Correspondence:
| | - Saverio Iacopino
- Electrophysiology Unit, Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, Italy;
| | | | | | - Roberto Verlato
- ULSS 6 Euganea, Ospedale di Camposampiero-Cittadella, 35013 Cittadella, Italy;
| | | | - Giulio Molon
- IRCCS Sacro Cuore don Calabria, 37024 Negrar, Italy;
| | | | | | | | | | | | - Marco Vitolo
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41121 Modena, Italy;
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Claudio Tondo
- Department of Clinical Electrophysiology & Cardiac Pacing, Heart Rhythm Center, Monzino Cardiac Center IRCCS, 20122 Milan, Italy;
- Department of Biochemical, Surgical and Dentist Sciences, University of Milan, 20122 Milan, Italy
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Ding WY, Gupta D, Wong CF, Lip GYH. Atrial fibrillation in the presence of chronic kidney disease: To ablate or not to ablate. Int J Clin Pract 2021; 75:e14723. [PMID: 34670349 DOI: 10.1111/ijcp.14723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Wern Yew Ding
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Dhiraj Gupta
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Christopher F Wong
- Department of Renal Medicine, Liverpool University Hospital, Liverpool, UK
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
- Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Liu X, Wang D, Tang B, Lv X. The effect of concomitant chronic kidney disease on the recurrence of atrial fibrillation after catheter ablation: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e25903. [PMID: 34011057 PMCID: PMC8137086 DOI: 10.1097/md.0000000000025903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Some new trials have reported the effectiveness of chronic kidney disease on recurrence of atrial fibrillation following catheter ablation. Limited by small number of studies and insufficient outcomes, previous meta-analyses also failed to draw a consistent conclusion on this topic. We thus conducted a new meta-analysis to systematically analyze the effect of chronic kidney disease on recurrence of atrial fibrillation following catheter ablation. METHODS Two independent investigators followed The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines to conduct the present meta-analysis. From the inception to June 2021, the EMBASE, PubMed, Web of Science, and Cochrane Library electronic databases were searched using the key phrases "atrial fibrillation," "chronic kidney disease," "catheter ablation," "renal failure," "renal function," "renal insufficiency," "end-stage renal disease," and "dialysis" for all relevant English-language trials. Observational or randomized controlled trial focusing on assessing the effectiveness of chronic kidney disease on recurrence of atrial fibrillation following catheter ablation was included. P < .05 was set as the significance level. RESULTS Our hypothesis was that chronic kidney disease is associated with increased atrial fibrosis and a higher risk of arrhythmia recurrence and that restoration of normal rhythm through catheter ablation is associated with improved kidney function. REGISTRATION NUMBER 10.17605/OSF.IO/3WJAE.
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Affiliation(s)
- Xiaodong Liu
- Department of Cardiology, Rizhao Hospital of Traditional Chinese Medicine, Shandong
| | - Dapeng Wang
- Department of Cardiology, Rizhao Hospital of Traditional Chinese Medicine, Shandong
| | - Bo Tang
- Department of Cardiology, Rizhao Hospital of Traditional Chinese Medicine, Shandong
| | - Xiuying Lv
- Department of Emergency, Suzhou Municipal Hospital, Anhui, China
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Boriani G, Vitolo M, Diemberger I, Proietti M, Valenti AC, Malavasi VL, Lip GYH. Optimizing indices of AF susceptibility and burden to evaluate AF severity, risk and outcomes. Cardiovasc Res 2021; 117:1-21. [PMID: 33913486 PMCID: PMC8707734 DOI: 10.1093/cvr/cvab147] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/15/2021] [Accepted: 04/29/2021] [Indexed: 02/06/2023] Open
Abstract
Atrial fibrillation (AF) has heterogeneous patterns of presentation concerning symptoms,
duration of episodes, AF burden, and the tendency to progress towards the terminal step of
permanent AF. AF is associated with a risk of stroke/thromboembolism traditionally
considered dependent on patient-level risk factors rather than AF type, AF burden, or
other characterizations. However, the time spent in AF appears related to an incremental
risk of stroke, as suggested by the higher risk of stroke in patients with clinical AF vs.
subclinical episodes and in patients with non-paroxysmal AF vs. paroxysmal AF. In patients
with device-detected atrial tachyarrhythmias, AF burden is a dynamic process with
potential transitions from a lower to a higher maximum daily arrhythmia burden, thus
justifying monitoring its temporal evolution. In clinical terms, the appearance of the
first episode of AF, the characterization of the arrhythmia in a specific AF type, the
progression of AF, and the response to rhythm control therapies, as well as the clinical
outcomes, are all conditioned by underlying heart disease, risk factors, and
comorbidities. Improved understanding is needed on how to monitor and modulate the effect
of factors that condition AF susceptibility and modulate AF-associated outcomes. The
increasing use of wearables and apps in practice and clinical research may be useful to
predict and quantify AF burden and assess AF susceptibility at the individual patient
level. This may help us reveal why AF stops and starts again, or why AF episodes, or
burden, cluster. Additionally, whether the distribution of burden is associated with
variations in the propensity to thrombosis or other clinical adverse events. Combining the
improved methods for data analysis, clinical and translational science could be the basis
for the early identification of the subset of patients at risk of progressing to a longer
duration/higher burden of AF and the associated adverse outcomes.
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Affiliation(s)
- Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Marco Vitolo
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy.,Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Igor Diemberger
- Department of Experimental, Diagnostic and Specialty Medicine, Institute of Cardiology, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - Marco Proietti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinico Scientifici Maugeri, Milan, Italy
| | - Anna Chiara Valenti
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Vincenzo Livio Malavasi
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom.,Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Abstract
Incidence and prevalence of atrial fibrillation (AF) and chronic kidney disease are increasing, and the two conditions commonly coexist. Renal impairment further increases the risk of ischemic stroke and systemic thromboembolism in patients with AF but also paradoxically predisposes to bleeding. Renal function should be monitored closely in patients with AF requiring oral anticoagulation therapy, particularly those receiving direct oral anticoagulants. Vitamin K antagonists can be used as part of a dose-adjusted anticoagulation regimen in patients with mild to moderate renal dysfunction. Dialysis-dependent patients taking vitamin K antagonists are at increased risk of sustaining major hemorrhage.
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Affiliation(s)
- Maria Stefil
- Department of Cardiology, Royal Liverpool Hospital, Prescot Street, Liverpool, L7 8XP, UK; Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool L14 3PE, UK
| | - Katarzyna Nabrdalik
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool L14 3PE, UK; Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool L14 3PE, UK; Department of Internal Medicine, Diabetology and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland; Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
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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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Takahashi Y, Yamaguchi T, Fukui A, Otsubo T, Hirota K, Kawano Y, Nakashima K, Tahara M, Kitai T, Kawaguchi A, Takahashi N, Node K. Impact of Renal Dysfunction on Left Atrial Structural Remodeling and Recurrence After Catheter Ablation for Atrial Fibrillation ― A Propensity Score Matching Analysis ―. Circ J 2020; 84:1254-1260. [DOI: 10.1253/circj.cj-20-0149] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yuya Takahashi
- Department of Cardiovascular Medicine, Saga University
- Department of Cardiology, Saga-ken Medical Center Koseikan
| | - Takanori Yamaguchi
- Department of Cardiovascular Medicine, Saga University
- Department of Cardiology, Saga-ken Medical Center Koseikan
| | - Akira Fukui
- Department of Cardiology, Saga-ken Medical Center Koseikan
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Toyokazu Otsubo
- Department of Cardiovascular Medicine, Saga University
- Department of Cardiology, Saga-ken Medical Center Koseikan
| | - Kei Hirota
- Department of Cardiology, Saga-ken Medical Center Koseikan
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Yuki Kawano
- Department of Cardiology, Saga-ken Medical Center Koseikan
| | | | - Mai Tahara
- Department of Cardiovascular Medicine, Saga University
| | | | - Atsushi Kawaguchi
- Education and Research Center for Community Medicine, Faculty of Medicine, Saga University
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
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Atrial fibrillation and chronic kidney disease conundrum: an update. J Nephrol 2019; 32:909-917. [DOI: 10.1007/s40620-019-00630-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 07/10/2019] [Indexed: 12/15/2022]
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