Atrial Fibrillation Recurrence Post-Ablation Across Heart Failure Categories: A Systematic Review and Meta-analysis.

IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiology Research Pub Date : 2025-02-01 Epub Date: 2025-01-21 DOI:10.14740/cr2020

Carl Hashem, Jacob Joseph, Scott Kinlay, Adelqui O Peralta, Peter S Hoffmeister, Matthew F Yuyun

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引用次数: 0

Abstract

Background: Previous studies have provided evidence of reduced recurrence of atrial fibrillation (AF), all-cause mortality, and heart failure (HF) hospitalizations after catheter ablation (CA) in both HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). Aggregate data comparing the efficacy of AF ablation and clinical endpoints in HF with mildly reduced ejection fraction (HFmrEF) to HFrEF and HFpEF are lacking.

Methods: We conducted a systematic review and meta-analysis aimed at determining any differences in AF recurrence rate, all-cause mortality, and HF hospitalizations among patients with HFrEF, HFmrEF, and HFpEF who underwent AF ablation. A systematic search of PubMed/MEDLINE, Embase, and Cochrane Library databases was performed until October 31, 2023.

Results: A total of seven studies comprising 3,795 patients were retained: HFrEF 1,281 (33.8%), HFmrEF 870 (22.9%), and HFpEF 1,644 (43.3%). After median follow-up of 24 months, there was no significant difference in rate of AF recurrence between the three HF categories: HFrEF 40% (30-49%), HFmrEF 35% (28-43%); and HFpEF 35% (25-45%). Only two studies which included outcomes in the three HF categories were identified. Pooled hazard ratio (HR) of all-cause mortality and HF hospitalization combined after ablation or other rhythm control compared to other conservative management were: HFrEF 0.77 (0.63 - 0.94); HFmrEF 0.81 (0.55 - 1.20); and HFpEF 0.74 (0.55 - 1.00).

Conclusions: CA has similar efficacy in the long-term resolution of AF among patients with HFrEF, HFmrEF, and HFpEF. Further studies are needed to provide a robust analysis on the potential impact of CA on all-cause mortality.

查看原文本刊更多论文

心力衰竭类别消融后房颤复发：系统回顾和荟萃分析。

背景：先前的研究已经提供了证据，证明在射血分数降低的HF （HFrEF）和保留射血分数的HF （HFpEF）中，导管消融（CA）后房颤（AF）复发、全因死亡率和心力衰竭（HF）住院的发生率降低。比较房颤消融对射血分数轻度降低（HFmrEF）与HFrEF和HFpEF的疗效和临床终点的综合数据缺乏。方法：我们进行了一项系统回顾和荟萃分析，旨在确定HFrEF、HFmrEF和HFpEF患者接受房颤消融后房颤复发率、全因死亡率和房颤住院率的差异。系统检索PubMed/MEDLINE、Embase和Cochrane图书馆数据库，直至2023年10月31日。结果：共有7项研究，包括3,795名患者：HFrEF 1,281 (33.8%), HFmrEF 870（22.9%）和HFpEF 1,644（43.3%）。中位随访24个月后，三种HF类型之间的房颤复发率无显著差异：HFrEF 40% (30-49%), HFmrEF 35% (28-43%)；HFpEF 35%（25-45%）。只有两项研究纳入了三种心力衰竭类型的结果。与其他保守治疗相比，消融或其他心律控制后全因死亡率和HF住院合并的合并风险比（HR）为：HFrEF 0.77 (0.63 - 0.94)；HFmrEF 0.81 (0.55 ~ 1.20)；HFpEF为0.74（0.55 - 1.00）。结论：CA对HFrEF、HFmrEF和HFpEF患者房颤的长期缓解效果相似。需要进一步的研究来对CA对全因死亡率的潜在影响进行强有力的分析。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiology Research CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

2.50

自引率

0.00%

发文量

期刊介绍： Cardiology Research is an open access, peer-reviewed, international journal. All submissions relating to basic research and clinical practice of cardiology and cardiovascular medicine are in this journal''s scope. This journal focuses on publishing original research and observations in all cardiovascular medicine aspects. Manuscript types include original article, review, case report, short communication, book review, letter to the editor.