Comparison of clinical outcomes between catheter ablation and permanent pacemaker implantation in Tachycardia-Bradycardia Syndrome patients: a meta-analysis

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2025-08-11 DOI:10.1016/j.ijcha.2025.101767

Sunu Budhi Raharjo , Emir Yonas , Sarah Naura Irbah , Dicky Armein Hanafy , Muhammad Rizky Felani , Aldo Ferly , Fa Po Chung

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Abstract

Introduction

Tachycardia-Bradycardia Syndrome (TBS) is a clinical disorder resulting from complications associated with sick sinus syndrome (SSS). In patients with SSS, TBS is marked by alternating episodes of tachycardia and bradycardia. This meta-analysis aims to evaluate and compare the differences in clinical outcomes between ablation and pacemaker treatments for TBS.

Methods

We performed a systematic search on libraries, including PubMed, EuropePMC, SCOPUS, Cochrane Central, and medRxiv, for preprint studies. The search terms used were “Tachycardia Bradycardia Syndrome,” “Pacing,” and “Ablation” between the pacing and ablation groups in TBS patients. Review Manager Software Version 5.4 (Cochrane Collaboration) was used to perform the meta-analysis.

Results

We identified 1,138 potential articles from our search, and 521 duplicates were removed. After screening the titles and abstracts of the remaining 662 articles, we obtained 23 potentially relevant articles. Finally, we included the remaining eight studies in our qualitative synthesis and meta-analysis, which comprised 1,266 patients.

Catheter ablation was associated with a lower incidence of AF recurrence (OR of 0.09 [0.04, 0.22; p < 0.001], with moderate heterogeneity (I² = 76 %, p < 0.001), stroke (OR of 0.28 [0.14, 0.53; p < 0.001] low heterogeneity I² = 0 %, p = 0.99 favouring the ablation group.) and lower mortality (OR of 0.37 [0.17, 0.80; p0.01] low heterogeneity I² = 0 %, p = 0.84 favouring the ablation group), compared to those who underwent pacemaker implantation in patients with TBS.

Conclusion

Catheter ablation resulted in a lower incidence of AF recurrence, stroke, and mortality compared to the pacemaker in TBS patients. There was no difference between groups regarding procedure-related complications and cardiovascular rehospitalization.

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心动过速-心动过缓综合征患者导管消融与永久性起搏器植入的临床结果比较：一项meta分析

心动过速-心动过缓综合征（TBS）是一种由病窦综合征（SSS）相关并发症引起的临床疾病。在SSS患者中，TBS以心动过速和心动过缓交替发作为特征。本荟萃分析旨在评估和比较消融和起搏器治疗TBS的临床结果差异。方法系统检索PubMed、EuropePMC、SCOPUS、Cochrane Central和medRxiv等图书馆的预印本研究。TBS患者起搏组和消融组之间的搜索词为“心动过速-心动过缓综合征”、“起搏”和“消融”。采用Review Manager Software Version 5.4 （Cochrane Collaboration）进行meta分析。结果我们从搜索中确定了1138篇潜在的文章，521篇重复的文章被删除。在筛选剩下的662篇文章的标题和摘要后，我们获得了23篇可能相关的文章。最后，我们将其余8项研究纳入定性综合和荟萃分析，共1266例患者。导管消融与房颤复发率较低相关(OR = 0.09 [0.04, 0.22；p & lt;0.001]，具有中等异质性(I2 = 76%, p <；0.001)、中风(OR为0.28 [0.14,0.53；p & lt;低异质性I2 = 0%, p = 0.99，有利于消融组)和较低的死亡率(OR为0.37 [0.17,0.80；[p0.01]低异质性I2 = 0%, p = 0.84有利于消融组)，与接受起搏器植入的TBS患者相比。结论与起搏器相比，导管消融导致房颤复发、卒中和死亡率降低。在手术相关并发症和心血管再住院方面，两组间无差异。

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来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.