使用呼吸机预防 OSA 患者消融术后心房颤动复发的效果

IF 4.3 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Sumeet S. Mutti MD
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引用次数: 0

摘要

治疗领域心血管疾病/心血管疾病风险因素背景随着心房颤动(AF)在全球的发病率不断上升,且其与阻塞性睡眠呼吸暂停(OSA)之间的联系已得到公认,本研究重点评估了持续气道正压(CPAP)疗法在减少导管式肺静脉隔离术后心房颤动复发方面的疗效。方法根据系统综述和荟萃分析首选报告项目(PRISMA)指南,我们进行了一项全面的系统综述和荟萃分析。检索仅限于 2010 年至 2023 年 6 月发表的英文期刊论文。我们的搜索跨越了多个数据库,目标是专门针对被诊断为 AHI 为 5 的 OSA 患者的房颤消融术后复发的研究。经过严格的筛选标准后,我们采用曼特尔-海恩斯泽尔(Mantel-Haenszel)方法进行分析,并将汇总相对风险(RR)作为核心结果指标。结果 我们从三项队列研究和两项意向治疗随机对照试验中的五项研究中提取了数据,共计1023名患者。共同效应模型和随机效应模型均一致表明,CPAP 干预可显著降低消融术后房颤复发率,汇总 RR 分别为 0.6075 和 0.6101。使用 CPAP 的患者与未使用 CPAP 的患者相比,贴片术后房颤复发的相对风险降低了 39.1%(随机效应模型)。异质性分析表明存在中等程度的变异性,Egger检验表明发表偏倚风险极低。结论研究结果突出表明,CPAP疗法在显著减少OSA患者房颤复发方面具有潜力,尤其是在消融术后的情况下。CPAP 的影响可延伸至纠正心房结构和电重塑,从而切实降低房颤复发率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
EFFECTS OF CPAP USE IN PREVENTING ATRIAL FIBRILLATION RECURRENCE POST-ABLATION IN OSA PATIENTS

Therapeutic Area

ASCVD/CVD Risk Factors

Background

With the escalating global prevalence of atrial fibrillation (AF) and its recognized link to obstructive sleep apnea (OSA), this study focuses on assessing the efficacy of continuous positive airway pressure (CPAP) therapy in reducing AF recurrence following catheter-based pulmonary vein isolation.

Methods

Following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, we conducted a comprehensive systematic review and meta-analysis. The search was limited to English-language journal articles published from 2010 up to June 2023. Our search spanned various databases, targeting studies reporting AF recurrence post-ablation exclusively in patients diagnosed with OSA with AHI > five. After stringent selection criteria, we applied the Mantel-Haenszel method for analysis, using the pooled relative risk (RR) as the core outcome measure.

Results

Data from Five studies with 1023 in total patients from three cohort studies and two intention-to-treat Randomized Control Trial was extracted. Both common effect and random effects models consistently demonstrated a substantial reduction in AF recurrence post-ablation attributed to CPAP intervention, yielding pooled RRs of 0.6075 and 0.6101, respectively. Patients who used CPAP showed 39.1% relative risk reduction (in the random effect model) of AF recurrence post-ablation compared to those who did not use CPAP. Heterogeneity analysis indicated moderate variability, and Egger's test suggested minimal risk of publication bias.

Conclusions

The findings highlight the potential of CPAP therapy in significantly curtailing AF recurrence among individuals with OSA, particularly in the context of post-ablation scenarios. CPAP's influence may extend to rectifying atrial structural and electrical remodeling, translating into a tangible decrease in AF recurrence rates.
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来源期刊
American journal of preventive cardiology
American journal of preventive cardiology Cardiology and Cardiovascular Medicine
CiteScore
6.60
自引率
0.00%
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0
审稿时长
76 days
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