心房颤动患者肺静脉隔离期间肾脏去神经治疗的 Meta 分析。

IF 2.3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Husam M. Salah MD , Karl-Philipp Rommel MD , Karl-Patrik Kresoja MD , Felix Mahfoud MD , Philipp Lurz MD, PhD , Jonathan P. Piccini MD, MHS , Marat Fudim MD, MHS
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引用次数: 0

摘要

肺静脉隔离术(PVI)已被确定为治疗症状性房颤(AF)的一线疗法,适用于部分症状性房颤患者以及抗心律失常药物治疗无效的患者。然而,PVI 后房颤复发率仍然很高,这促使人们探索肾脏去神经支配(RDN)等辅助疗法来改善疗效。本荟萃分析旨在评估 RDN 作为 PVI 的辅助疗法在减少房颤复发方面的疗效。我们对随机对照试验(RCT)进行了全面检索,比较了 RDN 加 PVI 与单用 PVI 的效果,共获得 9 项研究,955 名患者接受了研究。主要终点是 12 个月后不再发生房颤。结果显示,RDN+PVI 组有 61.7% 的患者摆脱了房颤,而单用 PVI 组仅有 52.6% 的患者摆脱了房颤(RR 1.32,95% CI 1.07-1.61,I²=48%)。这些研究结果表明,RDN 有可能提高 PVI 的疗效;然而,要证实这些结果并确定 RDN 在房颤治疗中的作用,还需要进一步开展大规模 RCT 研究,采用标准化方法并延长随访时间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Meta-Analysis of Renal Denervation Therapy During Pulmonary Vein Isolation in Atrial Fibrillation
Pulmonary vein isolation (PVI) has been established as a first-line therapy for symptomatic atrial fibrillation (AF) in selected patients with symptomatic AF and in those whose antiarrhythmic drug treatment failed. However, AF recurrence rates after PVI remain high, prompting the exploration of adjunct therapies, such as renal denervation (RDN), to improve outcomes. This meta-analysis aimed to assess the efficacy of RDN as an adjunct to PVI in reducing AF recurrence. A comprehensive search of randomized controlled trials comparing RDN plus PVI with PVI alone was conducted, yielding 9 studies with 955 patients. The primary end point was freedom from AF at 12 months. The results showed that 61.7% of patients in the RDN+PVI group were free from AF compared with 52.6% in the PVI alone group (risk ratio 1.32, 95% confidence interval 1.07 to 1.61, I² = 48%). These findings support the potential of RDN to enhance PVI efficacy; however, further large-scale randomized controlled trials with standardized methods and longer follow-up periods are necessary to confirm these results and establish the role of RDN in the treatment of AF.
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来源期刊
American Journal of Cardiology
American Journal of Cardiology 医学-心血管系统
CiteScore
4.00
自引率
3.60%
发文量
698
审稿时长
33 days
期刊介绍: Published 24 times a year, The American Journal of Cardiology® is an independent journal designed for cardiovascular disease specialists and internists with a subspecialty in cardiology throughout the world. AJC is an independent, scientific, peer-reviewed journal of original articles that focus on the practical, clinical approach to the diagnosis and treatment of cardiovascular disease. AJC has one of the fastest acceptance to publication times in Cardiology. Features report on systemic hypertension, methodology, drugs, pacing, arrhythmia, preventive cardiology, congestive heart failure, valvular heart disease, congenital heart disease, and cardiomyopathy. Also included are editorials, readers'' comments, and symposia.
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