Dong-Sheng Zhao1, Yi Shen2, Qing Zhang1, Gang Lin1, Yi-Hua Lu2, Bang-Tao Chen3, Lin-Sheng Shi1, Jian-Fei Huang4, Hui-He Lu4. 1. Department of Cardiology, The Second Affiliated Hospital of Nantong University, Nantong 226001, China. 2. Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong 226001, China. 3. Institute of Liver Diseases, Changzhi College, Shanxi Medical University, Taiyuan 030001, China. 4. Department of Cardiology, The Second Affiliated Hospital of Nantong University, Nantong 226001, China ntsyhjf@126.com lhh226001@126.com.
Abstract
AIMS: Over the past decade, catheter ablation (CA) has become an established therapy for symptomatic atrial fibrillation (AF). Atrial fibrillation is common in hypertrophic cardiomyopathy (HCM) patients, and restoring sinus rhythm is of great clinical benefit to them. Therefore, we conducted a systematic review and meta-analysis of the available data to evaluate the effectiveness and safety of CA for AF in patients with HCM. METHODS AND RESULTS: Six databases were searched to identify studies describing outcomes of CA of AF in HCM patients with a mean follow-up of ≥12 months after the index procedure. The following data were extracted: (i) single-procedure success, (ii) multiple-procedure success, and (iii) drug-free success. Fifteen studies involving 531 patients were included. Single-procedure freedom from atrial arrhythmia at the latest follow-up was 45.5% [95% confidence interval (CI): 34.8-56.2%]. With multiple procedures, the final success rate was 66.1% (95% CI: 55.3-76.9%) overall, 71.8% (95% CI: 61.6-82.0%) in paroxysmal AF, and 47.5% (95% CI: 36.0-59.0%) in non-paroxysmal AF. Without anti-arrhythmic drugs (AADs), single-procedure success rate at latest follow-up was 32.9% (95% CI: 21.7-41.1%); after multiple procedures, this raised to 50.4% (95% CI: 39.2-61.6%). The incidence of serious periprocedural complications was acceptable [5.1% (95% CI: 2.8-9.6%)]. Substantial heterogeneity (I(2)> 50%) was noted in the above groups. CONCLUSIONS: Catheter ablation of AF in patients with HCM is feasible, although more repeat procedures and AAD are needed to prevent AF recurrence. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Over the past decade, catheter ablation (CA) has become an established therapy for symptomatic atrial fibrillation (AF). Atrial fibrillation is common in hypertrophic cardiomyopathy (HCM) patients, and restoring sinus rhythm is of great clinical benefit to them. Therefore, we conducted a systematic review and meta-analysis of the available data to evaluate the effectiveness and safety of CA for AF in patients with HCM. METHODS AND RESULTS: Six databases were searched to identify studies describing outcomes of CA of AF in HCM patients with a mean follow-up of ≥12 months after the index procedure. The following data were extracted: (i) single-procedure success, (ii) multiple-procedure success, and (iii) drug-free success. Fifteen studies involving 531 patients were included. Single-procedure freedom from atrial arrhythmia at the latest follow-up was 45.5% [95% confidence interval (CI): 34.8-56.2%]. With multiple procedures, the final success rate was 66.1% (95% CI: 55.3-76.9%) overall, 71.8% (95% CI: 61.6-82.0%) in paroxysmal AF, and 47.5% (95% CI: 36.0-59.0%) in non-paroxysmal AF. Without anti-arrhythmic drugs (AADs), single-procedure success rate at latest follow-up was 32.9% (95% CI: 21.7-41.1%); after multiple procedures, this raised to 50.4% (95% CI: 39.2-61.6%). The incidence of serious periprocedural complications was acceptable [5.1% (95% CI: 2.8-9.6%)]. Substantial heterogeneity (I(2)> 50%) was noted in the above groups. CONCLUSIONS: Catheter ablation of AF in patients with HCM is feasible, although more repeat procedures and AAD are needed to prevent AF recurrence. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Nadia H Bakir; Robert M MacGregor; Ali J Khiabani; Farah N Musharbash; Matthew R Schill; Laurie A Sinn; Richard B Schuessler; Spencer J Melby; Marye J Gleva; Ralph J Damiano Journal: Ann Thorac Surg Date: 2021-03-01 Impact factor: 5.102
Authors: Guy Rozen; Gabby Elbaz-Greener; Ibrahim Marai; Nizar Andria; Seyed Mohammadreza Hosseini; Yitschak Biton; E Kevin Heist; Jeremy N Ruskin; Yulia Gavrilov; Shemy Carasso; Diab Ghanim; Offer Amir Journal: J Am Heart Assoc Date: 2020-06-23 Impact factor: 5.501