Effect of catheter ablation combined with left appendage occlusion for non-valvular atrial fibrillation: a meta-analysis

Abstract Objective To estimate the effect of catheter ablation combined with left appendage occlusion in the treatment of non-valvular atrial fibrillation (NVAF) by a method of meta-analysis. Methods Pubmed, Embase, and Cochrane Library were searched for the studies about catheter ablation combined...

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Main Authors: Jun Qu, Zhen Wang, Shuhao Wang
Format: Article
Language:English
Published: BMC 2022-05-01
Series:Journal of Cardiothoracic Surgery
Subjects:
Online Access:https://doi.org/10.1186/s13019-022-01885-9
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author Jun Qu
Zhen Wang
Shuhao Wang
author_facet Jun Qu
Zhen Wang
Shuhao Wang
author_sort Jun Qu
collection DOAJ
description Abstract Objective To estimate the effect of catheter ablation combined with left appendage occlusion in the treatment of non-valvular atrial fibrillation (NVAF) by a method of meta-analysis. Methods Pubmed, Embase, and Cochrane Library were searched for the studies about catheter ablation combined with left appendage occlusion in treating NVAF. The data analysis was performed using R 4.0.5 software. The retrieval time was from inception to May 12, 2021. Results A total of 18 published studies were identified in the meta-analysis, including 1385 participants. During the perioperative period of catheter ablation combined with left appendage occlusion in treating NVAF, the pooled incidences of pericardial effusion, major or minor bleeding events, and residual flow documented were 0.5%(95%CI 0.0002–0.0099), 1.42%(95% CI 0.00–0.04), 7.24%(95% CI 0.0447–0.0975), respectively. During the follow-up, the incidences of all-cause mortality, embolism events, and bleeding events were 0.32%(95%CI 0.0000–0.0071), 1.29%(95%CI 0.0037–0.0222), 2.07%(95% CI 0.0075–0.0339), respectively. In the follow-up period of the transesophageal echocardiography, the most complication was residual flow event with an incident rate of 10.80%(95% CI 0.054–0.1620). The maximum occurrence probability of residual flow events was 17.92% (95% CI 0.1133–0.2452). Moreover, the incident rate of NVAF recurrence was 29.23% (95% CI 0.2222–0.3623). Conclusion The meta-analysis suggests that the “one-stop” procedure is effective for those patients undergoing NVAF. However, Patients with more residual blood flow have a higher incidence of bleeding complications. More studies are warranted to verify the safety and efficacy of catheter ablation combined with left appendage occlusion in terms of the “one-stop” procedure.
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spelling doaj.art-5d0128e11b6d439c932b065c0ce0df0c2022-12-22T03:22:22ZengBMCJournal of Cardiothoracic Surgery1749-80902022-05-011711810.1186/s13019-022-01885-9Effect of catheter ablation combined with left appendage occlusion for non-valvular atrial fibrillation: a meta-analysisJun Qu0Zhen Wang1Shuhao Wang2Department of Internal Medicine-Cardiovascular, YanTai YuHuangDing HospitalDepartment of Internal Medicine-Cardiovascular, YanTai YuHuangDing HospitalDepartment of Internal Medicine-Cardiovascular, LiaoCheng People’s HospitalAbstract Objective To estimate the effect of catheter ablation combined with left appendage occlusion in the treatment of non-valvular atrial fibrillation (NVAF) by a method of meta-analysis. Methods Pubmed, Embase, and Cochrane Library were searched for the studies about catheter ablation combined with left appendage occlusion in treating NVAF. The data analysis was performed using R 4.0.5 software. The retrieval time was from inception to May 12, 2021. Results A total of 18 published studies were identified in the meta-analysis, including 1385 participants. During the perioperative period of catheter ablation combined with left appendage occlusion in treating NVAF, the pooled incidences of pericardial effusion, major or minor bleeding events, and residual flow documented were 0.5%(95%CI 0.0002–0.0099), 1.42%(95% CI 0.00–0.04), 7.24%(95% CI 0.0447–0.0975), respectively. During the follow-up, the incidences of all-cause mortality, embolism events, and bleeding events were 0.32%(95%CI 0.0000–0.0071), 1.29%(95%CI 0.0037–0.0222), 2.07%(95% CI 0.0075–0.0339), respectively. In the follow-up period of the transesophageal echocardiography, the most complication was residual flow event with an incident rate of 10.80%(95% CI 0.054–0.1620). The maximum occurrence probability of residual flow events was 17.92% (95% CI 0.1133–0.2452). Moreover, the incident rate of NVAF recurrence was 29.23% (95% CI 0.2222–0.3623). Conclusion The meta-analysis suggests that the “one-stop” procedure is effective for those patients undergoing NVAF. However, Patients with more residual blood flow have a higher incidence of bleeding complications. More studies are warranted to verify the safety and efficacy of catheter ablation combined with left appendage occlusion in terms of the “one-stop” procedure.https://doi.org/10.1186/s13019-022-01885-9AblationLeft appendage occlusionAtrial fibrillationMeta-analysis
spellingShingle Jun Qu
Zhen Wang
Shuhao Wang
Effect of catheter ablation combined with left appendage occlusion for non-valvular atrial fibrillation: a meta-analysis
Journal of Cardiothoracic Surgery
Ablation
Left appendage occlusion
Atrial fibrillation
Meta-analysis
title Effect of catheter ablation combined with left appendage occlusion for non-valvular atrial fibrillation: a meta-analysis
title_full Effect of catheter ablation combined with left appendage occlusion for non-valvular atrial fibrillation: a meta-analysis
title_fullStr Effect of catheter ablation combined with left appendage occlusion for non-valvular atrial fibrillation: a meta-analysis
title_full_unstemmed Effect of catheter ablation combined with left appendage occlusion for non-valvular atrial fibrillation: a meta-analysis
title_short Effect of catheter ablation combined with left appendage occlusion for non-valvular atrial fibrillation: a meta-analysis
title_sort effect of catheter ablation combined with left appendage occlusion for non valvular atrial fibrillation a meta analysis
topic Ablation
Left appendage occlusion
Atrial fibrillation
Meta-analysis
url https://doi.org/10.1186/s13019-022-01885-9
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