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Comparing Efficacy and Safety in Catheter Ablation Strategies for Paroxysmal Atrial Fibrillation : A Network Meta-Analysis of Randomized Controlled Trials

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  • نوع التسجيلة:
    Electronic Resource
  • الدخول الالكتروني :
    http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-184418
    Diagnostics, 2075-4418, 2022, 12:2
  • معلومة اضافية
    • Publisher Information:
      Linköpings universitet, Avdelningen för diagnostik och specialistmedicin Linköpings universitet, Medicinska fakulteten Region Östergötland, Kardiologiska kliniken US Linköpings universitet, Institutionen för hälsa, medicin och vård Region Östergötland, Fysiologiska kliniken US Linköpings universitet, Avdelningen för prevention, rehabilitering och nära vård Region Östergötland, Smärt och rehabiliteringscentrum Univ Paris, France Aristotle Univ Thessaloniki, Greece Karolinska Univ Hosp, Sweden Hippokrateion Hosp, Greece Aristotle Univ Thessaloniki, Greece Univ Paris, France MDPI 2022
    • Added Details:
      Charitakis, Emmanouil
      Metelli, Silvia
      Karlsson, Lars
      Antoniadis, Antonios P.
      Liuba, Ioan
      Almroth, Henrik
      Jönsson, Anders Hassel
      Schwieler, Jonas
      Sideris, Skevos
      Tsartsalis, Dimitrios
      Dragioti, Elena
      Fragakis, Nikolaos
      Chaimani, Anna
    • نبذة مختصرة :
      Although catheter ablation (CA) is an established treatment for paroxysmal atrial fibrillation (PAF), there is no consensus regarding the most efficient CA strategy. The objective of this network meta-analysis (NMA) was to compare the efficacy and safety of different CA strategies for PAF. A systematic search was performed in PubMed, Web of Science, and CENTRAL until the final search date, 5 October 2020. Randomised controlled trials (RCT) comparing different CA strategies and methods for pulmonary vein isolation (PVI) were included. Efficacy was defined as lack of arrhythmia recurrence after CA and safety as any reported complication related to the procedure during a minimum follow-up time of six months. In total, 43 RCTs comparing 11 different CA strategies involving 6701 patients were included. The risk of recurrence was significantly decreased in comparison with PVI with radiofrequency only for the following treatments: PVI with adjuvant ablation (RR: 0.79, CI: 0.65-0.97) and PVI with sympathetic modulation (RR: 0.64, CI: 0.46-0.88). However, PVI with radiofrequency was superior to non-PVI strategies (RR: 1.65, CI: 1.2-2.26). No statistically significant difference was found in safety between different CA strategies. Concerning different PVI strategies, no difference was observed either in efficacy or in safety between tested strategies. This NMA suggests that different PVI strategies are generally similar in terms of efficacy, while PVI with additional ablation or sympathetic modulation may be more effective than PVI alone. This study provides decision-makers with insights into the efficacy and safety of different CA strategies.
    • الموضوع:
      network meta-analysis; paroxysmal atrial fibrillation; catheter ablation; antiarrhythmic drugs; Neurology; Neurologi; Article, review/survey; info:eu-repo/semantics/article; text
    • الرقم المعرف:
      10.3390.diagnostics12020433
    • Note:
      application/pdf
      English
    • Other Numbers:
      UPE oai:DiVA.org:liu-184418
      0000-0002-2514-5324
      0000-0003-4852-3065
      0000-0001-9019-4125
      doi:10.3390/diagnostics12020433
      PMID 35204535
      ISI:000773701200001
      1349027847
    • Contributing Source:
      UPPSALA UNIV LIBR
      From OAIster®, provided by the OCLC Cooperative.
    • الرقم المعرف:
      edsoai.on1349027847
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