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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

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Meta-Analysis of Catheter Ablation versus Medical Therapy for Heart Failure Complicated with Atrial Fibrillation

Xi Zhu1, Yingbiao Wu1, Zhongping Ning1

  • 1Department of Cardiology, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai 201318, China.

Cardiology Research and Practice
|December 16, 2021
PubMed

Insights

Catheter ablation significantly reduces mortality and improves heart function in patients with heart failure and atrial fibrillation compared to medical therapy alone. This procedure enhances exercise capacity and quality of life.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Management

Background:

  • Atrial fibrillation (AF) is a common arrhythmia, often co-existing with heart failure (HF).
  • Managing patients with both AF and HF presents significant challenges, impacting prognosis and quality of life.

Purpose of the Study:

  • To compare the effectiveness of catheter ablation versus traditional medical therapy.
  • To evaluate outcomes in patients diagnosed with both heart failure and atrial fibrillation.

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted.
  • Searched major databases including PubMed, MEDLINE, Embase, Cochrane, Web of Science, and CNKI.
  • Assessed methodological quality using Cochrane risk of bias tool; analyzed results using forest plots, funnel plots, and sensitivity analysis.

Main Results:

  • Nine RCTs involving 1131 patients were analyzed.
  • Catheter ablation demonstrated a significant reduction in all-cause mortality (RR=0.53, P=0.0007).
  • Significant improvements were observed in left ventricular ejection fraction (LVEF) (MD=6.45, P<0.0001), 6-minute walking time (6MWT) (MD=28.32, P<0.0001), and quality of life (MLHFQ score) (MD=8.19, P=0.04).

Conclusions:

  • Catheter ablation offers superior outcomes compared to medical therapy for patients with heart failure and atrial fibrillation.
  • The procedure leads to better left ventricular ejection fraction, cardiac function, and exercise tolerance.
  • Catheter ablation is an effective treatment option for improving clinical status in this patient population.
Abstract

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