| Background:Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia with increased morbidity and mortality. Compared with traditional AADs, radiofrequency catheter ablation shows superiority with a higher success rate. However, the efficacy of ablation is still far from satisfied. Current evidence suggests that anti-remodeling therapy has emerged as a novel approach to reduce the recurrence rate of AF after ablation therapy. Objectives:This meta-analysis was designed to evaluate the preventive effects of anti-remodeling drugs on the AF recurrence after ablation.Methods:A systematic search of PUBMED, EMBASE, and Cochrane Central Register of Controlled Trials for randomized controlled trials (RCTs) which aimed to investigate the efficiency of anti-remodeling drugs after AF ablation was performed. Two investigators independently selected eligible studies and then extract relevant information. The data were pooled using random effects model. Subgroup analyses and sensitivity analysis were also performed.Results:Totally8RCTs involving831subjects were identified to fulfill the inclusion criteria. Overall, anti-remodeling therapy demonstrated a significant reduction of AF recurrence after ablation (RR0.64,95%CI,0.47-0.86, p=0.003) without significant heterogeneity (Qdf=7=11.17, p=0.13,I2=37%), especially in patients with paroxysmal AF (RR0.61,95%CI,0.41-0.93, p=0.02) and left atrium diameter<45mm (RR0.59, 95%CI,0.44-0.80, p=0.0008). Anti-structural remodeling drugs (ASRDs) displayed significant preventive effects (RR0.53,95%CI,0.31-0.89, p=0.02), while anti-electrical remodeling drugs (AERDs) did not (RR0.72,95%CI,0.50-1.05, p=0.09).Conclusions:It appears that the continuation of anti-remodeling therapy after ablation of AF may be necessary to reduce the risk of recurrence. According to the subgroup analysis, ASRDs play a significant role in preventing post-ablation AF recurrence while AERDs do not. Furthermore, patient with persistent and long-standing persistent AF and lager left atrium diameter may not get significant benefits from anti-remodeling therapy after ablation. Objectives:Thismeta-analysis was designed to evaluate the preventive effects of anti-remodeling drugs on the AF recurrence after ablation. Background:Current evidence suggests that anti-remodeling therapy has emerged as a novel approach to reduce the recurrence rate of atrial fibrillation (AF) after radiofrequency catheter ablation therapy.Methods:A systematic search of PUBMED, EMBASE, and Cochrane Central Register of Controlled Trials for randomized controlled trials (RCTs) which aimed to investigate the efficiency of anti-remodeling drugs after AF ablation was performed. The data were pooled using random effects model. Subgroup analyses and sensitivity analysis were also performed.Results:Totally8RCTs involving831subjects were identified to fulfill the inclusion criteria. Overall, anti-remodeling therapy demonstrated a significant reduction of AF recurrence after ablation (RR0.64,95%CI,0.47-0.86, p=0.003), especially in patients with paroxysmal AF (RR0.61,95%CI,0.41-0.93,p=0.02) and left atrium diameter<45mm (RR0.59,95%CI,0.44-0.80, p=0.0008). Anti-structural remodeling drugs (ASRDs) displayed significant preventive effects (RR0.53,95%CI,0.31-0.89, p=0.02), while anti-electrical remodeling drugs (AERDs) did not (RR0.72,95%CI,0.50-1.05,p=0.09).Conclusions:It appears that the continuation of anti-remodeling therapy after ablation of AF may be necessary to reduce the risk of recurrence. |
