| Objective To evaluate the efficiency of catheter ablation for atrial fibrillation patients with heart failure through Meta-analysis.Background For patients with persistent atrial fibrillation and heart failure,therapeutic strategies for drug-controlled rhythms do not significantly improve survival rates compared to controlling ventricular rate.However,catheter ablation showed good safety and efficacy in patients with heart failure with normal or decreased left ventricular systolic function.Compared with the efficacy of catheter ablation and simple drug cardioversion on the improvement of heart function,exercise tolerance,and quality of life in patients with heart failure and atrial fibrillation,further systematic evaluation is still needed.Methods Systematically searching the libraries including the Pubmed,Cochrane Library,EMBASE,ClinicalTrials.gov,CNKI,CBM and WANFANG DATA for articles reporting data of atrial fibrillation catheter ablation in patients with heart failure.Revman 5.3 was applied for meta analysis after quality assessment of included studies.Results 5 studies with 423 patients were included,of which 214patients undergoing catheter ablation.At overall term follow-up,catheter ablation significantly improved left ventricular ejection fraction(LVEF)(mean difference[MD]:5.21%,95%confidence interval[CI]:1.69%-8.73%,P=0.004),though obvious heterogeneity was detected(I ~2=80%,P=0.0006).After adjusting the measurement indicators and performing sensitivity analysis to exclude sources of heterogeneity,they were re-incorporated into software for meta-analysis.,and no heterogeneity was found between the studies(I ~2=0%,P=0.49).At this time,the LVEF's MD became 7.31%(95%CI:5.18-9.45,P<0.00001).At the same time,the changes of MLHFQ,6MWT,BNP,Peak VO2,and NHYA Class before and after treatment were analyzed,and compared with drug therapy,there were also significant improvements.Conclusions Compared with medical treatement,Catheter ablation significantly improved LVEF,heart function,exercise capacity and quality of life for persistent atrial fibrillation with heart failure patients. |
PDF Full Text Request