Efficacy Evaluation of Pulmonary Vein Combined With Additional Ablation in Atrial Fibrillation:a Meta-analysis of Randomized Controlled Trials
Objectives:To investigate whether circumferential pulmonary vein isolation(CPVI)combined with additional ablation reduces the recurrence rate of atrial fibrillation(AF)compared with CPVI alone.Methods:A literature search was conducted using the databases CNKI,Wanfang Data,VIP,Chinese Biomedical Literature Database,PubMed,Embase,the Cochrane Library.Randomized controlled studies that met the standards in recent ten years were screened,and the relevant literature contents were meta-analyzed by Review Manager 5.3 software.The comparison results of CPVI alone with CPVI combined with the additional ablation strategies in the recurrence of AF were summarized.Results:A total of 21 literatures were included with 3 357 patients,of whom 1 580 underwent CPVI alone and 1 777 underwent CPVI combined with additional site ablation.The follow-up time was more than 1 year.Meta-analysis showed that there was no significant difference between CPVI alone and CPVI combined ablation strategies in reducing AF recurrence(OR=0.86,95%CI:0.73-1.01,P=0.06).Subgroup analysis based on additional ablation site,AF type,left atrial diameter,and AF diagnosis time showed that only in the small left atrial diameter subgroup,CPVI combined with additional ablation further reduced the recurrence rate of AF(OR=0.68,95%CI:0.47-0.98,P=0.04).Conclusions:The ablation strategy of CPVI combined with additional sites could not reduce the recurrence rate of AF compared with CPVI alone.
NETL
NSTL
万方数据
