心房颤动环肺静脉隔离联合额外部位消融的疗效评价——一项随机对照试验的Meta分析
Efficacy Evaluation of Pulmonary Vein Combined With Additional Ablation in Atrial Fibrillation:a Meta-analysis of Randomized Controlled Trials
郭爽 1李天骄 2李树仁 1司会莉 1郝潇1
作者信息
- 1. 河北省人民医院 心内科,石家庄 050000
- 2. 河北省人民医院 体检中心,石家庄 050000
- 折叠
摘要
目的:探究环肺静脉隔离(CPVI)联合额外部位消融是否比单纯CPVI术后心房颤动(房颤)复发风险低.方法:计算机检索中国知网、万方数据库、维普网、中国生物医学文献数据库、PubMed、Embase、Cochrane图书馆等数据库,筛选出近10年符合标准的随机对照研究,应用Review Manager 5.3软件对文献相关内容进行Meta分析,总结比较单纯CPVI与CPVI联合额外部位消融策略在消融后房颤复发中的差异.结果:共纳入 21 篇文献,包括 21 项研究 3 357 例患者,其中 1 580 例行单纯CPVI,1 777 例行CPVI联合额外部位消融,随访时间均大于 1 年.Meta分析结果表明,与单纯CPVI相比,CPVI联合额外部位消融未降低房颤复发风险(OR=0.86,95%CI:0.73～1.01,P=0.06).根据额外消融部位、房颤类型、左心房内径、房颤诊断时间进行亚组分析,发现只在较小的左心房内径亚组中,CPVI联合额外部位消融进一步降低房颤复发风险(OR=0.68,95%CI:0.47～0.98,P=0.04),在其他亚组中未发现上述现象.结论:相比于单纯CPVI,CPVI联合额外部位的消融策略未降低消融后房颤复发风险.
Abstract
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.
关键词
心房颤动/射频消融/环肺静脉消融/复发Key words
atrial fibrillation/radiofrequency ablation/circumferential pulmonary vein isolation/recurrence引用本文复制引用
出版年
2024
NETL
NSTL
万方数据