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心脏手术中同期左房手术消融治疗心房颤动的荟萃分析:随机对照试验。

Left atrial concomitant surgical ablation for treatment of atrial fibrillation in cardiac surgery: A meta-analysis of randomized controlled trials.

机构信息

Department of Thoracic and Cardiovascular Surgery, Affiliated Taizhou Hospital of Wenzhou Medical University, Taizhou, China.

出版信息

PLoS One. 2018 Jan 23;13(1):e0191354. doi: 10.1371/journal.pone.0191354. eCollection 2018.

Abstract

INTRODUCTION

Surgical ablation is a generally established treatment for patients with atrial fibrillation undergoing concomitant cardiac surgery. Left atrial (LA) lesion set for ablation is a simplified procedure suggested to reduce the surgery time and morbidity after procedure. The present meta-analysis aims to explore the outcomes of left atrial lesion set versus no ablative treatment in patients with AF undergoing cardiac surgery.

METHODS

A literature research was performed in six database from their inception to July 2017, identifying all relevant randomized controlled trials (RCTs) comparing left atrial lesion set versus no ablative treatment in AF patient undergoing cardiac surgery. Data were extracted and analyzed according to predefined clinical endpoints.

RESULTS

Eleven relevant RCTs were included for analysis in the present study. The prevalence of sinus rhythm in ablation group was significantly higher at discharge, 6-month and 1-year follow-up period. The morbidity including 30 day mortality, late all-cause mortality, reoperation for bleeding, permanent pacemaker implantation and neurological events were of no significant difference between two groups.

CONCLUSIONS

The result of our meta-analysis demonstrates that left atrial lesion set is an effective and safe surgical ablation strategy for AF patients undergoing concomitant cardiac surgery.

摘要

简介

对于同时接受心脏手术的心房颤动患者,外科消融术是一种普遍确立的治疗方法。消融的左心房 (LA) 病变集被简化为一种程序,以减少手术后的手术时间和发病率。本荟萃分析旨在探讨心脏手术中房颤患者左心房病变集与无消融治疗的结果。

方法

从最初到 2017 年 7 月,在六个数据库中进行了文献研究,以确定所有比较心脏手术中房颤患者左心房病变集与无消融治疗的随机对照试验 (RCT)。根据预设的临床终点提取和分析数据。

结果

本研究纳入了 11 项相关 RCT 进行分析。消融组出院时、6 个月和 1 年随访期间窦性心律的发生率明显更高。两组之间 30 天死亡率、晚期全因死亡率、因出血再次手术、永久性起搏器植入和神经事件等发病率无显著差异。

结论

我们的荟萃分析结果表明,对于同时接受心脏手术的房颤患者,左心房病变集是一种有效且安全的外科消融策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a97/5779679/44884261bbd8/pone.0191354.g001.jpg

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