Shi Shuqing, Jia Qiulei, Shi Jingjing, Shi Shuai, Yuan Guozhen, Hu Yuanhui
Cardiovascular Department, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Graduate School, Beijing University of Chinese Medicine, Beijing, China.
Medicine (Baltimore). 2020 Sep 18;99(38):e22368. doi: 10.1097/MD.0000000000022368.
The high recurrence rate of atrial fibrillation (AF) after recovering sinus rhythm has always been a clinical problem. Despite the established and widespread use of antiarrhythmic drugs, which one is better for maintaining sinus rhythm is still controversial. This study aims to summarize the randomized controlled trials (RCTs) of amiodarone combined with beta blockers to maintain sinus rhythm in AF, and to determine an effective and safe intervention for the prevention of AF recurrence through network meta-analysis (NMA).
A comprehensive search of the RCTs comparing amiodarone with different beta-blockers to maintain sinus rhythm of AF patients will be conducted from the inception to December 2019 in the Cochrane Library, PubMed, Web of Science, EMBASE, Chinese Biomedical Literature Database (SinoMed), Chinese National Knowledge Infrastructure (CNKI), and WanFang database. The primary outcomes will be the recurrence of AF and frequency of embolization complications. The secondary outcomes will be the symptom improvements and adverse events. Risk of bias assessment of the included RCTs will be conducted according to the Cochrane collaboration's risk of bias tool. Pairwise meta-analyses and Bayesian network meta-analyses will be performed for all related outcome measures. GRADE will be used to evaluate the quality of evidence.
The results of this NMA will be published in a peer-reviewed journal.
This NMA may provide more recommendations for patients and researchers, such as which treatment is better for a particular case of AF, and what may be the hotspots for the future studies.
The protocol for this NMA has been registered on PROSPERO under the number CRD42020164438.
房颤（AF）恢复窦性心律后高复发率一直是临床难题。尽管抗心律失常药物已确立并广泛应用，但哪种药物更有利于维持窦性心律仍存在争议。本研究旨在总结胺碘酮联合β受体阻滞剂维持房颤患者窦性心律的随机对照试验（RCT），并通过网状Meta分析（NMA）确定预防房颤复发的有效且安全的干预措施。
从Cochrane图书馆、PubMed、科学网、EMBASE、中国生物医学文献数据库（SinoMed）、中国知网（CNKI）和万方数据库建库至2019年12月，全面检索比较胺碘酮与不同β受体阻滞剂维持房颤患者窦性心律的RCT。主要结局将是房颤复发和栓塞并发症发生率。次要结局将是症状改善情况和不良事件。将根据Cochrane协作网的偏倚风险工具对纳入的RCT进行偏倚风险评估。将对所有相关结局指标进行成对Meta分析和贝叶斯网状Meta分析。将采用GRADE评估证据质量。
本NMA结果将发表在同行评审期刊上。
本NMA可能为患者和研究人员提供更多建议，例如哪种治疗方法对特定房颤病例更好，以及未来研究的热点可能是什么。
PROSPERO注册号：本NMA方案已在PROSPERO上注册，注册号为CRD42020164438。
