Sun Fuqiang, Liu Honghao, Zhang Qi, Lu Fanfan, Zhan Haibo, Zhou Jiawei
Department of Cardiovascular Surgery.
Department of Emergency.
Medicine (Baltimore). 2020 Oct 2;99(40):e22195. doi: 10.1097/MD.0000000000022195.
Conflicting data have been reported related to the impact of atrial fibrillation (AF) on outcomes after transcatheter mitral valve repair with MitraClip (MC) implantation. In this study, we assessed the prognosis of MC-treated patients according to the presence of pre-existing AF.
Randomized and observational studies reporting outcomes of pre-existing AF or sinus rhythm in patients undergoing MC treatment were identified with an electronic search. Outcomes of interest were short-and long-term mortality, stroke, bleeding, rehospitalization, myocardial infarction (MI), cardiogenic shock, acute procedure success, the hospital stay, and the number of Clips implanted.
Eight studies (8466 individuals) were eligible. Compared to sinus rhythm, long-term mortality, the risk of bleeding, rehospitalization, and longer hospital stay were significantly higher in AF groups, whereas similar correlations were found in the analysis of other outcomes.
AF may be related with worse outcomes in patients undergoing MC implantation, including long-term mortality, major bleeding, and rehospitalization. AF should be taken into account when referring a patient for MC treatment.
关于心房颤动（AF）对经导管二尖瓣修复术（使用MitraClip（MC）植入）后结局的影响，已有相互矛盾的数据报道。在本研究中，我们根据术前是否存在AF评估了接受MC治疗患者的预后。
通过电子检索确定了报告接受MC治疗患者术前AF或窦性心律结局的随机和观察性研究。感兴趣的结局包括短期和长期死亡率、中风、出血、再次住院、心肌梗死（MI）、心源性休克、急性手术成功率、住院时间以及植入的夹子数量。
八项研究（8466名个体）符合条件。与窦性心律相比，AF组的长期死亡率、出血风险、再次住院率和更长的住院时间显著更高，而在其他结局分析中发现了类似的相关性。
AF可能与接受MC植入的患者的更差结局相关，包括长期死亡率、大出血和再次住院。在推荐患者接受MC治疗时应考虑AF因素。
