导管消融术后复发性心房颤动的左心耳功能和结构预测因素：一项观察性研究的荟萃分析

Left atrial appendage function and structure predictors of recurrent atrial fibrillation after catheter ablation: A meta-analysis of observational studies.

作者信息

Han Shaojie, Liu Ming, Jia Ruikun, Cen Zhifu, Guo Ran, Liu Guobin, Cui Kaijun

机构信息

Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.

Interventional Operating Room, Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.

出版信息

Front Cardiovasc Med. 2022 Oct 20;9:1009494. doi: 10.3389/fcvm.2022.1009494. eCollection 2022.

BACKGROUND

The results of studies evaluating the left atrial appendage (LAA) function and structure as predictors of atrial fibrillation (AF) recurrence after catheter ablation (CA) are contradictory. Therefore, we performed a meta-analysis to assess whether the LAA function and structure can predict the recurrence of AF after CA.

METHODS

The PubMed, EMBASE, Web of Science, and Cochrane library databases were used to conduct a comprehensive literature search. Finally, 37 studies encompassing 11 LAA parameters were included in this meta-analysis.

RESULTS

Compared with those in the non-recurrence group, the recurrence group had increased LAA volume (SMD 0.53, 95% CI [0.36, 0.71] < 0.00001), LAA volume index, LAA orifice area, and LAA orifice short/long axis and decreased LAA emptying flow velocity (SMD -0.54, 95% CI [-0.68, -0.40], < 0.00001), LAA filling flow velocity, and LAA ejection fraction, while there was no significant difference in LAA morphology or LAA depth.

CONCLUSION

Large LAA structure of pre-ablation (LAA volume, orifice area, orifice long/short axis, and volume index) and decreased LAA function of pre-ablation (LAA emptying flow velocity, filling flow velocity, ejection fraction, and LASEC) increase the odds of AF recurrence after CA.

SYSTEMATIC REVIEW REGISTRATION

[https://www.crd.york.ac.uk/prospero/], identifier [CRD42022324533].

背景

评估左心耳（LAA）功能和结构作为导管消融（CA）后房颤（AF）复发预测指标的研究结果相互矛盾。因此，我们进行了一项荟萃分析，以评估LAA功能和结构是否可预测CA后AF的复发。

方法

使用PubMed、EMBASE、科学网和Cochrane图书馆数据库进行全面的文献检索。最终，本荟萃分析纳入了37项研究，涵盖11个LAA参数。

结果

与未复发组相比，复发组的LAA容积增加（标准化均数差[SMD]0.53，95%置信区间[CI][0.36，0.71]，P<0.00001）、LAA容积指数、LAA开口面积、LAA开口短/长轴增加，而LAA排空流速降低（SMD -0.54，95%CI[-0.68，-0.40]，P<0.00001）、LAA充盈流速、LAA射血分数降低，而LAA形态或LAA深度无显著差异。