Al-Sadawi Mohammed, Aleem Saadat, Aslam Faisal, Jacobs Robin, Stevens Gregg, Almasry Ibrahim, Singh Abhijeet, Fan Roger, Rashba Eric
Stony Brook Heart Institute, Stony Brook Medicine, Stony Brook, New York.
Library Education and Clinical Services, University of Massachusetts, Worcester, Massachusetts.
Heart Rhythm O2. 2022 Jun 30;3(5):520-525. doi: 10.1016/j.hroo.2022.06.009. eCollection 2022 Oct.
There are few prospective studies assessing the benefits of rhythm control of atrial fibrillation (AF) in patients with heart failure and preserved ejection fraction (HFpEF), which accounts for 50% of all heart failure patients.
Conduct a meta-analysis to assess the effects of rhythm control (ablation and/or antiarrhythmic medications) vs rate control on all-cause mortality in AF patients with HFpEF.
Databases were searched for studies reporting the effect of rhythm control vs rate control on mortality in patients with HFpEF (Ovid MEDLINE, EMBASE, Scopus, Web of Science, Google Scholar, and EBSCO CINAHL). The search was not restricted to time or publication status. The primary endpoint was all-cause mortality. The minimum duration of follow-up required for inclusion was 1 year.
The literature search identified 1210 candidate studies; 5 studies and 16,825 patients were included. The study population had 57% men with a mean age of 71± 2.5 years. Rhythm control for AF was associated with lower all-cause mortality (odds ratio 0.735, 95% confidence interval 0.665-0.813; < .001) as compared to rate control.
Rhythm control for AF in patients with HFpEF was associated with decreased all-cause mortality.
心力衰竭且射血分数保留（HFpEF）的患者占所有心力衰竭患者的50%，但评估房颤（AF）节律控制益处的前瞻性研究较少。
进行一项荟萃分析，以评估节律控制（消融和/或抗心律失常药物）与心率控制对HFpEF房颤患者全因死亡率的影响。
检索数据库，查找报告节律控制与心率控制对HFpEF患者死亡率影响的研究（Ovid MEDLINE、EMBASE、Scopus、Web of Science、Google Scholar和EBSCO CINAHL）。检索不限于时间或发表状态。主要终点是全因死亡率。纳入所需的最短随访时间为1年。
文献检索确定了1210项候选研究；纳入了5项研究和16825例患者。研究人群中男性占57%，平均年龄为71±2.5岁。与心率控制相比，房颤的节律控制与较低的全因死亡率相关（优势比0.735，95%置信区间0.665 - 0.813；P <.001）。
HFpEF患者的房颤节律控制与全因死亡率降低相关。
