Rujirachun Pongprueth, Wattanachayakul Phuuwadith, Taveeamornrat Svita, Ungprasert Patompong, Tokavanich Nithi, Jongnarangsin Krit
Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Department of Medicine, Albert Einstein Healthcare Network, Philadelphia, Pennsylvania, USA.
Clin Cardiol. 2025 Jan;48(1):e70021. doi: 10.1002/clc.70021.
The association between rheumatoid arthritis (RA) and the risk of developing atrial fibrillation (AF) is well-established. However, data on the impact of RA on AF recurrence postcatheter ablation (CA) remain unclear. This current study aimed to assess the impact of RA on AF recurrence after catheter-based pulmonary vein isolation.
Potentially eligible studies were identified from Medline and EMBASE databases from inception to December 20, 2023. Eligible study must consist of two cohorts of patients with and without RA who underwent catheter ablation for AF. Pooled risk ratio (RR) and 95% CI were calculated using Dersimonian and Laird's random-effect, generic inverse variance approach.
The meta-analysis includes three retrospective cohort studies with a total of 700 patients. The pooled analysis found a significantly increased risk of AF recurrence after CA among patients with RA compared to patients without RA with the pooled RR of 1.59 (95% CI, 1.10-2.29, I 14%). Increased risk of early recurrence (within 90 days) was also observed with the pooled RR of 2.70 (95% CI, 1.74-4.19, I 0%).
The current study found that patients with RA have a higher risk of AF recurrence after CA for AF, including the risk of early recurrence.
类风湿关节炎（RA）与心房颤动（AF）发生风险之间的关联已得到充分证实。然而，关于RA对导管消融（CA）后AF复发影响的数据仍不明确。本研究旨在评估RA对基于导管的肺静脉隔离术后AF复发的影响。
从Medline和EMBASE数据库建库至2023年12月20日检索可能符合条件的研究。符合条件的研究必须包括两组接受AF导管消融的患者，一组有RA，另一组无RA。采用德西蒙尼安和莱尔德随机效应、通用逆方差法计算合并风险比（RR）和95%置信区间（CI）。
荟萃分析纳入三项回顾性队列研究，共700例患者。汇总分析发现，与无RA的患者相比，RA患者CA后AF复发风险显著增加，合并RR为1.59（95%CI，1.10 - 2.29，I² = 14%）。还观察到早期复发（90天内）风险增加，合并RR为2.70（95%CI，1.74 - 4.19，I² = 0%）。
本研究发现，RA患者AF行CA后AF复发风险较高，包括早期复发风险。
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