“一站式”治疗对合并房间隔分流的房颤患者疗效满意：基于临床经验汇总的证据
'One Stop' Therapy has a Satisfying Performance on AF Patients with Interatrial Communication: Evidence from Pooled Clinical Experience.
作者信息
Zhang Zhi-Yuan, Li Feng, Geng Chi, Chen Yu-Qi, Peng Si-Liang, Zhang Yao-Ting, Zhang You, Gu Xiao-Song, Li Hui
机构信息
Department of Cardiology, The Second Affiliated Hospital of Soochow University, 215004 Suzhou, Jiangsu, China.
出版信息
Rev Cardiovasc Med. 2025 Apr 16;26(4):26662. doi: 10.31083/RCM26662. eCollection 2025 Apr.
BACKGROUND
Left atrial appendage closure (LAAC) has been reported to be a viable alternative to prevent thromboembolic events for atrial fibrillation (AF) patients. Interatrial communication closure, such as atrial septal defect (ASD) and patent foramen ovale (PFO) closure could significantly decrease the occurrence of stroke. For AF patients with interatrial communication, the success rate as well as the long-term outcomes of 'One stop' closure remain elusive.
METHODS
Studies were systematically screened using online databases (including PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure (CNKI) database, and WanFang database) from their establishment to 1st August 2024. We utilized a fixed-effect model to synthesize the success rate and the long-term outcomes. Subgroup analysis was performed to identify the potential confounders.
RESULTS
A total of 7 studies comprising 156 patients were included. ASD/PFO closure combined with LAAC showed a high degree of feasibility, with a success rate of 1.00 (95% CI: 0.99, 1.00; < 0.001). Meanwhile, 'One stop' ASD/PFO closure combined with LAAC exhibited a high long-term safety and a low occurrence of complications. Moreover, subgroup analysis revealed that the bleeding event occurrence was relatively higher in the male proportion ≥50% subgroup and HAS-BLED score ≥3 subgroup, respectively.
CONCLUSIONS
ASD/PFO closure combined with LAAC has a satisfying performance on AF patients with interatrial communication.
THE PROSPERO REGISTRATION
CRD42023462221, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023462221.
背景
据报道，左心耳封堵术（LAAC）是预防心房颤动（AF）患者血栓栓塞事件的一种可行替代方案。房间隔交通封堵术，如房间隔缺损（ASD）和卵圆孔未闭（PFO）封堵术，可显著降低中风的发生率。对于合并房间隔交通的AF患者，“一站式”封堵术的成功率及长期疗效仍不明确。
方法
使用在线数据库（包括PubMed、Cochrane图书馆、Web of Science、Embase、中国知网（CNKI）数据库和万方数据库）对从建库至2024年8月1日的研究进行系统筛选。我们采用固定效应模型来综合成功率和长期疗效。进行亚组分析以识别潜在的混杂因素。
结果
共纳入7项研究，包含156例患者。ASD/PFO封堵联合LAAC显示出高度可行性，成功率为1.00（95%CI：0.99，1.00；P<0.001）。同时，“一站式”ASD/PFO封堵联合LAAC显示出较高的长期安全性和较低的并发症发生率。此外，亚组分析显示，男性比例≥50%亚组和HAS - BLED评分≥3亚组的出血事件发生率相对较高。
结论
ASD/PFO封堵联合LAAC对合并房间隔交通的AF患者具有令人满意的疗效。
PROSPERO注册号：CRD42023462221，https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023462221
Zotero 插件