Systematic review and meta-analysis of catheter ablation of ventricular tachycardia in ischemic heart disease.

Autor:	Martinez BK; University of Connecticut School of Pharmacy, Storrs, Connecticut; Hartford Hospital Evidence-Based Practice Center, Hartford, Connecticut., Baker WL; University of Connecticut School of Pharmacy, Storrs, Connecticut; Hartford Hospital Evidence-Based Practice Center, Hartford, Connecticut., Konopka A; University of Connecticut School of Pharmacy, Storrs, Connecticut., Giannelli D; University of Connecticut School of Pharmacy, Storrs, Connecticut., Coleman CI; University of Connecticut School of Pharmacy, Storrs, Connecticut; Hartford Hospital Evidence-Based Practice Center, Hartford, Connecticut., Kluger J; Hartford HealthCare Heart and Vascular Institute, Hartford Hospital, Hartford, Connecticut; University of Connecticut School of Medicine, Farmington, Connecticut., Cronin EM; Hartford HealthCare Heart and Vascular Institute, Hartford Hospital, Hartford, Connecticut; University of Connecticut School of Medicine, Farmington, Connecticut. Electronic address: edmond.cronin@hhchealth.org.
Jazyk:	angličtina
Zdroj:	Heart rhythm [Heart Rhythm] 2020 Jan; Vol. 17 (1), pp. e206-e219. Date of Electronic Publication: 2019 May 10.
DOI:	10.1016/j.hrthm.2019.04.024
Abstrakt:	Background: Patients with ischemic heart disease (IHD) are at risk for ventricular tachycardia (VT). Catheter ablation (CA) may reduce this risk. Objective: To perform a systematic review and meta-analysis of randomized controlled trials (RCTs) of CA of VT in patients with IHD. Methods: Literature searches of MEDLINE, the Cochrane Central Register of Controlled Trials (CENTRAL), and the Cochrane Database of Systematic Reviews (CDSR) were performed from January 2000 through April 2018 to identify RCTs comparing a strategy of CA vs no ablation in patients with IHD and an implantable cardioverter defibrillator (ICD). Outcomes of interest included appropriate ICD therapies, appropriate ICD shocks, VT storm, recurrent VT/ventricular fibrillation (VF), cardiac hospitalizations, and all-cause mortality. Using an inverse variance random-effects model, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for each endpoint. Results: A total of 5 RCTs (N = 635 patients) were included, with a duration of follow-up ranging from 6 months to 27.9 months. Patients who underwent CA experienced decreased odds of appropriate ICD therapies (OR 0.49; 95% CI 0.28-0.87), appropriate ICD shocks (OR 0.52; 95% CI 0.28-0.96), VT storm (OR 0.64; 95% CI 0.43-0.95), and cardiac hospitalization (OR 0.67; 95% CI 0.46-0.97) vs those who did not undergo ablation. There was no evidence of a benefit for recurrent VT/VF (OR 0.87; 95% CI 0.41-1.85), although this endpoint was not reported in all trials, or for all-cause mortality (OR 0.89; 95% CI 0.60-1.34). Conclusion: In this systematic review and meta-analysis of RCTs, CA was associated with a significant reduction in the odds of appropriate ICD therapies, appropriate ICD shocks, VT storm, and cardiac hospitalizations in patients with IHD. (Copyright © 2019 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu