Cryoballoon ablation for atrial fibrillation in patients with heart failure and reduced left ventricular ejection fraction: A systematic review and meta-analysis.

Autor: Taha AM; Faculty of Medicine, Fayoum University, Fayoum, Egypt., Hendi NI; Faculty of Medicine, Ain Shams University, Egypt., Elwekel AB; Faculty of Medicine, Al-Azhar University, Cairo, Egypt., Atia A; Faculty of Medicine, Cairo University, Cairo, Egypt., Taha NA; MARS-Global, London, UK., Shrestha AB; M Abdur Rahim Medical College, Dinajpur, Bangladesh., Elbanna M; Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Jazyk: angličtina
Zdroj: Clinical cardiology [Clin Cardiol] 2024 Jan; Vol. 47 (1), pp. e24177. Date of Electronic Publication: 2023 Oct 25.
DOI: 10.1002/clc.24177
Abstrakt: The coexistence of atrial fibrillation (AF) with heart failure (HF) is prevalent, leading to severe complications. This review aimed to investigate the success rate and efficacy of cryoballoon ablation (CBA) by measuring the improvement in the New York Heart Association (NYHA) classification and the effect on the left ventricular systolic function in patients with AF accompanied by heart failure with reduced ejection fraction (HFrEF). Electronic databases search included PubMed, Web of Science, and Scopus in January 2023. Outcomes addressed the following: left ventricular ejection fraction (LVEF) improvement, AF recurrence, NYHA classification improvement, and mortality. STATA 17.0 software was used for data analysis. The effect size for the studies was a standard mean difference (SMD) with a 95% confidence interval (CI) for outcomes. Proportion analysis with 95% CI was used for freedom from early AF and AF after 2 years and all-cause death. We included six studies, including 1699 HF patients with 365 HFrEF patients. The SMD of postoperative LVEF compared to preoperative LVEF in HFrEF was 0.99 ([95% CI: 0.60, 1.39], p = .00), and for NYHA was -1.12 ([95% CI: -1.36, -0.87], p = .00). The analysis results in HFrEF patients for freedom from AF after 1 year was 65% ([95% CI: 0.55, 0.75], and after 2 years was 39% ([95% CI: 0.10, 0.67]). Proportional analysis was conducted for all-cause death, resulting in 3% mortality ([95% CI: -0.01, 0.07]). Cryoablation of AF accompanied by HFrEF appeared safe as it reduced AF recurrence and enhanced clinical outcomes.
(© 2023 The Authors. Clinical Cardiology published by Wiley Periodicals, LLC.)
Databáze: MEDLINE
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