The Effect of Catheter Ablation on Left Atrial Size and Function for Patients with Atrial Fibrillation: An Updated Meta-Analysis
| Autor: | Laxman Gyawali, Li Su, Jianling Wang, Dan Li, Bin Xiong, Jinjin Jing |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Funnel plot medicine.medical_treatment lcsh:Medicine Catheter ablation Cochrane Library Internal medicine Atrial Fibrillation medicine Humans Heart Atria lcsh:Science Aged Multidisciplinary medicine.diagnostic_test business.industry lcsh:R Atrial fibrillation Publication bias Middle Aged medicine.disease Confidence interval Meta-analysis Cardiology Catheter Ablation lcsh:Q Female business Electrocardiography Research Article |
| Zdroj: | PLoS ONE PLoS ONE, Vol 10, Iss 7, p e0129274 (2015) |
| ISSN: | 1932-6203 |
| Popis: | Background Catheter ablation (CA) for atrial fibrillation (AF) is now an important therapeutic modality for patients with AF. However, data regarding changes in left atrial (LA) function after CA have indicated conflicting results depending on the AF types, follow-up period, and the analytical imaging tools. The objective of this review was to analyze the effect of CA on the LA size and function for patients with AF. Methods We searched for studies regarding LA size and function pre- and post-ablation in PubMed, Embase, the Cochrane Library, and Web of Knowledge through May 2014. LA function was measured by LA ejective fraction (LAEF), LA active ejective fraction (LAAEF), or both. Total and subgroup analyses were implemented using Cochrane Review Manager Version 5.2. Weighted mean differences with 95% confidence intervals were used to express the results of continuous outcomes using fixed or random effect models. I2 was used to calculate heterogeneity. To assess publication bias, Egger’s test and Begg’s funnel plot were performed using Stata 12.0. Results Twenty-five studies (2040 enrolled patients) were selected for this meta-analysis. The LA diameter (LAD), maximum LA volume, and minimal LA volume were significantly decreased post-ablation, as compared with those at a pre-ablation visit. Compared with the pre-ablation outcomes, we found no significant differences in LAEF/LAAEF at a post-ablation follow-up. Decreases in LA volume and LAEF remained significant post-ablation for paroxysmal AF (PAF); however, the LAEF was insignificant changes in persistent AF (PeAF). Heterogeneity was significant in spite which individual study was excluded. A publication bias was not found. In a meta-regression analysis, we did not find any factor that contributed to the heterogeneity. Conclusion With CA, LA volumes and LAD were decreased significantly in patients with AF; LAEF was not significant changes in patients with PeAF but decreased in those with PAF. |
| Databáze: | OpenAIRE |
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