...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Circulation. Arrhythmia and electrophysiology >Atrioventricular nodal ablation in atrial fibrillation a meta-analysis and systematic review
【24h】

Atrioventricular nodal ablation in atrial fibrillation a meta-analysis and systematic review

机译：房颤房室结消融的荟萃分析与系统评价

获取原文
获取原文并翻译 | 示例
   

获取外文期刊封面封底 >>

       
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Background-In the treatment of patients with refractory atrial fibrillation (AF), the safety and efficacy of atrioventricular nodal ablation (AVNA) versus pharmacotherapy alone remains unclear. Additionally, the impact of AVNA in patients with reduced systolic function is of growing interest. Methods and Results-A total of 5 randomized or prospective trials were included for efficacy review (314 patients), 11 studies for effectiveness review (810 patients), and 47 studies for safety review (5632 patients). All-cause mortality was similar between AVNA and medical therapy (3.1% versus 3.3%; relative risk ratio, 1.05; 95% confidence interval [CI], 0.29 -3.85). There was no significant difference in exercise duration or ejection fraction (EF) with AVNA relative to pharmacotherapy. In subgroup analysis, patients with baseline systolic dysfunction (116 patients; mean EF, 44%) showed significant relative improvement in EF after AVNA (+4% greater; 95% CI, 3.11- 4.89). In pooled observational analysis, AVNA was also associated with significant improvement in EF only in patients with systolic dysfunction (+7.44%; 95% CI, 5.4 -9.5). The incidence of procedure-related mortality (0.27%) and malignant arrhythmia (0.57%) was low. At mean follow-up of 26.5 months, the incidence of sudden cardiac death after AVNA was 2.1%. There was significant heterogeneity in quality-of-life scales used; compared with pharmacotherapy, AVNA was associated with significant improvement in several symptoms (palpitations, dyspnea). Conclusions-In the management of refractory AF, AVNA is associated with improvement in symptoms and quality of life, with a low incidence of procedure morbidity. In patients with reduced systolic function, AVNA demonstrates small but significantly improved echocardiographic outcomes relative to medical therapy alone.
机译：背景-在难治性房颤（AF）患者的治疗中，房室结消融（AVNA）与单纯药物治疗的安全性和疗效尚不清楚。另外，AVNA对收缩功能降低的患者的影响日益引起人们的关注。方法和结果-总共包括5项随机或前瞻性试验进行疗效评估（314例患者），11项有效性评估研究（810例患者）和47项安全性评估研究（5632例患者）。 AVNA和药物治疗之间的全因死亡率相似（3.1％比3.3％;相对危险度1.05; 95％置信区间[CI]为0.29 -3.85）。与药物治疗相比，AVNA的运动时间或射血分数（EF）没有显着差异。在亚组分析中，基线收缩期功能障碍的患者（116例;平均EF，44％）显示AVNA后EF的相对改善显着（+ 4％; 95％CI，3.11-4.89）。在汇总观察性分析中，仅在收缩功能不全的患者中，AVNA还与EF的显着改善相关（+ 7.44％; 95％CI，5.4 -9.5）。与手术相关的死亡率（0.27％）和恶性心律不齐（0.57％）的发生率较低。平均随访26.5个月，AVNA后心源性猝死的发生率为2.1％。生活质量量表存在很大的异质性。与药物治疗相比，AVNA与多种症状（心pit，呼吸困难）的显着改善相关。结论-在难治性AF的治疗中，AVNA与症状和生活质量的改善相关，而手术发病率较低。在收缩功能降低的患者中，相对于单独的药物治疗，AVNA表现出较小但显着改善的超声心动图结果。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号