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首页> 外文期刊>Journal of cardiovascular medicine >Catheter ablation of atrial fibrillation with uninterrupted anticoagulation: a meta-analysis of six randomized controlled trials
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Catheter ablation of atrial fibrillation with uninterrupted anticoagulation: a meta-analysis of six randomized controlled trials

机译：导管消融心房颤动与不间断的抗凝血：六种随机对照试验的荟萃分析

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Aims Uninterrupted anticoagulation is recommended during the ablation of atrial fibrillation. This meta-analysis compared the safety and efficacy of uninterrupted direct oral anticoagulants (DOACs) to uninterrupted vitamin K antagonists (VKAs) during atrial fibrillation ablation. Methods The meta-analysis included eligible randomized controlled trials from 2009 to 2019. Odds ratios (ORs) and 95% confidence intervals were pooled using a random effects model and a sensitivity analysis was performed by sequentially removing one study or DOAC at a time. Results Six studies were included; 1288 received DOAC and 1081 VKA. Pooled ORs indicated a lower nonsignificant incidence in DOACs vs. VKA of composite outcome of major bleeding, stroke, or transient ischemic attack, and mortality (0.69; 0.28-1.71; 31 vs. 45 events), major bleeding alone (0.66; 0.30-1.47; 27 vs. 41 events), and cardiac tamponade (0.56; 0.21-1.45; eight vs. 13 events) with a slightly higher occurrence of minor bleeding (1.17; 0.89-1.56; 139 vs. 106 events) and silent cerebral thromboembolic events (1.12; 0.75-1.66; 72 vs. 58 among 442 and 376 patients performing MRI study). Sensitivity analyses confirmed overall results: pooled ORs ranged from 0.56 to 1.00 for the composite outcome and from 0.54 to 0.92 for major bleedings. Conclusion Uninterrupted DOAC is a safe and effective alternative to uninterrupted VKA during atrial fibrillation ablation.
机译：目的房颤消融时建议不间断抗凝。这项荟萃分析比较了房颤消融期间不间断直接口服抗凝剂（DOAC）和不间断维生素K拮抗剂（VKAs）的安全性和有效性。方法荟萃分析包括2009年至2019年符合条件的随机对照试验。使用随机效应模型汇总优势比（or）和95%置信区间，并通过一次顺序删除一项研究或DOAC进行敏感性分析。结果共纳入6项研究；1288个接收到DOAC和1081个VKA。合并的ORs表明，DOACs与VKA相比，大出血、中风或短暂性脑缺血发作的综合结果和死亡率（0.69；0.28-1.71；31对45个事件）的发生率较低，无显著性差异，仅大出血（0.66；0.30-1.47；27对41个事件），心脏压塞（0.56；0.21-1.45；8对13个事件），轻微出血（1.17；0.89-1.56；139对106个事件）和无症状脑血栓栓塞事件（442和376名进行MRI研究的患者中1.12；0.75-1.66；72对58个事件）的发生率略高。敏感性分析证实了总体结果：综合结果的合并ORs范围为0.56至1.00，严重出血的合并ORs范围为0.54至0.92。结论在心房颤动消融过程中，不间断DOAC是一种安全有效的替代不间断VKA的方法。

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