Meta-analysis of clinical effect and long-term efficacy of catheter ablation in treatment of hypertrophic cardiomyopathy atrial fibrillation
PANG Aibo1, HUANG Wei1, LING Cunbao1, ZHANG Chunyan1, LV Jungang2
1. Birth Defects Prevention and Control Technology Research Center, Medical Research and Innovation Department of Chinese PLA General Hospital, Beijing 100853, China; 2. The Third Department of Internal Medicine,Beijing General Hospital of Chinese People's Armed Police Force, Beijing 100027,China
Abstract：Objective To investigate the long-term outcome, clinical efficacy, and safety of catheter ablation (CA) in the treatment of hypertrophic cardiomyopathy (HCM) patients with atrial fibrillation (AF) and to summarize the predictive factors of recurrent arrhythmias. Methods The retrieval time was from January 2013 to January 2022. A total of 18 literatures meeting the criteria for CA postoperative in patients with HCM and AF were included in Pubmed, CNKI, NOS and other electronic databases. Meta-analysis was performed using Revman software to summarize the success rate of CA, adverse reactions and complications. To evaluate the clinical efficacy, long-term outcome and safety of CA in HCM with AF. Results A total of 826 patients with HCM complicated with AF were treated with CA and followed up after discontinuation of oral medication. Meta-analysis showed that the clinical observation recovery rate was 69.98%, 95%CI: 1.99 (1.72,2.30), P<0.00001. 64 patients underwent surgery and complications. 95%CI was 0.09 (0.08,0.10), P<0.00001. The success rate of CA conversion in HCM patients with AF is high, which can effectively convert to sinus rhythm. Some patients can maintain sinus rhythm with the assistance of oral heart-rate lowering drugs. The covariates predicting recurrence/success after CA surgery were left atrial diameter(LAD)and left ventricular ejection fraction(LVEF). Conclusions CA in the treatment of HCM combined with AF has a high recurrence rate, significant clinical effect, fewer complications, low mortality, and good safety. LAD and left atrial volume index are the most important factors for AF recurrence after CA.
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2023, Vol. 34 
