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Catheter ablation versus medical rate control for persistent atrial fibrillation in patients with heart failure
| Content Provider | Semantic Scholar |
|---|---|
| Author | Zhu, Min Zhou, Xinbin Cai, Hongwen Wang, Zhijun Xu, Huimin Chen, Shenjie Chen, Jie Xu, Xiao Ming Xu, Haibin Mao, Wei |
| Copyright Year | 2016 |
| Abstract | BACKGROUND The effectiveness of restoring the sinus rhythm by catheter ablation relative to that of medical rate control for persistent atrial fibrillation (AF) patients with heart failure (HF) remains to be defined. METHODS We systematically searched Embase, Pubmed, the Cochrane Library, and ClinicalTrials.gov for articles that compared the outcomes of interest between catheter ablation and medical rate control therapy in persistent AF patients with HF and left ventricular systolic dysfunction (LVSD). The primary endpoint was the change in the left ventricular ejection fraction (LVEF) following catheter ablation or medical rate control therapy relative to baseline. Other endpoints included changes in cardiac function and exercise capacity, including the New York Heart Association (NYHA) class, the brain natriuretic peptide (BNP) level, the peak oxygen consumption (peak VO2), the 6-minute walk test (6MWT) results, and quality of life (QOL). RESULTS Three randomized controlled trials (RCTs) with 143 patients were included. At the overall term follow-up, catheter ablation significantly improved the LVEF (mean difference [MD]: 6.22%; 95% confidence interval [CI]: 0.7-11.74, P = 0.03) and peak VO2 (MD: 2.81 mL/kg/min; 95% CI: 0.78-4.85, P = 0.007) and reduced the NYHA class (MD: 0.9; 95% CI: 0.59-1.21, P < 0.001) and the Minnesota Living with Heart Failure Questionnaires (MLHFQ) scores (MD: -11.05; 95% CI: -19.45 - -2.66, P = 0.01) compared with the medical rate control for persistent AF patients with HF. Alterations in parameters, such as the BNP level, 6MWT, and Short Form-36 (SF-36) questionnaire scores also revealed trends that favored catheter ablation therapy, although these differences were not significant. CONCLUSION Catheter ablation resulted in improved LVEF, cardiac function, exercise capacity, and QOL for persistent AF patients with HF compared with the medical rate control strategy. |
| Starting Page | 448 |
| Ending Page | 455 |
| Page Count | 8 |
| File Format | PDF HTM / HTML |
| PubMed reference number | 27472728v1 |
| Alternate Webpage(s) | https://doi.org/10.1097/MD.0000000000004377 |
| DOI | 10.1097/md.0000000000004377 |
| Journal | Medicine |
| Volume Number | 95 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | 6-Minute Walk Test Addison Disease Atrial Fibrillation Cardiac ablation Catheter related infection Confidence Intervals Ejection fraction (procedure) Heart Atrium Heart failure Heart valve disease Left ventricular ejection fraction Left ventricular systolic dysfunction Malignant Fibrous Histiocytoma Nesiritide Oxygen consumption measurement Patients Perceived quality of life Randomized Controlled Trials as Topic Sinus - general anatomical term Ventricular Dysfunction, Left Ventricular Fibrillation |
| Content Type | Text |
| Resource Type | Article |
