Comparison between the efficacy of catheter ablation and ventricular rate control in treating persistent atrial fibrillation complicating heart failure: systematic evaluation and Meta analysis
Abstract：ObjectiveTo make systematic evaluation on the efficacy of catheter ablation in treating the patients with persistent atrial fibrillation(PAF) complicating heart failure(HF). MethodsAfter systematic search in PubMed, Cochrane Library, Embase, Clinical Trials. gov, CNKI, CBM and Wanfang Database, we screened out the experiments related to comparison between the efficacy of catheter ablation and ventricular rate control in treating PAF complicating HF, and adopted them in our study. Meta analysis was performed with the software of Revman 5.3. ResultsWe retrieved and summarized 5 randomized controlled trials, enrolling 423 patients (214 accepting the treatment of catheter ablation). Meta analysis results showed that left ventricular ejection fraction(LVEF) significantly increased after catheter ablation and MD was 521% (95%CI：169-873, P=0004). However, obvious heterogenicity existed among different studies(I2=80%, P=00006). The measurement indexes were adjusted with heterogeneous sources excluded by sensitivity analysis before being readopted into the software for Meta analysis. No heterogenicity was found among the related literatures(I2=0%, P=049), and at present the MD of LVEF became 731%(95%CI：518-945, P<0000 01). Simultaneously, changes of MLHFQ, 6MWT, BNP, Peak VO2 and NHYA Class were analyzed before and after the treatment. These indexes also significantly improved if compared with those in the treatment of ventricular rate control. ConclusionCompared with the treatment of ventricular rate control, catheter ablation shows a tendency of improving LVEF, heart function, kinetism and life quality in the patients with PAF and HF, however, its specific efficacy requires for further research.
尹春娥, 王福军, 周芳. 导管消融与室率控制治疗持续性房颤合并心力衰竭疗效比较的系统评价与Meta分析[J]. 实用心电学杂志, 2019, 28(1): 42-48.
YIN Chun-E, WANG Fu-Jun, ZHOU Fang. Comparison between the efficacy of catheter ablation and ventricular rate control in treating persistent atrial fibrillation complicating heart failure: systematic evaluation and Meta analysis. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2019, 28(1): 42-48.
2019, Vol. 28 
