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The Effect of Catheter Ablation on Left Atrial Size and Function for Patients with Atrial Fibrillation: An Updated Meta-Analysis.

Xiong B, Li D, Wang J, Gyawali L, Jing J, Su L - PLoS ONE (2015)

Bottom Line: The LA diameter (LAD), maximum LA volume, and minimal LA volume were significantly decreased post-ablation, as compared with those at a pre-ablation visit.Compared with the pre-ablation outcomes, we found no significant differences in LAEF/LAAEF at a post-ablation follow-up.With CA, LA volumes and LAD were decreased significantly in patients with AF; LAEF was not significant changes in patients with PeAF but decreased in those with PAF.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, The Chongqing Cardiac Arrhythmias Service Center, Chongqing, China.

ABSTRACT

Background: Catheter ablation (CA) for atrial fibrillation (AF) is now an important therapeutic modality for patients with AF. However, data regarding changes in left atrial (LA) function after CA have indicated conflicting results depending on the AF types, follow-up period, and the analytical imaging tools. The objective of this review was to analyze the effect of CA on the LA size and function for patients with AF.

Methods: We searched for studies regarding LA size and function pre- and post-ablation in PubMed, Embase, the Cochrane Library, and Web of Knowledge through May 2014. LA function was measured by LA ejective fraction (LAEF), LA active ejective fraction (LAAEF), or both. Total and subgroup analyses were implemented using Cochrane Review Manager Version 5.2. Weighted mean differences with 95% confidence intervals were used to express the results of continuous outcomes using fixed or random effect models. I2 was used to calculate heterogeneity. To assess publication bias, Egger's test and Begg's funnel plot were performed using Stata 12.0.

Results: Twenty-five studies (2040 enrolled patients) were selected for this meta-analysis. The LA diameter (LAD), maximum LA volume, and minimal LA volume were significantly decreased post-ablation, as compared with those at a pre-ablation visit. Compared with the pre-ablation outcomes, we found no significant differences in LAEF/LAAEF at a post-ablation follow-up. Decreases in LA volume and LAEF remained significant post-ablation for paroxysmal AF (PAF); however, the LAEF was insignificant changes in persistent AF (PeAF). Heterogeneity was significant in spite which individual study was excluded. A publication bias was not found. In a meta-regression analysis, we did not find any factor that contributed to the heterogeneity.

Conclusion: With CA, LA volumes and LAD were decreased significantly in patients with AF; LAEF was not significant changes in patients with PeAF but decreased in those with PAF.

No MeSH data available.


Related in: MedlinePlus

Flow chart of the literature search and study selection processes.
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pone.0129274.g001: Flow chart of the literature search and study selection processes.

Mentions: We identified 1566 references from electronic databases using the previously described strategy. According to the inclusion criteria, 92 citations were retrieved and required further evaluation after screening the title, abstract, or both. Forty-one reviews and 14 case reports were excluded. Two studies reported median and inter-quartile range outcomes; 6 studies included surgical ablation; 2 studies had a follow-up of <3 months; and 2 studies included HF patients. Finally, 25 studies (2040 enrolled patients) were selected for this meta-analysis [9–33]. The selection process is demonstrated in a flow chart (Fig 1). The characteristics of each included study are listed in Table 1. The primary results of each included study are shown in Table 2.


The Effect of Catheter Ablation on Left Atrial Size and Function for Patients with Atrial Fibrillation: An Updated Meta-Analysis.

Xiong B, Li D, Wang J, Gyawali L, Jing J, Su L - PLoS ONE (2015)

Flow chart of the literature search and study selection processes.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493108&req=5

pone.0129274.g001: Flow chart of the literature search and study selection processes.
Mentions: We identified 1566 references from electronic databases using the previously described strategy. According to the inclusion criteria, 92 citations were retrieved and required further evaluation after screening the title, abstract, or both. Forty-one reviews and 14 case reports were excluded. Two studies reported median and inter-quartile range outcomes; 6 studies included surgical ablation; 2 studies had a follow-up of <3 months; and 2 studies included HF patients. Finally, 25 studies (2040 enrolled patients) were selected for this meta-analysis [9–33]. The selection process is demonstrated in a flow chart (Fig 1). The characteristics of each included study are listed in Table 1. The primary results of each included study are shown in Table 2.

Bottom Line: The LA diameter (LAD), maximum LA volume, and minimal LA volume were significantly decreased post-ablation, as compared with those at a pre-ablation visit.Compared with the pre-ablation outcomes, we found no significant differences in LAEF/LAAEF at a post-ablation follow-up.With CA, LA volumes and LAD were decreased significantly in patients with AF; LAEF was not significant changes in patients with PeAF but decreased in those with PAF.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, The Chongqing Cardiac Arrhythmias Service Center, Chongqing, China.

ABSTRACT

Background: Catheter ablation (CA) for atrial fibrillation (AF) is now an important therapeutic modality for patients with AF. However, data regarding changes in left atrial (LA) function after CA have indicated conflicting results depending on the AF types, follow-up period, and the analytical imaging tools. The objective of this review was to analyze the effect of CA on the LA size and function for patients with AF.

Methods: We searched for studies regarding LA size and function pre- and post-ablation in PubMed, Embase, the Cochrane Library, and Web of Knowledge through May 2014. LA function was measured by LA ejective fraction (LAEF), LA active ejective fraction (LAAEF), or both. Total and subgroup analyses were implemented using Cochrane Review Manager Version 5.2. Weighted mean differences with 95% confidence intervals were used to express the results of continuous outcomes using fixed or random effect models. I2 was used to calculate heterogeneity. To assess publication bias, Egger's test and Begg's funnel plot were performed using Stata 12.0.

Results: Twenty-five studies (2040 enrolled patients) were selected for this meta-analysis. The LA diameter (LAD), maximum LA volume, and minimal LA volume were significantly decreased post-ablation, as compared with those at a pre-ablation visit. Compared with the pre-ablation outcomes, we found no significant differences in LAEF/LAAEF at a post-ablation follow-up. Decreases in LA volume and LAEF remained significant post-ablation for paroxysmal AF (PAF); however, the LAEF was insignificant changes in persistent AF (PeAF). Heterogeneity was significant in spite which individual study was excluded. A publication bias was not found. In a meta-regression analysis, we did not find any factor that contributed to the heterogeneity.

Conclusion: With CA, LA volumes and LAD were decreased significantly in patients with AF; LAEF was not significant changes in patients with PeAF but decreased in those with PAF.

No MeSH data available.


Related in: MedlinePlus