Inducibility of atrial fibrillation after catheter ablation predicts recurrences of atrial fibrillation: a meta‐analysis.

Background: Pulmonary vein isolation (PVI) is a component of standard care for patients with symptomatic atrial fibrillation (AF). Procedural inducibility of AF following PVI has been suggested as predictor of AF recurrence but is discussed controversially. This meta‐analysis aimed at evaluating the...

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Publicado en:Pacing & Clinical Electrophysiology Vol. 44; no. 4; pp. 667 - 677
Autores principales: Millenaar, Dominic, Becker, Nicolas, Pavlicek, Valérie, Wintrich, Jan, Böhm, Michael, Mahfoud, Felix, Ukena, Christian
Formato: meta analysis research systematic review tables/charts Journal Article
Publicado: Wiley-Blackwell Apr2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2021
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Inducibility of atrial fibrillation after catheter ablation predicts recurrences of atrial fibrillation: a meta‐analysis.
      aug:
        au:
          Millenaar, Dominic
          Becker, Nicolas
          Pavlicek, Valérie
          Wintrich, Jan
          Böhm, Michael
          Mahfoud, Felix
          Ukena, Christian
        affil: Department of Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine, Saarland University Hospital, Homburg/Saar, Germany
      sug:
        subj:
          Pulmonary Veins Surgery
          Catheter Ablation Methods
          Atrial Fibrillation Surgery
          Recurrence
          Human
          Systematic Review
          Meta Analysis
          Electrophysiology
          Medline
          Odds Ratio
          Confidence Intervals
          Male
          Female
          Heart Conduction System Physiopathology
          Isoproterenol
          Male
          Female
      ab: Background: Pulmonary vein isolation (PVI) is a component of standard care for patients with symptomatic atrial fibrillation (AF). Procedural inducibility of AF following PVI has been suggested as predictor of AF recurrence but is discussed controversially. This meta‐analysis aimed at evaluating the relevance of electrophysiological inducibility of AF following PVI for future AF recurrences. Methods: A literature search of MEDLINE and Web of Science was performed until April 2020. Prospective trials of PVI in patients with AF and post‐procedural atrial stimulation to test for inducibility of AF as well as adequate follow‐up for AF recurrence (defined as AF >10 s to >10 min at follow‐up) were included. Odds ratios (ORs) were analyzed using random‐effects models. Results: A total of 11 trials with 1544 patients (follow‐up 7–39 months, age 56 ± 6 years, predominantly male 74 ± 6%) were included. Inducibility of AF post‐PVI was predictive for AF recurrence during follow‐up (OR 2.08; 95% CI 1.25 to 3.46). Prediction for AF recurrence at follow‐up was better for patients with paroxysmal AF (OR 4.06; 95% CI 1.39 to 11.91), stimulation in the CS (OR 2.82, 95% CI 1.17 to 6.79). A trend towards higher ORs was seen without the use of isoproterenol (OR 2.43; 95% CI 1.17 to 5.07), as well as few stimulations during induction and a short definition of AF in meta‐regression analyses. Conclusions: Electrophysiological inducibility of AF following PVI was predictive for future recurrence of AF, in particular in patients with paroxysmal AF, stimulation in only CS and no use of isoproterenol.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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