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Surgical Ablation for Atrial Fibrillation During Mitral Valve Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Gemelli, Marco ; Gallo, Michele ; Addonizio, Mariangela ; Van den Eynde, Jef ; Pradegan, Nicola ; Danesi, Tommaso Hinna ; Pahwa, Siddharth ; Dixon, Lauren K. ; Slaughter, Mark S. ; Gerosa, Gino

The American journal of cardiology, 2023-12, Vol.209, p.104-113 [Periódico revisado por pares]

United States: Elsevier Inc

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Título:
Surgical Ablation for Atrial Fibrillation During Mitral Valve Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Autor: Gemelli, Marco ; Gallo, Michele ; Addonizio, Mariangela ; Van den Eynde, Jef ; Pradegan, Nicola ; Danesi, Tommaso Hinna ; Pahwa, Siddharth ; Dixon, Lauren K. ; Slaughter, Mark S. ; Gerosa, Gino
Assuntos: Ablation ; atrial fibrillation ; Atrial Fibrillation - complications ; Bias ; Cardiac arrhythmia ; Catheter Ablation - methods ; Clinical trials ; Fibrillation ; Heart Valve Prosthesis Implantation - methods ; Humans ; Implantation ; Meta-analysis ; Mitral valve ; Mitral Valve - surgery ; Mortality ; Pacemakers ; Patients ; Randomized Controlled Trials as Topic ; RCT ; Stroke - complications ; Stroke - etiology ; Systematic review ; Technology adoption ; Text analysis ; Thromboembolism ; Treatment Outcome
É parte de: The American journal of cardiology, 2023-12, Vol.209, p.104-113
Notas: SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ObjectType-Review-1
ObjectType-Article-3
ObjectType-Undefined-4
Descrição: Although surgical ablation has been shown to produce excellent outcomes at follow-up for patients with atrial fibrillation who underwent mitral valve replacement/repair (MVR), this procedure is not commonly performed. Our objective was to conduct a systematic review and meta-analysis to evaluate the outcomes of concomitant surgical ablation during MVR. Three databases were systematically reviewed for randomized clinical trials published by August 2022. The primary outcome was sinus rhythm (SR) at 12 months. Secondary outcomes included SR at discharge and 6 months, all-cause mortality, permanent pacemaker implantation, and stroke and thromboembolic events. A random-effects meta-analysis was performed, calculating odds ratios (ORs) for each outcome. Thirteen studies were included, involving 1,089 patients comparing patients who underwent either isolated MVR (“MVR-only”) or concomitant surgical ablation during MVR (“MVR+Ablation”). The odds of SR were significantly higher in the MVR+Ablation group at discharge (OR 9.62, 95% confidence interval [CI] 4.87 to 19.02, I2 = 55%), at 6-month follow-up (OR 7.21, 95% CI 4.30 to 12.11, I2 = 34%), and at 1-year follow-up (OR 8.41, 95% CI 5.14 to 13.77, I2 = 48%). All-cause mortality was not different in the groups, as were stroke and thromboembolic events, whereas the odds of permanent pacemaker implantation were slightly higher in the MVR+Ablation group (OR 1.87, 95% CI 1.11 to 3.17, I2 = 0%). Concomitant surgical ablation during MVR showed excellent outcomes at short-term follow-up, despite a slightly higher rate of permanent pacemaker implantation. Further studies with longer follow-ups are needed to assess if the SR is maintained over the years.
Editor: United States: Elsevier Inc
Idioma: Inglês

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Surgical Ablation for Atrial Fibrillation During Mitral Valve Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Gemelli, Marco ; Gallo, Michele ; Addonizio, Mariangela ; Van den Eynde, Jef ; Pradegan, Nicola ; Danesi, Tommaso Hinna ; Pahwa, Siddharth ; Dixon, Lauren K. ; Slaughter, Mark S. ; Gerosa, Gino

United States: Elsevier Inc

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