Efficacy of Short-Term Antiarrhythmic Drugs Use after Catheter Ablation of Atrial Fibrillation—A Systematic Review with Meta-Analyses and Trial Sequential Analyses of Randomized Controlled TrialsReportar como inadecuado




Efficacy of Short-Term Antiarrhythmic Drugs Use after Catheter Ablation of Atrial Fibrillation—A Systematic Review with Meta-Analyses and Trial Sequential Analyses of Randomized Controlled Trials - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Background

The efficacy of short-term antiarrhythmic drugs AADs use compared with no-AADs prescription after catheter ablation of atrial fibrillation AF in preventing atrial arrhythmia recurrence is uncertain.

Methods

We searched PubMed, Embase, and the Cochrane Library through December 2015 to identify randomized controlled trials RCTs which evaluated the efficacy of short-term AADs use compared with no-AADs prescription after AF ablation in preventing atrial arrhythmia recurrence. The primary outcome was labeled as early atrial arrhythmia recurrence within 3 months after ablation. Secondary outcome was defined as late recurrence after 3 months of ablation. Random-effects model or fixed-effects model was used to estimate relative risks RRs with 95% confidence intervals CIs.

Results

Six RCTs with 2,667 patients were included into this meta-analysis. Compared with no-AADs administration after AF ablation, short-term AADs use was associated with significant reduction of early atrial arrhythmia recurrence RR, 0.68; 95% CI, 0.52–0.87; p = 0.003. Trial sequential analysis TSA showed that the cumulative Z-curve crossed the trial sequential monitoring boundary for benefit, establishing sufficient and conclusive evidence. However, compared with no-AADs prescription, short-term AADs use after AF ablation didn’t significantly reduce the risk of late atrial arrhythmia recurrence RR, 0.92; 95% CI, 0.83–1.03; p = 0.15. TSA supported this result; meanwhile the estimated required information size 1,486 patients was also met.

Conclusion

Short-term use of AADs after AF ablation can significantly decrease the risk of early atrial arrhythmia recurrence but not lead to corresponding reduction in risk of late atrial arrhythmia recurrence.



Autor: Weijie Chen , Hang Liu , Zhiyu Ling, Yanping Xu, Jinqi Fan, Huaan Du, Peilin Xiao, Li Su, Zengzhang Liu, Xianbin Lan, Bernhard Zr

Fuente: http://plos.srce.hr/



DESCARGAR PDF




Documentos relacionados