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Opposite effect of ablation on early/late-phase thromboembolic incidence in patients with atrial fibrillation: A meta-analysis on more than 100 000 individuals

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机构: [1]Department of Cardiology, The First Affiliated Hospital, Sun Yet-sen University, Guangzhou, China [2]Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China [3]The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China [4]The Third Affiliated Hospital, Sun Yet-sen University, Guangzhou, China
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关键词: atrial fibrillation catheter ablation meta-analysis thromboembolism

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Background Atrial fibrillation (AF) is an important risk factor for thromboembolic events, for which catheter ablation represents an effective therapy for rhythm control. Intuitively, ablation may reduce the incidence of thromboembolism, but data is quite limited. Hypothesis Catheter ablation was associated with the fewer risk of thromboembolism compared with nonablation in patients with AF. Methods A systematic search was performed in PubMed, EMBASE, the Web of Science, and the Cochrane Library from inception to September 2019. Random-effects model was used to estimate the risk ratios (RR) for the thromboembolic events between the ablation and nonablation groups. Results Twenty-five studies (12 randomized controlled trials and 13 observational studies) with 104 687 participants were included. Pooled analysis suggested that ablation was associated with a 35% lower risk of total thromboembolic events compared to nonablation group (RR = 0.65; 95% CI, 0.51-0.82;P= .0003). When separated into early-phase (<30 days) and late-phase (>30 days) events, ablation was associated with an increased early-phase thromboembolism (RR = 1.96; 95% CI, 1.35-2.83;P= .0004) but a decreased late-phase thromboembolism (RR = 0.75; 95% CI, 0.63-0.90;P= .002). Subgroup analysis according to different study types found similar results were found in observation studies, but not in RCT studies because the sample size was too small to be conclusive. Conclusions In patients with AF, catheter ablation was associated with a fewer risk of overall and late-phase thromboembolism in comparison with nonablation. However, over the early postoperative period, catheter ablation was associated with the double higher risk of thromboembolic events.

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出版当年[2019]版:
大类 | 3 区 医学
小类 | 4 区 心脏和心血管系统
最新[2025]版:
大类 | 3 区 医学
小类 | 3 区 心脏和心血管系统
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出版当年[2018]版:
Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
最新[2023]版:
Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

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第一作者机构: [1]Department of Cardiology, The First Affiliated Hospital, Sun Yet-sen University, Guangzhou, China [2]Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China
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通讯机构: [1]Department of Cardiology, The First Affiliated Hospital, Sun Yet-sen University, Guangzhou, China [2]Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China [*1]Department of Cardiology, The First Affiliated Hospital, Sun Yet-sen University, 58 Zhongshan 2nd Rd., Guangzhou 510080, China.
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