We have located links that may give you full text access.
JOURNAL ARTICLE
META-ANALYSIS
Cardiac resynchronization therapy after atrioventricular junction ablation for symptomatic atrial fibrillation: a meta-analysis.
AIMS: Atrioventricular junction (AVJ) ablation with permanent pacing improves symptoms in selected patients with atrial fibrillation (AF). The optimal pacing modality after AVJ ablation remains unclear. We performed a meta-analysis of randomized controlled trials to examine whether cardiac resynchronization therapy (CRT) is superior to right ventricular (RV) pacing in this patient population.
METHODS AND RESULTS: We searched the MEDLINE and EMBASE databases for studies evaluating the effect of CRT vs. RV pacing after AVJ ablation for AF. Pooled risk ratios (RRs) and mean differences with 95% confidence intervals (CIs) were calculated for categorical and continuous outcomes, respectively, using a random effects model. Five trials involving 686 patients (413 in CRT and 273 in RV pacing group) were included in the analysis. On the basis of the pooled estimate across the studies, CRT resulted in a non-significant reduction in mortality (RR = 0.75, 95% CI 0.43-1.30; P= 0.30) and a significant reduction in hospitalizations for heart failure (RR = 0.38, 95% CI = 0.17-0.85; P= 0.02) compared with RV pacing. Cardiac resynchronization therapy did not improve 6 min walk distance (mean difference 15.7, 95% CI -7.2 to 38.5 m; P= 0.18) and Minnesota Living with Heart Failure quality-of-life score (mean difference -3.0, 95% CI -8.6 to 2.6; P= 0.30) compared with RV pacing. The change in left ventricular ejection fraction between baseline and 6 months favoured CRT (mean change 2.0%, 95% CI 1.5-2.4%; P< 0.001).
CONCLUSION: Cardiac resynchronization therapy may be superior to RV pacing in patients undergoing AVJ ablation for AF. Further studies, adequately powered to detect clinical outcomes, are required.
METHODS AND RESULTS: We searched the MEDLINE and EMBASE databases for studies evaluating the effect of CRT vs. RV pacing after AVJ ablation for AF. Pooled risk ratios (RRs) and mean differences with 95% confidence intervals (CIs) were calculated for categorical and continuous outcomes, respectively, using a random effects model. Five trials involving 686 patients (413 in CRT and 273 in RV pacing group) were included in the analysis. On the basis of the pooled estimate across the studies, CRT resulted in a non-significant reduction in mortality (RR = 0.75, 95% CI 0.43-1.30; P= 0.30) and a significant reduction in hospitalizations for heart failure (RR = 0.38, 95% CI = 0.17-0.85; P= 0.02) compared with RV pacing. Cardiac resynchronization therapy did not improve 6 min walk distance (mean difference 15.7, 95% CI -7.2 to 38.5 m; P= 0.18) and Minnesota Living with Heart Failure quality-of-life score (mean difference -3.0, 95% CI -8.6 to 2.6; P= 0.30) compared with RV pacing. The change in left ventricular ejection fraction between baseline and 6 months favoured CRT (mean change 2.0%, 95% CI 1.5-2.4%; P< 0.001).
CONCLUSION: Cardiac resynchronization therapy may be superior to RV pacing in patients undergoing AVJ ablation for AF. Further studies, adequately powered to detect clinical outcomes, are required.
Full text links
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app