Renal sympathetic denervation improves clinical outcomes in patients undergoing catheter ablation for atrial fibrillation and history of hypertension : A meta-analysis
© 2019 Wiley Periodicals, Inc..
BACKGROUND: Currently, there is limited data regarding the impact of adjunctive renal sympathetic denervation (RSDN) with pulmonary vein isolation (PVI) in hypertensive patients with atrial fibrillation (AF).
METHODS: A comprehensive literature search for studies comparing RSDN + PVI vs PVI alone for AF and history of hypertension until 1 January 2019 was performed. The results were expressed as risk ratio (RR) for the categorical variables and mean difference (MD) for the continuous variables with 95% confidence intervals (CIs).
RESULTS: A total of six eligible (four randomized and two prospective nonrandomized) studies consisting of 432 patients (306 paroxysmal AF and 126 persistent AF) were included (RSDN + PVI group: 186 patients and PVI group: 246 patients). Follow-up is more than or equal to 1 year. Compared with PVI, RSDN + PVI significantly decreased the risk of AF recurrence (RR = 0.58, 95% confidence interval [CI] = 0.47-0.72, P < 0.00001) on follow-up. Fluoroscopy (MD = +5.53 minutes, 95% CI = 0.76-10.31, P = 0.02) and procedure time (MD = +34.85 minutes, 95% CI = 23.55-46.16, P < 0.00001) was significantly longer with the PVI + RSDN group compared with PVI alone. There were no significant differences in complications between both groups. Test of heterogeneity was low for all clinical outcomes (I2 = 0%).
CONCLUSION: Our meta-analysis demonstrates that RSDN as an adjunct to PVI appears to be safe and improves clinical outcomes in both paroxysmal and persistent AF and history of hypertension.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2019 |
|---|---|
| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:30 |
|---|---|
| Enthalten in: |
Journal of cardiovascular electrophysiology - 30(2019), 5 vom: 21. Mai, Seite 702-708 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Atti, Varunsiri [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Atrial fibrillation |
|---|
| Anmerkungen: |
Date Completed 19.08.2020 Date Revised 19.08.2020 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1111/jce.13868 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM29350587X |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM29350587X | ||
| 003 | DE-627 | ||
| 005 | 20231225075451.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2019 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1111/jce.13868 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n0978.xml |
| 035 | |a (DE-627)NLM29350587X | ||
| 035 | |a (NLM)30723989 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Atti, Varunsiri |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Renal sympathetic denervation improves clinical outcomes in patients undergoing catheter ablation for atrial fibrillation and history of hypertension |b A meta-analysis |
| 264 | 1 | |c 2019 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 19.08.2020 | ||
| 500 | |a Date Revised 19.08.2020 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2019 Wiley Periodicals, Inc. | ||
| 520 | |a BACKGROUND: Currently, there is limited data regarding the impact of adjunctive renal sympathetic denervation (RSDN) with pulmonary vein isolation (PVI) in hypertensive patients with atrial fibrillation (AF) | ||
| 520 | |a METHODS: A comprehensive literature search for studies comparing RSDN + PVI vs PVI alone for AF and history of hypertension until 1 January 2019 was performed. The results were expressed as risk ratio (RR) for the categorical variables and mean difference (MD) for the continuous variables with 95% confidence intervals (CIs) | ||
| 520 | |a RESULTS: A total of six eligible (four randomized and two prospective nonrandomized) studies consisting of 432 patients (306 paroxysmal AF and 126 persistent AF) were included (RSDN + PVI group: 186 patients and PVI group: 246 patients). Follow-up is more than or equal to 1 year. Compared with PVI, RSDN + PVI significantly decreased the risk of AF recurrence (RR = 0.58, 95% confidence interval [CI] = 0.47-0.72, P < 0.00001) on follow-up. Fluoroscopy (MD = +5.53 minutes, 95% CI = 0.76-10.31, P = 0.02) and procedure time (MD = +34.85 minutes, 95% CI = 23.55-46.16, P < 0.00001) was significantly longer with the PVI + RSDN group compared with PVI alone. There were no significant differences in complications between both groups. Test of heterogeneity was low for all clinical outcomes (I2 = 0%) | ||
| 520 | |a CONCLUSION: Our meta-analysis demonstrates that RSDN as an adjunct to PVI appears to be safe and improves clinical outcomes in both paroxysmal and persistent AF and history of hypertension | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a atrial fibrillation | |
| 650 | 4 | |a atrial fibrillation recurrence | |
| 650 | 4 | |a hypertension | |
| 650 | 4 | |a pulmonary vein isolation | |
| 650 | 4 | |a renal sympathetic denervation | |
| 700 | 1 | |a Turagam, Mohit K |e verfasserin |4 aut | |
| 700 | 1 | |a Garg, Jalaj |e verfasserin |4 aut | |
| 700 | 1 | |a Lakkireddy, Dhanunjaya |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of cardiovascular electrophysiology |d 1996 |g 30(2019), 5 vom: 21. Mai, Seite 702-708 |w (DE-627)NLM074905481 |x 1540-8167 |7 nnns |
| 773 | 1 | 8 | |g volume:30 |g year:2019 |g number:5 |g day:21 |g month:05 |g pages:702-708 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1111/jce.13868 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 30 |j 2019 |e 5 |b 21 |c 05 |h 702-708 | ||