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Catheter ablation for atrial fibrillation in hypertrophic cardiomyopathy: a systematic review and meta-analysis

Atrial fibrillation (AF) is common in hypertrophic cardiomyopathy (HCM) and is associated with a high risk of stroke. The efficacy and safety of catheter ablation in this setting is poorly characterised. We aimed to systematically review the existing literature and to perform a meta-analysis to dete... Full description

Journal Title: Heart (British Cardiac Society) 2016, Vol.102 (19), p.1533-1543
Main Author: Providencia, Rui
Other Authors: Elliott, Perry , Patel, Kiran , McCready, Jack , Babu, Girish , Srinivasan, Neil , Bronis, Kostantinos , Papageorgiou, Nikolaos , Chow, Anthony , Rowland, Edward , Lowe, Martin , Segal, Oliver R , Lambiase, Pier D
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: England: British Medical Association
ID: ISSN: 1355-6037
Link: https://www.ncbi.nlm.nih.gov/pubmed/27234160
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recordid: cdi_proquest_miscellaneous_1827924874
title: Catheter ablation for atrial fibrillation in hypertrophic cardiomyopathy: a systematic review and meta-analysis
format: Article
creator:
  • Providencia, Rui
  • Elliott, Perry
  • Patel, Kiran
  • McCready, Jack
  • Babu, Girish
  • Srinivasan, Neil
  • Bronis, Kostantinos
  • Papageorgiou, Nikolaos
  • Chow, Anthony
  • Rowland, Edward
  • Lowe, Martin
  • Segal, Oliver R
  • Lambiase, Pier D
subjects:
  • Abridged Index Medicus
  • Adult
  • Aged
  • Anti-Arrhythmia Agents - therapeutic use
  • Atrial fibrillation
  • Atrial Fibrillation - diagnosis
  • Atrial Fibrillation - etiology
  • Atrial Fibrillation - physiopathology
  • Atrial Fibrillation - surgery
  • Cardiomyopathy, Hypertrophic
  • Cardiomyopathy, Hypertrophic - complications
  • Care and treatment
  • Catheter Ablation - adverse effects
  • Chi-Square Distribution
  • Disease-Free Survival
  • Female
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Recurrence
  • Reoperation
  • Risk Factors
  • Treatment Outcome
ispartof: Heart (British Cardiac Society), 2016, Vol.102 (19), p.1533-1543
description: Atrial fibrillation (AF) is common in hypertrophic cardiomyopathy (HCM) and is associated with a high risk of stroke. The efficacy and safety of catheter ablation in this setting is poorly characterised. We aimed to systematically review the existing literature and to perform a meta-analysis to determine the efficacy and safety of catheter ablation of AF in patients with HCM. Random-effects meta-analysis of studies comparing HCM versus non-HCM controls. The outcomes of freedom from AF/atrial tachycardia, and acute procedure-related complications were assessed. Studies were searched on MEDLINE, EMBASE, COCHRANE and clinicaltrials.gov. Fourteen studies were considered eligible for the systematic review, of which five were included in the meta-analysis. Freedom from AF/atrial tachycardia relapse was higher in patients without HCM (after a single procedure: 38.7% HCM vs 49.8% controls, OR=2.25, 95% CI 1.09 to 4.64, p=0.03; after ≥1 procedure: 51.8% HCM vs 71.2% controls, OR=2.62, 95% CI 1.52 to 4.51, p=0.0006; I(2)=33% and 26%, respectively). Risk of procedure-related adverse events was low. Repeat procedures (mean difference=0.16, 95% CI 0.0 to 0.32, p=0.05, I(2)=53%) and antiarrhythmic drugs (OR=4.70, 95% CI 2.31 to 9.55, p
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 1355-6037
fulltext: fulltext
issn:
  • 1355-6037
  • 1468-201X
url: Link


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titleCatheter ablation for atrial fibrillation in hypertrophic cardiomyopathy: a systematic review and meta-analysis
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creatorProvidencia, Rui ; Elliott, Perry ; Patel, Kiran ; McCready, Jack ; Babu, Girish ; Srinivasan, Neil ; Bronis, Kostantinos ; Papageorgiou, Nikolaos ; Chow, Anthony ; Rowland, Edward ; Lowe, Martin ; Segal, Oliver R ; Lambiase, Pier D
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descriptionAtrial fibrillation (AF) is common in hypertrophic cardiomyopathy (HCM) and is associated with a high risk of stroke. The efficacy and safety of catheter ablation in this setting is poorly characterised. We aimed to systematically review the existing literature and to perform a meta-analysis to determine the efficacy and safety of catheter ablation of AF in patients with HCM. Random-effects meta-analysis of studies comparing HCM versus non-HCM controls. The outcomes of freedom from AF/atrial tachycardia, and acute procedure-related complications were assessed. Studies were searched on MEDLINE, EMBASE, COCHRANE and clinicaltrials.gov. Fourteen studies were considered eligible for the systematic review, of which five were included in the meta-analysis. Freedom from AF/atrial tachycardia relapse was higher in patients without HCM (after a single procedure: 38.7% HCM vs 49.8% controls, OR=2.25, 95% CI 1.09 to 4.64, p=0.03; after ≥1 procedure: 51.8% HCM vs 71.2% controls, OR=2.62, 95% CI 1.52 to 4.51, p=0.0006; I(2)=33% and 26%, respectively). Risk of procedure-related adverse events was low. Repeat procedures (mean difference=0.16, 95% CI 0.0 to 0.32, p=0.05, I(2)=53%) and antiarrhythmic drugs (OR=4.70, 95% CI 2.31 to 9.55, p<0.0001, I(2)=0%) are more frequently needed in patients with HCM to prevent arrhythmia relapse. Sensitivity analyses suggested that the outcome in patients with HCM with less dilated atria and paroxysmal AF may be more comparable to the general population. The observed complication rate of catheter ablation of AF in patients with HCM was low. Even though the risk of relapse is twofold higher, catheter ablation can be effective in patients with HCM and AF, particularly in patients with paroxysmal AF and smaller atria.
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subjectAbridged Index Medicus ; Adult ; Aged ; Anti-Arrhythmia Agents - therapeutic use ; Atrial fibrillation ; Atrial Fibrillation - diagnosis ; Atrial Fibrillation - etiology ; Atrial Fibrillation - physiopathology ; Atrial Fibrillation - surgery ; Cardiomyopathy, Hypertrophic ; Cardiomyopathy, Hypertrophic - complications ; Care and treatment ; Catheter Ablation - adverse effects ; Chi-Square Distribution ; Disease-Free Survival ; Female ; Humans ; Male ; Middle Aged ; Odds Ratio ; Recurrence ; Reoperation ; Risk Factors ; Treatment Outcome
ispartofHeart (British Cardiac Society), 2016, Vol.102 (19), p.1533-1543
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descriptionAtrial fibrillation (AF) is common in hypertrophic cardiomyopathy (HCM) and is associated with a high risk of stroke. The efficacy and safety of catheter ablation in this setting is poorly characterised. We aimed to systematically review the existing literature and to perform a meta-analysis to determine the efficacy and safety of catheter ablation of AF in patients with HCM. Random-effects meta-analysis of studies comparing HCM versus non-HCM controls. The outcomes of freedom from AF/atrial tachycardia, and acute procedure-related complications were assessed. Studies were searched on MEDLINE, EMBASE, COCHRANE and clinicaltrials.gov. Fourteen studies were considered eligible for the systematic review, of which five were included in the meta-analysis. Freedom from AF/atrial tachycardia relapse was higher in patients without HCM (after a single procedure: 38.7% HCM vs 49.8% controls, OR=2.25, 95% CI 1.09 to 4.64, p=0.03; after ≥1 procedure: 51.8% HCM vs 71.2% controls, OR=2.62, 95% CI 1.52 to 4.51, p=0.0006; I(2)=33% and 26%, respectively). Risk of procedure-related adverse events was low. Repeat procedures (mean difference=0.16, 95% CI 0.0 to 0.32, p=0.05, I(2)=53%) and antiarrhythmic drugs (OR=4.70, 95% CI 2.31 to 9.55, p<0.0001, I(2)=0%) are more frequently needed in patients with HCM to prevent arrhythmia relapse. Sensitivity analyses suggested that the outcome in patients with HCM with less dilated atria and paroxysmal AF may be more comparable to the general population. The observed complication rate of catheter ablation of AF in patients with HCM was low. Even though the risk of relapse is twofold higher, catheter ablation can be effective in patients with HCM and AF, particularly in patients with paroxysmal AF and smaller atria.
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16Humans
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19Odds Ratio
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21Reoperation
22Risk Factors
23Treatment Outcome
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titleCatheter ablation for atrial fibrillation in hypertrophic cardiomyopathy: a systematic review and meta-analysis
authorProvidencia, Rui ; Elliott, Perry ; Patel, Kiran ; McCready, Jack ; Babu, Girish ; Srinivasan, Neil ; Bronis, Kostantinos ; Papageorgiou, Nikolaos ; Chow, Anthony ; Rowland, Edward ; Lowe, Martin ; Segal, Oliver R ; Lambiase, Pier D
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abstractAtrial fibrillation (AF) is common in hypertrophic cardiomyopathy (HCM) and is associated with a high risk of stroke. The efficacy and safety of catheter ablation in this setting is poorly characterised. We aimed to systematically review the existing literature and to perform a meta-analysis to determine the efficacy and safety of catheter ablation of AF in patients with HCM. Random-effects meta-analysis of studies comparing HCM versus non-HCM controls. The outcomes of freedom from AF/atrial tachycardia, and acute procedure-related complications were assessed. Studies were searched on MEDLINE, EMBASE, COCHRANE and clinicaltrials.gov. Fourteen studies were considered eligible for the systematic review, of which five were included in the meta-analysis. Freedom from AF/atrial tachycardia relapse was higher in patients without HCM (after a single procedure: 38.7% HCM vs 49.8% controls, OR=2.25, 95% CI 1.09 to 4.64, p=0.03; after ≥1 procedure: 51.8% HCM vs 71.2% controls, OR=2.62, 95% CI 1.52 to 4.51, p=0.0006; I(2)=33% and 26%, respectively). Risk of procedure-related adverse events was low. Repeat procedures (mean difference=0.16, 95% CI 0.0 to 0.32, p=0.05, I(2)=53%) and antiarrhythmic drugs (OR=4.70, 95% CI 2.31 to 9.55, p<0.0001, I(2)=0%) are more frequently needed in patients with HCM to prevent arrhythmia relapse. Sensitivity analyses suggested that the outcome in patients with HCM with less dilated atria and paroxysmal AF may be more comparable to the general population. The observed complication rate of catheter ablation of AF in patients with HCM was low. Even though the risk of relapse is twofold higher, catheter ablation can be effective in patients with HCM and AF, particularly in patients with paroxysmal AF and smaller atria.
copEngland
pubBritish Medical Association
pmid27234160
doi10.1136/heartjnl-2016-309406
orcididhttps://orcid.org/0000-0003-3383-3984
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