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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:
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
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
rightsPublished by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing
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8Chow, Anthony
9Rowland, Edward
10Lowe, Martin
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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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14Disease-Free Survival
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16Humans
17Male
18Middle Aged
19Odds Ratio
20Recurrence
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
oafree_for_read