A systematic review and meta-analysis of catheter ablation for atrial fibrillation

Abstract

Background: This study analyzes and compares the efficacy of using catheter ablation (CA) and traditional drug treatments for atrial fibrillation (AF). Through a systematic review and meta-analysis, it seeks to provide a theoretical basis for using clinical CA for patients with AF. Methods: We searched through articles detailing randomly controlled trials (RCTs) that assessed the surgical effect of CA on the treatment of AF. These articles were published before January 31, 2000 in various English databases, including PubMed, Embase, Medline, Ovid, Springer, and Web of Sciences. The Cochrane Handbook for Systematic Reviews of Intervention 5.0.2 was adopted for the bias risk assessment, and Review Manager 5.3 software was used for the meta-analysis of the articles. Results: A total of 2,098 patients drawn from 13 articles were included in the study. For patients in the experimental group (Exp. group), the meta-analysis showed an increase in the effects of clinical treatment [mean deviation (MD) =3.91; 95% confidence interval (CI), 3.15–4.85; Z=12.36; P<0.00001], an improvement in daily life function (MD =1.45; 95% CI, 1.03–1.87; Z=6.82; P<0.00001), a decrease in body weakness (MD =−2.84; 95% CI, −3.24 to −2.45; Z=14.16; P <0.00001), and an increase in quality of life score (MD =14.15; 95% CI, 7.24–21.05; Z=4.01; P<0.0001). The Exp. group also experienced a reduction in postoperative pain level (MD =−2.5; 95% CI, −3.11 to −1.89; Z=8.04; P<0.00001), reoccurrence of symptomatic AF (OR =0.27; 95% CI, 0.11–0.67; Z=2.82; P=0.005), rehospitalization (MD =0.15; 95% CI, 0.07–0.31; Z=5.11; P<0.00001), other arrhythmia (MD =0.33; 95% CI, 0.18–0.6; Z=3.62; P=0.0003), and pulmonary vein stenosis (PVS) (MD =0.32; 95% CI, 0.14–0.72; Z=2.74; P=0.006). However, in contrast to patients in the control group (Ctrl group), the ‘bleeding’ mentioned above showed no statistical difference. Discussion: CA has a good postoperative clinical effect on AF patients, reducing incidences of pain, adverse reactions, and rehospitalization. For this reason, CA is a suitable treatment for AF patients who do not effectively respond to drug therapy.