Efficacy and safety of surgical radiofrequency ablation for atrial fibrillation during cardiac surgery: a meta-analysis / 中华胸心血管外科杂志

ABSTRACT

Objective The purpose of this sturdy was to conduct a meta-analysis of published randomised controlled trials(RCT) comparing the clinical outcomes of radiofrequency ablation(RFA) versus surgery alone(SA) in all patients with cardiac surgery.Methods PubMed, Embase, the Cochrane Controlled Trials Register databases, CNKI, CBM disc and VIP datebases were searched, and study eligibility and conducted data abstraction were determined independently and in duplicate.Literature searches from database establishment to November 2014.The heterogeneity and data were analyzed by the software of Rev Man 5.2.Results Of 564 studies identified, 8 studies met eligibility criteria, and included a total of 591 patients.In efficacy, The number of patients in sinus rhythm(SR) was signifcantly improved in RFA group compared to SA group at discharge(OR =10.59;95％ CI 3.81-29.45).This effect on SR remained at all follow-up periods until ＞ 1 year.In safety, there was no significant difference in the incidence of hospital mortality(OR =1.17;95％ CI 0.41-3.35) and mortality rate in follow up period(OR =0.77;95％ CI 0.35-1.69) between RFA group and SA group.Similar results were shown in the incidence of permanent pacemaker(OR =0.65;95 ％ CI 0.28-1.52;P =0.32) , thromboembolic events (OR =1.61;95 ％ CI 0.54-4.84;P =0.40), postoperative re-intervention for bleeding (OR =0.45;95 ％ CI 0.12-1.70;P =0.24).Conclusion The results of the current randomized trials demonstrates that concomitant surgical radiofrequency ablation and cardiac surgery is safe and effective at restoring sinus rhythm.