PMID- 25156448
OWN - NLM
STAT- MEDLINE
DCOM- 20150715
LR  - 20211021
IS  - 1932-8737 (Electronic)
IS  - 0160-9289 (Print)
IS  - 0160-9289 (Linking)
VI  - 37
IP  - 11
DP  - 2014 Nov
TI  - Effects of atrioventricular nodal ablation on permanent atrial fibrillation 
      patients with cardiac resynchronization therapy: a systematic review and 
      meta-analysis.
PG  - 707-15
LID - 10.1002/clc.22312 [doi]
AB  - Cardiac resynchronization therapy (CRT) is a well-established therapy for 
      patients with heart failure (HF) and wide QRS configuration, especially for those 
      in sinus rhythm. However, for those with permanent AF, atrioventricular nodal 
      (AVN) ablation use remains under debate. Our objective was to evaluate clinical 
      outcomes and mortality of AVN ablation in HF patients with permanent AF receiving 
      CRT. Electronic publication database and reference lists through October 1, 2013 
      were searched. Observational cohort studies comparing CRT patients with AF who 
      received either AVN ablation or medical therapy were selected. Outcomes included 
      mortality, CRT nonresponse, changes in left ventricular remodeling, and 
      functional outcomes, such as New York Heart Association (NYHA) functional class, 
      quality of life, and 6-minute hall walk distance. Of 1641 reports identified, 13 
      studies with 1256 patients were included. Among patients with permanent AF and 
      insufficient biventricular pacing (< 90%), those who had undergone AVN ablation 
      compared to those who did not had numerically lower all-cause mortality (risk 
      ratio [RR]: 0.63, 95% confidence interval [CI]: 0.42 to 0.96, P = 0.03) and 
      significantly lower nonresponse to CRT (RR: 0.41, 95% CI: 0.31 to 0.54, P < 
      0.00001). Furthermore, AVN ablation was not associated with additional 
      improvements on left ventricular ejection fraction, NYHA functional class, 
      6-minute hall walking distance, and quality of life. In patients with permanent 
      AF undergoing CRT, AVN ablation tended to reduce mortality potentially and 
      improved clinical response when it was applied to patients with inadequate 
      biventricular pacing (< 90%). Randomized controlled trials are needed to further 
      address the efficacy of AVN ablation among this population.
CI  - (c) 2014 Wiley Periodicals, Inc.
FAU - Yin, Jie
AU  - Yin J
AD  - Department of Cardiology, Shandong Provincial Qianfoshan Hospital, Ji'nan, 
      Shandong, China; Department of Cardiology School of Medicine, Shandong 
      University, Ji'nan, Shandong, China.
FAU - Hu, Hesheng
AU  - Hu H
FAU - Wang, Ye
AU  - Wang Y
FAU - Xue, Mei
AU  - Xue M
FAU - Li, Xiaolu
AU  - Li X
FAU - Cheng, Wenjuan
AU  - Cheng W
FAU - Li, Xinran
AU  - Li X
FAU - Yan, Suhua
AU  - Yan S
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20140825
PL  - United States
TA  - Clin Cardiol
JT  - Clinical cardiology
JID - 7903272
SB  - IM
MH  - Atrial Fibrillation/*therapy
MH  - Atrioventricular Node/*surgery
MH  - *Cardiac Resynchronization Therapy
MH  - *Catheter Ablation
MH  - Exercise Test
MH  - Humans
MH  - Quality of Life
MH  - Stroke Volume
PMC - PMC6649403
EDAT- 2014/08/27 06:00
MHDA- 2015/07/16 06:00
PMCR- 2014/08/25
CRDT- 2014/08/27 06:00
PHST- 2014/04/29 00:00 [received]
PHST- 2014/06/06 00:00 [revised]
PHST- 2014/06/11 00:00 [accepted]
PHST- 2014/08/27 06:00 [entrez]
PHST- 2014/08/27 06:00 [pubmed]
PHST- 2015/07/16 06:00 [medline]
PHST- 2014/08/25 00:00 [pmc-release]
AID - CLC22312 [pii]
AID - 10.1002/clc.22312 [doi]
PST - ppublish
SO  - Clin Cardiol. 2014 Nov;37(11):707-15. doi: 10.1002/clc.22312. Epub 2014 Aug 25.