ISSN 2149-2263 | E-ISSN 2149-2271
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Efficacy and Safety of Catheter Ablation Combined with Left Atrial Appendage Closure in the Treatment of Atrial Fibrillation: A Systematic Review and Meta-Analysis [Anatol J Cardiol]
Anatol J Cardiol. 2022; 26(3): 154-162 | DOI: 10.5152/AnatolJCardiol.2021.766

Efficacy and Safety of Catheter Ablation Combined with Left Atrial Appendage Closure in the Treatment of Atrial Fibrillation: A Systematic Review and Meta-Analysis

An Wang1, Jingbo Jiang2, Zhitao Xie1, Guoqiang Zhong1
1Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
2Department of Cardiology, Guilin People’s Hospital, Guilin, China

Background: Catheter ablation combined with left atrial appendage closure is effective in treating atrial fibrillation. However, the effectiveness of this combined treatment compared with catheter ablation alone is still controversial.
Methods: We searched studies in databases, including The Cochrane Library, PubMed, EMBASE, and Web of Science, that compared catheter ablation combined with left atrial appendage closure and catheter ablation alone in the treatment of atrial fibrillation. These studies reported at least one of the following outcomes: the freedom from atrial arrhythmia rate, the procedure time, the fluoroscopy time, perioperative complications, thromboembolic events, and bleeding events during follow-up. The risk ratio and standard mean difference with 95% CI were analyzed by the random-effects model.
Results: Five studies involving 699 people were included in our meta-analysis. We found no significant difference in the freedom from atrial arrhythmia rate (risk ratio=0.93, 95% CI=0.83-1.04, I 2=0%, P=.21) between the 2 groups. Catheter ablation combined with left atrial appendage closure showed significantly longer procedure and fluoroscopy
times than catheter ablation alone (standard mean difference=1.26, 95% CI=0.85-1.67, P <.00001 and standard mean difference=1.19, 95% CI=0.53-1.85, P=.0004, respectively). With regard to safety outcomes, no significant differences were observed in perioperative complications (RR=1.62, 95% CI=0.99-2.63, I 2=0%, P=.05), thromboembolic events (RR=0.67, 95% CI=0.15-3.11, I 2=0%, P=.61), or bleeding events (RR=0.67, 95% CI=0.11-3.88, P=.65) between the 2 groups during follow-up.
Conclusion: The freedom from atrial arrhythmia rate and safety outcomes of catheter ablation combined with left atrial appendage closure are similar to those of catheter ablation alone. Catheter ablation combined with left atrial appendage closure appears to have longer procedure and fluoroscopy times than catheter ablation alone.

Keywords: Atrial fibrillation, catheter ablation, left atrial appendage closure, meta-analysis

An Wang, Jingbo Jiang, Zhitao Xie, Guoqiang Zhong. Efficacy and Safety of Catheter Ablation Combined with Left Atrial Appendage Closure in the Treatment of Atrial Fibrillation: A Systematic Review and Meta-Analysis. Anatol J Cardiol. 2022; 26(3): 154-162

Corresponding Author: Guoqiang Zhong
Manuscript Language: English


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