Pacing and clinical electrophysiology : PACE
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Pacing Clin Electrophysiol · May 2019
Meta AnalysisProphylactic pulmonary vein isolation during cavotricuspid isthmus ablation for atrial flutter: A meta-analysis.
Atrial arrhythmias (AA), including atrial fibrillation (AF), have been reported in patients after cavotricuspid isthmus (CTI) ablation for typical atrial flutter (AFL). Several studies have examined the effect of performing concomitant pulmonary vein isolation (PVI) with CTI on recurrent AA. These studies were analyzed to determine the overall effect of this approach on recurrent AA. ⋯ This meta-analysis shows addition of a prophylactic PVI during CTI ablation significantly reduces recurrent AA at 1 year without significantly increasing major complications.
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Pacing Clin Electrophysiol · Nov 2014
Meta AnalysisPerioperative anticoagulation management in patients on chronic oral anticoagulant therapy undergoing cardiac devices implantation: a meta-analysis.
The perioperative anticoagulation strategy during cardiac implantable electronic devices (CIEDs) implantation is highly variable without consensus among implanting physicians. A systematic literature search was performed in MEDLINE, EMBASE, and the Cochrane Library to identify clinical trials in patients on chronic oral anticoagulant (OAC) therapy undergoing CIEDs implantation. Bleeding and thromboembolic events were compared among heparin bridging, continued OAC, and interrupted OAC groups. ⋯ There was no significant difference between OAC continuation and OAC interruption group in bleeding (RR 0.90, 95% CI, 0.65-1.24, P = 0.52) and thromboembolic (RR 0.57, 95% CI, 0.16-2.01, P = 0.38) complications. The OAC interruption group had an obviously lower incidence of bleeding in comparison with the heparin bridging group and no statistical significance was observed in thrombus occurrence. Implantation of CIEDs with continuous OAC therapy may offer the best option by combining the lower risk of bleeding with rare thromboembolism compared with heparin bridging and OAC interruption therapy.
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Pacing Clin Electrophysiol · Nov 2014
Meta AnalysisRelationship between brain natriuretic peptides and recurrence of atrial fibrillation after successful direct current cardioversion: a meta-analysis.
Atrial fibrillation (AF) recurrence is common after successful direct current cardioversion (DCCV), with a 40% rate of recurrence within the first month. Several studies have investigated the potential association between brain natriuretic peptide (BNP) or N-terminal (NT)-proBNP levels before DCCV and the risk of AF recurrence, but results have been inconsistent. We, therefore, conducted a systematic review and meta-analysis of all available data to determine whether sinus rhythm (SR) maintenance after successful DCCV may be determined by preprocedural BNP and NT-proBNP levels. ⋯ Our analysis suggests that low preprocedural BNP/NT-proBNP levels are associated with SR maintenance. The use of BNP or NT-proBNP for prediction of long-term response to DCCV appears to be useful and should be further evaluated.
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Pacing Clin Electrophysiol · Jun 2014
Meta AnalysisLandiolol hydrochloride for prevention of atrial fibrillation after cardiac surgery: a meta-analysis.
Atrial fibrillation (AF) is the most common arrhythmic complication after cardiac surgery. Several studies have compared the efficacy of landiolol and placebo or other agents in preventing new-onset AF in patients after cardiac surgery. In this study, we conducted a meta-analysis to determine whether landiolol is effective in preventing new-onset AF after cardiac surgery. ⋯ Landiolol administration in the perioperative period can reduce the occurrence of AF after cardiac surgery without increasing the risk of major complications. It can be used to prevent new-onset AF safely after cardiac surgery.
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Pacing Clin Electrophysiol · Aug 2013
Meta AnalysisTiming and route of amiodarone for prevention of postoperative atrial fibrillation after cardiac surgery: a network regression meta-analysis.
We attempted to evaluate if an oral-only regimen was as effective in preventing postoperative atrial fibrillation (POAF) after cardiac surgery, in comparison to a regimen that included intravenous (IV) administration using a network meta-analysis of available data, and also attempted to assess if preoperative administration at least 1 day before surgery was superior to postoperative prophylaxis (at least 1 day after surgery). ⋯ This systematic review suggests a regimen of both oral-only and one including IV administration, as well pre- and postoperative administration of amiodarone is effective in prevention of POAF after cardiac surgery.