Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing
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J Interv Card Electrophysiol · Mar 2018
Review Meta AnalysisN-3 polyunsaturated fatty acids for prevention of postoperative atrial fibrillation: updated meta-analysis and systematic review.
N-3 polyunsaturated fatty acids (PUFA) have been postulated to have an anti-arrhythmic effect on postoperative atrial fibrillation (POAF), with conflicting results among studies. This study on pooled data evaluated the effect of PUFA on POAF among patients undergoing cardiac surgery. ⋯ PUFA appears to reduce the incidence of POAF. However, the said protective effect may be influenced by EPA/DHA ratio, with < 1 appearing preferable. PUFA efficacy on POAF prevention appeared insignificant when compared with non-fish oils and only apparent in the setting of CABG alone. Further studies are needed to confirm the effect of PUFA on POAF and to assess the proper use of PUFA against POAF.
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J Interv Card Electrophysiol · Apr 2017
Review Meta AnalysisAtrial fibrillation inducibility during cavotricuspid isthmus-dependent atrial flutter ablation as a predictor of clinical atrial fibrillation. A meta-analysis.
Atrial fibrillation (AF) and cavotricuspid isthmus (CTI)-dependent atrial flutter (AFL) are two separate entities that coexist in a significant percentage of patients. We sought to investigate whether AF inducibility during CTI AFL ablation predicted the occurrence of AF at follow-up after successful AFL ablation. ⋯ Although ablation for CTI AFL is highly effective, AF continues to be a long-term risk for individuals undergoing this procedure. AF induced by pacing protocols in patients undergoing CTI AFL predicts for future AF. Inducible AF is a clinically relevant finding that may help guide decisions for long-term anticoagulation after successful typical AFL ablation especially in patients with elevated CHADS-VASc scores (≥2) and in considering prophylactic PVI during CTI AFL ablation.
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J Interv Card Electrophysiol · Mar 2017
Review Meta AnalysisMeta-analysis of efficacy and safety of apixaban and uninterrupted apixaban therapy compared to vitamin K antagonists in patients undergoing catheter ablation for atrial fibrillation.
Apixaban is a Factor Xa inhibitor increasingly being used for stroke prevention in atrial fibrillation (AF). Although several studies have been done, the efficacy and safety of apixaban during the peri-procedural period of AF ablation remains unclear. We sought to systematically review pooled data from these various studies to evaluate thromboembolic and bleeding risks in patients undergoing catheter ablation for AF who are treated with apixaban (interrupted and uninterrupted). ⋯ Our study demonstrates patients treated with apixaban and VKA during the peri-procedural period for AF ablation have similar rates of TE and bleeding complications. Interrupted and uninterrupted apixaban strategies were associated with similar outcomes.
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J Interv Card Electrophysiol · Sep 2016
Review Meta AnalysisApixaban for periprocedural anticoagulation during catheter ablation of atrial fibrillation: a systematic review and meta-analysis of 1691 patients.
Apixaban, a direct factor Xa inhibitor recently approved for thromboembolic prophylaxis in patients with nonvalvular atrial fibrillation (AF), is increasingly used in patients undergoing catheter ablation of AF. However, large randomized studies supporting its use in the ablation context are still lacking. We undertook the present meta-analysis to assess the impact of apixaban in terms of thromboembolic and bleeding events in patients undergoing AF ablation as compared to warfarin. ⋯ The rates of death, thromboembolic events, major bleedings including cardiac tamponade, and minor bleedings in patients on apixaban undergoing AF ablation are very low and similar to that seen in patients treated with uninterrupted warfarin. Although primary driven by nonrandomized studies, these results support apixaban as periprocedural anticoagulation during AF ablation procedures.
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J Interv Card Electrophysiol · Nov 2011
Review Meta Analysis Comparative StudyCardiac resynchronization therapy in patients with mild heart failure: a systematic review and meta-analysis.
Cardiac resynchronization therapy (CRT) reduces symptoms and improves survival in patients with advanced heart failure (New York Heart Association (NYHA) functional class III-IV), reduced ejection fraction, and wide QRS complex. Whether CRT has the same benefit also in asymptomatic or mildly symptomatic heart failure patients is controversial. Our objective is to summarize the available evidence on the effects of CRT in asymptomatic or mildly symptomatic (NYHA I-II) heart failure patients. ⋯ Among patients with mild (NYHA II) heart failure, CRT reduces mortality and the risk of heart failure events, induces a favorable LV reverse remodeling and slows the progression of heart failure symptoms.