RT Journal Article
SR Electronic
T1 Anaesthesia use in catheter ablation for atrial fibrillation: a systematic review and meta-analysis of observational studies
JF Heart Asia
JO Heart Asia
FD BMJ Publishing Group Ltd, British Cardiovascular Society and Asia Pacific Heart Association
SP e011155
DO 10.1136/heartasia-2018-011155
VO 11
IS 2
A1 Ka Hou Christien Li
A1 Tian Sang
A1 Cheng Chan
A1 Mengqi Gong
A1 Yingzhi Liu
A1 Aaron Jesuthasan
A1 Guangping Li
A1 Tong Liu
A1 Michael H S Lam
A1 William KK Wu
A1 Matthew T V Chan
A1 Fang-zhou Liu
A1 Cheng Chen
A1 Jeffery Ho
A1 Yunlong Xia
A1 Gary Tse
A1 ,
YR 2019
UL http://heartasia.bmj.com/content/11/2/e011155.abstract
AB Objectives This meta-analysis and systematic review seeks to compare both characteristic parameters and procedural outcomes of atrial fibrillation (AF) catheter ablation in patients under general anaesthesia (GA)/deep sedation and mild/moderate sedation.Background Catheter ablation has become a widely applied intervention for treating symptomatic AF and arrhythmias that are refractory to medical therapy. It can be conducted through from mild sedation to GA.Methods PubMed and Embase were searched up to July 2018 for randomised controlled trials, cohort and observational studies that assessed the outcomes of catheter ablation under GA/deep sedation or mild/moderate sedation. Nine studies were included in this meta-analysis after screening with the inclusion and exclusion criteria. Heterogeneity between studies and publication bias was evaluated by I2 index and Egger’s regression, respectively.Results Our meta-analysis found catheter AF ablation with GA/deep sedation to be associated with reduced risk of recurrence (RR: 0.79, 95% CI 0.56 to 1.13, p=0.20) and complications (RR: 0.95, 95% CI 0.64 to 1.42, p=0.82), though statistically insignificant. In terms of procedural parameters, there was no significant difference between the two groups for both procedural time (SMD: −0.13, 95% CI −0.90 to 0.63, p=0.74) and fluoroscopy time (SMD: −0.41, 95% CI −1.40 to 0.58, p=0.41). Univariate meta-regression did not reveal any covariates as a moderating factor for complication and recurrence risk.Conclusion Apart from an increased likelihood of procedural success, ablation by GA/deep sedation was found to be non-significantly different from the mild/moderate sedation approach in both procedural parameters and outcome measures.