Ablation strategies for arrhythmogenic right ventricular cardiomyopathy:a systematic review and meta-analysis
Li-Shui SHEN1
Li-Min LIU1
Li-Hui ZHENG1
Feng HU1
Zhi-Cheng HU1
Shang-Yu LIU1
Jin-Rui GUO2
Kush Kumar Bhagat3
Yan YA1
1.Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing, China2.Arrhythmia Center, Yunnan Fuwai Cardiovascular Hospital, Kunming China3.Eternal hospital, Jaipur, Rajasthan, India
摘要：Background Catheter ablation for ventricular tachycardia (VT) in patients with arrhythmogenic right ventricular cardiomyopathy(ARVC) has significantly evolved over the past decade. However, different ablation strategies showed inconsistency in acute and long-term outcomes. Methods We searched the databases of Medline, Embase and Cochrane Library through October 17,2019 for studies describing the clinical outcomes of VT ablation in ARVC. Data including VT recurrence, all-cause mortality, acute procedural efficacy and major pro?cedural complications were extracted. A meta-analysis with trial sequential analysis was further performed in comparative studies of endo-epicardial versus endocardial-only ablation. Results A total of 24 studies with 717 participants were enrolled. The literatures of epicardial ablation were mainly published after 2010 with total ICD implantation of 73.7％, acute efficacy of 89.8％, major complication of 5.2％, follow-up of 28.9 months, VT freedom of 75.3％, all-cause mortality of 1.1 ％ and heart transplantation of 0.6％. Meta-analysis of 10 comparative studies revealed that compared with endocardial-only approach, epicardial ablation significantly decreased VT recurrence (OR:0.50; 95％ CI: 0.30-0.85; P = 0.010), but somehow increased major procedural complications (OR: 4.64; 95％ CI: 1.28-16.92; P = 0.02),with not evident improvement of acute efficacy (OR: 2.74; 95％ CI: 0.98-7.65; P = 0.051) or all-cause mortality (OR: 0.87; 95％ CI:0.09-8.31; P = 0.90). Conclusion Catheter ablation for VT in ARVC is feasible and effective. Epicardial ablation is associated with better long-term VT freedom, but with more major complications and unremarkable survival or acute efficacy benefit.
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论文发表日期：2020-11-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：10( 694-703 )
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