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- Bytyci, I. Ibadete, et al.
(författare)
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Left atrial size as predictor of recurrences after catheter ablation in paroxysmal atrial fibrillation : a systematic review and meta-analysis
- 2017
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Ingår i: European Journal of Heart Failure. - : European Society of Cardiology. - 1388-9842 .- 1879-0844. ; 19:S1, s. 80-80
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Tidskriftsartikel (refereegranskat)abstract
- Background and Aim: Left atrial (LA) enlargement is associated with paroxysmal atrial fibrillation (PAF) incidence and outcome. The predictive role of the LA size in AF treatment with catheter ablation is still controversial. The aim of this meta-analysis was to analyze the potential association between LA diameter in patients with PAF undergoing ablation and AF recurrence after ablation.Methods: We systematically searched PubMed-Medline, EMBASE, Scopus, Google Scholar and the Cochrane Central Registry, up to December 2016 in order to select clinical trial and observational studies, which assessed the predictive role of LA diameter in AF recurrence after catheter-ablation. 2962 patients from 16 studies with paroxysmal AF (PAF) were included.Results: The pooled analysis showed that after a follow-up period of 19. 66± 8.31 months, patients with AF recurrence had larger LA size compared with those without AF recurrence, with a weighted mean difference (WMD) 2.31 ([95% CI 1.27 to 3.34], P < 0.0001). LA diameter ≥40 mm predicted AF recurrence HR:1.04 [95% CI 1.00 to 1.08], P=0.04), but the best cut-off value, in all included patients, was ≥50mm HR:3.08 [95% CI 1.47 to 6.49], P=0.003).Conclusions: Enlarged left atrium in patients with PAF undergoing catheter ablation predicts recurrences. The diameter more than 50 mm is the best cut-off of the recurrences of AF, but diameter of 40 mm also can predict recurrences in these patients.
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- Bytyci, Ibadete, et al.
(författare)
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Left atrial strain increases in CRT responders : a systematic review and meta-analysis
- 2018
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Ingår i: European Heart Journal. - : OXFORD UNIV PRESS. - 0195-668X .- 1522-9645. ; 39, s. 422-422
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background and aim: Impaired left atrial (LA) strain is associated with myocardial fibrosis and carries poor prognosis, especially arrhythmia. Cardiac resynchronization therapy (CRT) is associated with reserved LA remodeling and reduced arrhythmia. The aim of this meta-analysis was to assess the relationship between CRT and LA function improvement.Methods: We systematically searched PubMed-Medline, EMBASE, Scopus, Google Scholar and the Cochrane Central Registry, up to February 2018 in order to select clinical trials and observational studies, which assessed the predictive value of LA strain of CRT response. The left ventricular end-systolic volume (LVESV) reduction ≥15 ml and/or LV ejection fraction (EF) increase ≥10% were the documented criteria for assessment of CRT response.Results: A total of 299 patients (181 responders and 118 non-responders to CRT) from 5 observational studies, with mean follow-up period of 6 months were included in this meta-analysis. The pooled analysis showed no difference between baseline LA strain in the two groups with weighted mean difference (WMD) 1.07% [95% CI -2.37 to 4.51, P=0.54, Figure 1]. After the follow-up period, LA strain in the CRT responders significantly increased, WMD 27.7% [95% CI 23.1 to 32.6, P<0.001, Figure 2, a)], but not in the non-responders, WMD -34.5 [95% CI -38.4 to -30.6, p<0.001, Figure 2, b)].Conclusions: Improvement of LA strain in CRT responders reflects LA reserve remodeling. These results support the importance of LA function in patients treated by CRT for heart failure.
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