Atrial fibrillation catheter ablation in endurance athletes: systematic review and meta-analysis,Journal of Interventional Cardiac Electrophysiology

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Atrial fibrillation catheter ablation in endurance athletes: systematic review and meta-analysis
Journal of Interventional Cardiac Electrophysiology ( IF 2.1 ) Pub Date : 2023-07-19 , DOI: 10.1007/s10840-023-01574-0
Narut Prasitlumkum ₁ , Nithi Tokavanich ₂ , Noppachai Siranart ₃ , Witina Techasatian ₄ , Wisit Cheungpasitporn ₅ , Leenhapong Navaravong ₆ , Ronpichai Chokesuwattanaskul ₇

Affiliation

Background

Atrial fibrillation (AF) management in endurance athletes (EA) is challenging due to the paucity of data, especially on the efficacy and safety of catheter ablation (CA). The hypothesis is that the efficacy and safety of AF CA in EA are comparable to the non-EA.

Methods

Databases from EMBASE, Medline, PubMed, and Cochrane were searched from inception through February 2023. Studies with available information on efficacy and safety profiles were included. Effect estimates from the individual studies were extracted and combined using random effect and generic inverse variance method of DerSimonian and Laird.

Results

Nine observational studies with a total of 1129 participants were identified, of whom 51% were EA. Our analysis found that rate of atrial arrhythmia (AA) recurrences following AF CA was not statistically different between EA and non-EA (RR 1.04, I² = 57.6%, p = 0.54). The AA survival rates after a single ablation in EA was 60.2%, which improved up to 77% after multiple ablations during the follow-up period. Infrequent complication rates ranging from 0 to 7.6% were observed, with no mortality.

Conclusions

Our meta-analysis suggests that AF CA is as effective and safe in EA as in non-EA. In the future, AF CA should be considered as a first-line therapeutic choice in this patient group.

中文翻译：

耐力运动员心房颤动导管消融术：系统评价和荟萃分析

背景

由于缺乏数据，尤其是关于导管消融术（CA）的有效性和安全性的数据，耐力运动员（EA）的心房颤动（AF）管理具有挑战性。假设是 AF CA 在 EA 中的疗效和安全性与非 EA 相当。

方法

检索了从建库到 2023 年 2 月的 EMBASE、Medline、PubMed 和 Cochrane 的数据库。纳入了有关疗效和安全性概况的可用信息的研究。使用 DerSimonian 和 Laird 的随机效应和通用逆方差方法提取和合并来自单个研究的效应估计值。

结果

确定了 9 项观察性研究，共涉及 1129 名参与者，其中 51% 是 EA。我们的分析发现，AF CA 后房性心律失常（AA）复发率在 EA 和非 EA 之间没有统计学差异（RR 1.04，I ² = 57.6%，p = 0.54）。EA 单次消融后的 AA 生存率为 60.2%，在随访期间多次消融后提高至 77%。观察到 0% 至 7.6% 的罕见并发症发生率，无死亡率。