Efficacy and safety of one-stop interventional therapy for atrial fibrillation:a systematic review and Meta-analysis

Gao Xianbu; Li Changjin; Huang Songqun; Zhang Sha; Song Xiaowei; Zhao Xianxian; Guo Zhifu; Wu Hong

doi:10.3969/j.issn.1674-4055.2023.10.04

Abstract：Objective To systematically evaluate the efficacy and safety of one-stop interventional therapy(catheter ablation combined with left atrial appendage occlusion)for atrial fibrillation.Methods The Cochrane Library,PubMed,Embase,CNKI and Wanfang databases were systematically searched.The retrieval time limit was from the establishment of the database to July 31,2022.The data of clinical study of one-stop interventional therapy for atrial fibrillation versus catheter ablation therapy were searched.After selecting the literature and extracting the data,the quality of the included literature was evaluated,and the RevMan 5.3 software was used for meta-analysis.Results A total of 1215 patients were included in 8 studies(1 randomized controlled study,7 observational studies),including 507 patients in the one-stop intervention group and 708 patients in the single-catheter ablation group.Meta analysis showed that in terms of effectiveness,there was no significant difference in the recurrence rate of atrial arrhythmia between the two groups during the follow-up period(OR=1.24,95%CI:0.94～1.65,I2=0%,P=0.13).In terms of safety,there were no significant differences in the incidence of perioperative complications(OR=1.53,95%CI:0.92～2.54,I2=0%,P=0.10),thrombotic events(OR=0.61,95%CI:0.20～1.82,I2=0%,P=0.37),and bleeding events(OR=0.72,95%CI:0.28～1.82,I2=0%,P=0.48)between the two groups during follow-up.Conclusion One-stop intervention for atrial fibrillation is similar to catheter ablation alone in terms of efficacy and safety.One-stop interventional therapy may be an effective and safe strategy for patients with atrial fibrillation who are at high risk of stroke and unable to take long-term oral anticoagulants or who have contraindications to anticoagulation.