Systematic Review of Sacubitril/Valsartan in Preventing Late Recurrence of Atrial Fibrillation after Radiofrequency Ablation

HU Yucai; QIU Boyong; XING Zuoying; DONG Zhengwei; WANG Yongxia

doi:10.12102/j.issn.1672-1349.2025.15.003

Abstract：Objective:To evaluate the effectiveness of sacubitril/valsartan on late recurrence of atrial fibrillation after radiofrequency ablation.Methods:The databases of PubMed,the Cochrane Library,Web of Science,CNKI,WanFang Data,and VIP Data were searched to collect randomized controlled trials(RCTs)evaluating sacubitril/valsartan in the treatment of atrial fibrillation after radiofrequency ablation.The retrieval time was from the establishment of the database to May 1,2024.Two researchers independently screened the literature,extracted the data,evaluated the risk of bias in the included studies,and performed a Meta-analysis using RevMan 5.3 software.Results:A total of 10 RCTs involving 929 patients were included.The results of Meta-analysis showed that compared with the control group,the late recurrence rate(OR=0.39,95%CI 0.30-0.51,P＜0.000 01),left atrial diameter(LAD)(MD=-0.25,95%CI-0.32--0.18,P＜0.000 01),left atrial volume index(LAVI)(MD=-5.06,95%CI-7.13--2.99,P＜0.000 01),left ventricular end-diastolic diameter(LVEDD)(MD=-0.16,95%CI-0.25--0.07,P＜0.000 01),N-terminal pro-brain natriuretic peptide(NT-proBNP)(MD=-133.87,95%CI-157.61--110.13,P＜0.000 01),C-reactive protein(CRP)(MD=-0.98,95%CI-1.16--0.81,P＜0.000 01),interleukin-6(IL-6)(MD=-3.33,95%CI-3.62--3.05,P＜0.000 01)decreased significantly in the experimental group,and left ventricular ejection fraction(LVEF)(MD=4.71,95%CI4.13-5.28,P＜0.000 01)increased significantly.Conclusion:Current research indicates that sacubitril/valsartan is effective in preventing late recurrence after radiofrequency ablation of atrial fibrillation.Due to the limited quantity and quality of the included literature,the above conclusions need to be verified by more high-quality studies.