PDF(Pubmed)
Abstract：
UNASSIGNED: Inherited Primary Arrhythmias Syndromes (IPAS), especially Brugada syndrome (BrS), have been associated with arrhythmogenic substrates that can be targeted through ablation. This meta-analysis evaluated the outcomes of catheter ablation (CA) in different types of IPAS based on procedural guidance and location.
UNASSIGNED: A systematic search was conducted across multiple databases to identify studies reporting on ventricular arrhythmia (VA) events before and after CA in IPAS, including BrS, Long-QT syndrome (LQTS), Early repolarization syndrome (ERS), and Idiopathic ventricular fibrillation (IVF). The primary outcomes were VA recurrence and VA burden, evaluated through conditional subgroup analysis. Procedural data were collected as secondary outcomes.
UNASSIGNED: A total of 21 studies involving 584 IPAS patients who underwent CA were included. Following a mean follow-up duration of 33.5 months, substrate-based ablation demonstrated efficacy in reducing VA recurrence across all types of IPAS [RR 0.23; 95% CI (0.13-0.39); p < .001; I 2 = 74%]. However, activation guidance ablation was found to be effective only in IVF cases. Although recurrences still occurred, CA was successful in reducing VA burden [MD -4.70; 95% CI (-6.11-(-3.29); p < .001; I 2 = 74%]. The mean size of arrhythmogenic substrate was 15.70 cm2 [95% CI (12.34-19.99 cm2)], predominantly distributed in the epicardial right ventricular outflow tract (RVOT) in BrS cases and LQTS [Proportion 0.99; 95% CI (0.96-1.00) and Proportion 0.82; 95% CI ( 0.59-1.00), respectively].
UNASSIGNED: Substrate-based CA has demonstrated effective prevention of VA and reduction in VA burden in IPAS cases.
UNASSIGNED: A systematic search was conducted across multiple databases to identify studies reporting on ventricular arrhythmia (VA) events before and after CA in IPAS, including BrS, Long-QT syndrome (LQTS), Early repolarization syndrome (ERS), and Idiopathic ventricular fibrillation (IVF). The primary outcomes were VA recurrence and VA burden, evaluated through conditional subgroup analysis. Procedural data were collected as secondary outcomes.
UNASSIGNED: A total of 21 studies involving 584 IPAS patients who underwent CA were included. Following a mean follow-up duration of 33.5 months, substrate-based ablation demonstrated efficacy in reducing VA recurrence across all types of IPAS [RR 0.23; 95% CI (0.13-0.39); p < .001; I 2 = 74%]. However, activation guidance ablation was found to be effective only in IVF cases. Although recurrences still occurred, CA was successful in reducing VA burden [MD -4.70; 95% CI (-6.11-(-3.29); p < .001; I 2 = 74%]. The mean size of arrhythmogenic substrate was 15.70 cm2 [95% CI (12.34-19.99 cm2)], predominantly distributed in the epicardial right ventricular outflow tract (RVOT) in BrS cases and LQTS [Proportion 0.99; 95% CI (0.96-1.00) and Proportion 0.82; 95% CI ( 0.59-1.00), respectively].
UNASSIGNED: Substrate-based CA has demonstrated effective prevention of VA and reduction in VA burden in IPAS cases.
摘要：
■遗传性原发性心律失常综合征（IPAS），尤其是Brugada综合征（BrS），与可以通过消融靶向的致心律失常基质有关。该荟萃分析根据程序指导和位置评估了不同类型IPAS的导管消融（CA）结果。
■在多个数据库中进行了系统搜索，以确定IPAS中CA前后室性心律失常（VA）事件的研究报告，包括BrS,长QT综合征（LQTS），早期复极综合征(ERS),和特发性心室纤颤（IVF）。主要结果是VA复发和VA负担，通过条件子群分析进行评估。收集手术数据作为次要结果。
■共纳入21项研究，涉及584名接受CA的IPAS患者。平均随访时间为33.5个月，在所有类型的IPAS中,基于基质的消融在减少VA复发方面均有疗效[RR0.23;95%CI(0.13-0.39);p<.001;I2=74%].然而,发现激活引导消融仅在IVF病例中有效.虽然复发仍然发生，CA成功降低了VA负担[MD-4.70;95%CI(-6.11-(-3.29);p<.001;I2=74%]。致心律失常底物的平均大小为15.70cm2[95%CI(12.34-19.99cm2)],在BrS病例和LQTS中主要分布在心外膜右心室流出道（RVOT）[比例0.99;95％CI（0.96-1.00）和比例0.82;95％CI（0.59-1.00），分别]。
■在IPAS病例中，基于底物的CA已证明有效预防VA并减少VA负担。
■在多个数据库中进行了系统搜索，以确定IPAS中CA前后室性心律失常（VA）事件的研究报告，包括BrS,长QT综合征（LQTS），早期复极综合征(ERS),和特发性心室纤颤（IVF）。主要结果是VA复发和VA负担，通过条件子群分析进行评估。收集手术数据作为次要结果。
■共纳入21项研究，涉及584名接受CA的IPAS患者。平均随访时间为33.5个月，在所有类型的IPAS中,基于基质的消融在减少VA复发方面均有疗效[RR0.23;95%CI(0.13-0.39);p<.001;I2=74%].然而,发现激活引导消融仅在IVF病例中有效.虽然复发仍然发生，CA成功降低了VA负担[MD-4.70;95%CI(-6.11-(-3.29);p<.001;I2=74%]。致心律失常底物的平均大小为15.70cm2[95%CI(12.34-19.99cm2)],在BrS病例和LQTS中主要分布在心外膜右心室流出道（RVOT）[比例0.99;95％CI（0.96-1.00）和比例0.82;95％CI（0.59-1.00），分别]。
■在IPAS病例中，基于底物的CA已证明有效预防VA并减少VA负担。
