PDF(Pubmed)
Abstract：
Atrial fibrillation (AF) management has witnessed a paradigm shift, with an increasing emphasis on rhythm control strategies. This systematic review aims to comprehensively assess and compare the efficacy and safety of catheter ablation versus medical therapy in the treatment of AF. A systematic search was conducted across major electronic databases, including PubMed, Embase, and the Cochrane Library, from inception to the present. Randomized controlled trials (RCTs) and observational studies comparing catheter ablation with medical therapy for AF were included. The primary outcomes included rhythm control success, recurrence rates, and adverse events. Secondary outcomes encompassed quality of life, hospitalization rates, and mortality. A total of six studies met the inclusion criteria, comprising 2,859 participants. Catheter ablation significantly improved rhythm control success compared to medical therapy. Subgroup analyses demonstrated variations in outcomes based on patient characteristics, procedural techniques, and follow-up durations. Recurrence rates favored ablation; however, ablation was associated with a higher incidence of minor complications and major adverse events. Catheter ablation demonstrates superior efficacy in achieving and maintaining rhythm control compared to medical therapy in the management of AF. Despite the increased risk of procedural complications, the overall safety profile remains acceptable. This systematic review provides valuable insights for clinicians and informs shared decision-making between patients and healthcare providers when choosing between catheter ablation and medical therapy for AF treatment.
摘要：
心房颤动(AF)管理见证了范式的转变，越来越重视节奏控制策略。本系统评价旨在全面评估和比较导管消融与药物治疗房颤的疗效和安全性。对主要电子数据库进行了系统检索,包括PubMed,Embase,还有Cochrane图书馆,从开始到现在。纳入随机对照试验（RCT）和观察性研究，比较导管消融与药物治疗房颤。主要结果包括节律控制成功，复发率,和不良事件。次要结果包括生活质量，住院率，和死亡率。共有六项研究符合纳入标准,包括2,859名参与者。与药物治疗相比，导管消融显着提高了节律控制的成功率。亚组分析显示基于患者特征的结果差异，程序技术，和后续持续时间。复发率有利于消融；然而，消融与较高的次要并发症和主要不良事件发生率相关.与药物治疗相比，导管消融在实现和维持心律控制方面具有出色的疗效。尽管手术并发症的风险增加，总体安全状况仍可接受.本系统综述为临床医生提供了有价值的见解，并在选择导管消融和药物治疗进行房颤治疗时，告知患者和医疗保健提供者之间的共同决策。
