Clinical outcomes after ablation and pacing therapy for atrial fibrillation : a meta-analysis.
BACKGROUND
Radiofrequency ablation of the atrioventricular node and permanent pacing are used for symptomatic relief in patients with medically refractory atrial fibrillation. In this study, meta-analysis was used to clarify clinical outcomes and survival after ablation and pacing therapy using data from the published literature.


RESULTS
We used 21 studies with a total of 1181 patients in the meta-analysis. All patients had medically refractory atrial tachyarrhythmias, primarily atrial fibrillation (97%). Nineteen measures of clinical outcome, encompassing quality of life, ventricular function, exercise duration, and healthcare use, were derived from the studies. The meta-analysis demonstrated significant improvement after ablation and pacing therapy in all outcome measures except fractional shortening, which demonstrated a trend toward improvement (P=0.08). Ejection fraction did show significant improvement (P<0.001). The calculated 1-year total and sudden death mortality rates after ablation and pacing therapy were 6.3% and 2.0%, respectively.


CONCLUSIONS
Ablation and pacing therapy improves a broad range of clinical outcomes for patients with medically refractory atrial fibrillation. The calculated 1-year mortality rates after this therapy are low and comparable with medical therapy.
Wood
M A
MA
Virginia Commonwealth University/Medical College of Virginia, Richmond, VA 23298-0053, USA.
Brown-Mahoney
C
C
Kay
G N
GN
Ellenbogen
K A
KA
D000368:Aged; D001281:Atrial Fibrillation / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D016896:Treatment Outcome