title: Outcomes of catheter ablation of atrial fibrillation in patients with hypertrophic cardiomyopathy: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Over the past decade, catheter ablation (CA) has become an established therapy for symptomatic atrial fibrillation (AF). Atrial fibrillation is common in hypertrophic cardiomyopathy (HCM) patients, and restoring sinus rhythm is of great clinical benefit to them. Therefore, we conducted a systematic review and meta-analysis of the available data to evaluate the effectiveness and safety of CA for AF in patients with HCM.
  
  
  RESULTS
  Six databases were searched to identify studies describing outcomes of CA of AF in HCM patients with a mean follow-up of ≥12 months after the index procedure. The following data were extracted: (i) single-procedure success, (ii) multiple-procedure success, and (iii) drug-free success. Fifteen studies involving 531 patients were included. Single-procedure freedom from atrial arrhythmia at the latest follow-up was 45.5% [95% confidence interval (CI): 34.8-56.2%]. With multiple procedures, the final success rate was 66.1% (95% CI: 55.3-76.9%) overall, 71.8% (95% CI: 61.6-82.0%) in paroxysmal AF, and 47.5% (95% CI: 36.0-59.0%) in non-paroxysmal AF. Without anti-arrhythmic drugs (AADs), single-procedure success rate at latest follow-up was 32.9% (95% CI: 21.7-41.1%); after multiple procedures, this raised to 50.4% (95% CI: 39.2-61.6%). The incidence of serious periprocedural complications was acceptable [5.1% (95% CI: 2.8-9.6%)]. Substantial heterogeneity (I(2)> 50%) was noted in the above groups.
  
  
  CONCLUSIONS
  Catheter ablation of AF in patients with HCM is feasible, although more repeat procedures and AAD are needed to prevent AF recurrence.
authors.affiliation: Department of Cardiology, The Second Affiliated Hospital of Nantong University, Nantong 226001, China.
authors.forename: Dong-Sheng
authors.initials: DS
authors.lastname: Zhao
authors.affiliation: Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong 226001, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Shen
authors.affiliation: Department of Cardiology, The Second Affiliated Hospital of Nantong University, Nantong 226001, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, The Second Affiliated Hospital of Nantong University, Nantong 226001, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Lin
authors.affiliation: Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong 226001, China.
authors.forename: Yi-Hua
authors.initials: YH
authors.lastname: Lu
authors.affiliation: Institute of Liver Diseases, Changzhi College, Shanxi Medical University, Taiyuan 030001, China.
authors.forename: Bang-Tao
authors.initials: BT
authors.lastname: Chen
authors.affiliation: Department of Cardiology, The Second Affiliated Hospital of Nantong University, Nantong 226001, China.
authors.forename: Lin-Sheng
authors.initials: LS
authors.lastname: Shi
authors.affiliation: Department of Cardiology, The Second Affiliated Hospital of Nantong University, Nantong 226001, China ntsyhjf@126.com lhh226001@126.com.
authors.forename: Jian-Fei
authors.initials: JF
authors.lastname: Huang
authors.affiliation: Department of Cardiology, The Second Affiliated Hospital of Nantong University, Nantong 226001, China ntsyhjf@126.com lhh226001@126.com.
authors.forename: Hui-He
authors.initials: HH
authors.lastname: Lu
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006328:Cardiac Catheterization / Q000009:adverse effects; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications* / Q000175:diagnosis; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents
keywords: Ablation; Arrhythmia; Atrial fibrillation; Hypertrophic cardiomyopathy