title: Effect of catheter ablation versus antiarrhythmic drugs on atrial fibrillation: A meta-analysis of randomized controlled trials.
abstract: The aim of the present study was to compare the health outcomes of catheter ablation therapy against those of antiarrhythmic drugs (AADs) in the management of atrial fibrillation (AF). The effects of catheter ablation and AADs on a number of parameters were compared, including AF recurrence, all-cause mortality, stroke/transient ischemic attack (TIA) and quality of life (QoL). A systematic literature search of PubMed, Embase and the Cochrane Central Register of Controlled Trials was conducted to obtain relevant randomized controlled trials. The relative risks (RRs) and 95% confidence intervals (CIs) of AF recurrence, all-cause mortality and stroke/TIA between catheter ablation and AADs were subsequently calculated. Weighted mean differences (WMDs) and 95% CIs were used to evaluate the QoL between the two therapy groups. In total, 11 randomized trials, which included 1,763 AF patients, were eligible for the meta-analysis. Overall, the results indicated that catheter ablation produces superior outcomes compared with AADs in reducing AF recurrence (RR, 0.47; 95% CI, 0.38-0.58; P<0.001) and improving the QoL (physical component summary: WMD, 2.23; 95% CI, 0.24-4.21; P=0.03; mental component summary: WMD, 2.69; 95% CI, 0.04-5.35; P=0.05). However, no statistically significant difference was identified between the two groups with regard to the incidence of all-cause mortality (RR, 0.87; 95% CI, 0.37-2.06; P=0.76) and stroke/TIA (RR, 1.83; 95% CI, 0.73-4.55; P=0.20). In summary, catheter ablation was demonstrated to markedly reduce AF recurrence and improve QoL when compared with AAD therapy. However, the incidence rates of all-cause mortality and stroke/TIA were comparable between catheter ablation and AAD therapy.
authors.affiliation: Department of Thoracic Surgery, Linyi People's Hospital, Linyi, Shandong 276000, P.R. China.
authors.forename: Lei-Zhi
authors.initials: LZ
authors.lastname: Shi
authors.affiliation: Department of Thoracic Surgery, Linyi People's Hospital, Linyi, Shandong 276000, P.R. China.
authors.forename: Rui
authors.initials: R
authors.lastname: Heng
authors.affiliation: Department of Internal Medicine, Linyi People's Hospital, Linyi, Shandong 276000, P.R. China.
authors.forename: Shi-Min
authors.initials: SM
authors.lastname: Liu
authors.affiliation: Department of Thoracic Surgery, Linyi People's Hospital, Linyi, Shandong 276000, P.R. China.
authors.forename: Fei-Yan
authors.initials: FY
authors.lastname: Leng
keywords: antiarrhythmic drugs; atrial fibrillation; catheter ablation; meta-analysis