TY - JOUR
T1 - Outcomes of concomitant surgical ablation in patients undergoing surgical myectomy for hypertrophic obstructive cardiomyopathy
T2 - A systematic review and meta-analysis
AU - Kharbanda, Rohit K.
AU - Ramdat Misier, Nawin L.
AU - van den Eynde, Jef
AU - el Mathari, Sulayman
AU - Tomšič, Anton
AU - Palmen, Meindert
AU - Klautz, Robert J. M.
N1 - Publisher Copyright: © 2023 The Authors
PY - 2023/9/15
Y1 - 2023/9/15
N2 - Objective: Studies investigating the efficacy of concomitant surgical atrial fibrillation (AF) ablation in hypertrophic obstructive cardiomyopathy (HOCM) patients undergoing myectomy are scarce and limited in terms of sample size. We aim to summarize current outcomes of concomitant surgical AF ablation in HOCM patients undergoing surgical myectomy. Methods: This systematic review and meta-analysis was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We included all studies reporting any of the following outcomes of concomitant surgical AF ablation in HOCM patients: freedom from recurrence of AF, overall survival and complications. Outcomes were evaluated using traditional meta-analysis at given time-points and using pooled Kaplan-Meier curves. Results: A total of 13 studies were included, resulting in a total of 616 individual patients available for analysis. AF was paroxysmal in 68.1% of the patients (95% CI 56.0–78.2%; I2 = 87.1%; 8 studies, 583 participants). The majority of patients (86.2%) underwent either conventional Cox Maze III or IV (95% CI 39.7–98.3%; I2 = 92.4%; 8 studies, 616 patients) procedure. The incidence of early post-operative pacemaker implantation was 6.1% (95% CI 3.1–11.8%). Overall survival at 3, 5 and 7 years was 95.6% (95% CI 93.4–97.9%), 93.6% (95% CI 90.8–96.5%) and 90.5% (95% CI 86.5–94.6%), respectively. Freedom from recurrent AF at 3, 5 and 7 years was 77.6% (95% CI 73.7–81.7%), 70.6% (95% CI 65.8–75.7) and 63.2% (95% CI 56.2–73.8%), respectively. Conclusion: This meta-analysis supports concomitant surgical AF ablation at the time of surgical myectomy in HOCM patients, as it seems to be safe and effective in terminating AF.
AB - Objective: Studies investigating the efficacy of concomitant surgical atrial fibrillation (AF) ablation in hypertrophic obstructive cardiomyopathy (HOCM) patients undergoing myectomy are scarce and limited in terms of sample size. We aim to summarize current outcomes of concomitant surgical AF ablation in HOCM patients undergoing surgical myectomy. Methods: This systematic review and meta-analysis was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We included all studies reporting any of the following outcomes of concomitant surgical AF ablation in HOCM patients: freedom from recurrence of AF, overall survival and complications. Outcomes were evaluated using traditional meta-analysis at given time-points and using pooled Kaplan-Meier curves. Results: A total of 13 studies were included, resulting in a total of 616 individual patients available for analysis. AF was paroxysmal in 68.1% of the patients (95% CI 56.0–78.2%; I2 = 87.1%; 8 studies, 583 participants). The majority of patients (86.2%) underwent either conventional Cox Maze III or IV (95% CI 39.7–98.3%; I2 = 92.4%; 8 studies, 616 patients) procedure. The incidence of early post-operative pacemaker implantation was 6.1% (95% CI 3.1–11.8%). Overall survival at 3, 5 and 7 years was 95.6% (95% CI 93.4–97.9%), 93.6% (95% CI 90.8–96.5%) and 90.5% (95% CI 86.5–94.6%), respectively. Freedom from recurrent AF at 3, 5 and 7 years was 77.6% (95% CI 73.7–81.7%), 70.6% (95% CI 65.8–75.7) and 63.2% (95% CI 56.2–73.8%), respectively. Conclusion: This meta-analysis supports concomitant surgical AF ablation at the time of surgical myectomy in HOCM patients, as it seems to be safe and effective in terminating AF.
KW - Atrial fibrillation
KW - Hypertrophic obstructive cardiomyopathy
KW - Myectomy
KW - Surgical ablation
UR - http://www.scopus.com/inward/record.url?scp=85163368715&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ijcard.2023.05.049
DO - https://doi.org/10.1016/j.ijcard.2023.05.049
M3 - Article
C2 - 37263356
SN - 0167-5273
VL - 387
JO - International journal of cardiology
JF - International journal of cardiology
M1 - 131099
ER -