Endocardial-Epicardial Catheter Ablation Versus Endocardial Catheter Ablation Alone for Ventricular Arrhythmia in Patients With Structural Heart Disease (Meta-Analysis of Reconstructed Time-to-Event Data)
<p>Endocardial-epicardial (Endo-epi) catheter ablation (CA) has been shown to reduce the rate of ventricular arrhythmia (VA) ablation in patients with structural heart disease (SHD). However, the effectiveness of this technique compared with endocardial (Endo) CA alone remains uncertain. This...
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2023
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| _version_ | 1864513564165799936 |
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| author | Nour Shaheen (14034758) |
| author2 | Ahmed Shaheen (15205087) Mohamed Elmasry (14254660) Abdulqadir J. Nashwan (16328993) |
| author2_role | author author author |
| author_facet | Nour Shaheen (14034758) Ahmed Shaheen (15205087) Mohamed Elmasry (14254660) Abdulqadir J. Nashwan (16328993) |
| author_role | author |
| dc.creator.none.fl_str_mv | Nour Shaheen (14034758) Ahmed Shaheen (15205087) Mohamed Elmasry (14254660) Abdulqadir J. Nashwan (16328993) |
| dc.date.none.fl_str_mv | 2023-06-28T00:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1016/j.amjcard.2023.05.068 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Endocardial-Epicardial_Catheter_Ablation_Versus_Endocardial_Catheter_Ablation_Alone_for_Ventricular_Arrhythmia_in_Patients_With_Structural_Heart_Disease_Meta-Analysis_of_Reconstructed_Time-to-Event_Data_/23633736 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Cardiovascular medicine and haematology Mathematical sciences Statistics Ventricular Arrhythmia Endocardial-Epicardial Heart Disease Endocardial Catheter Ablation |
| dc.title.none.fl_str_mv | Endocardial-Epicardial Catheter Ablation Versus Endocardial Catheter Ablation Alone for Ventricular Arrhythmia in Patients With Structural Heart Disease (Meta-Analysis of Reconstructed Time-to-Event Data) |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <p>Endocardial-epicardial (Endo-epi) catheter ablation (CA) has been shown to reduce the rate of ventricular arrhythmia (VA) ablation in patients with structural heart disease (SHD). However, the effectiveness of this technique compared with endocardial (Endo) CA alone remains uncertain. This meta-analysis aims to compare the effectiveness of Endo-epi versus Endo alone in reducing the risk of VA recurrence in patients with SHD. We searched PubMed, Embase, and Cochrane Central Register with a comprehensive strategy. We used reconstructed time-to-event data to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for VA recurrence accompanied by at least one Kaplan–Meier curve for ventricular tachycardia recurrence. Our meta-analysis included 11 studies with a total of 977 patients. Endo-epi had a significantly lower risk of VA recurrence compared with those treated with Endo alone (HR 0.43, 95% CI 0.32 to 0.57, p <0.001). Subgroup analysis based on the type of cardiomyopathy revealed that patients with arrhythmogenic right ventricular cardiomyopathy and ischemic cardiomyopathy (ICM) benefited significantly from Endo-epi in reducing the risk of VA recurrence (HR 0.835, 0.55 to 0.87, p <0.021). However, there was no significant difference with non-ICM (HR 0.440, 0.55 to 0.87, p <0.33). The analysis of conditional survival showed that patients who remained free of VA recurrence for 5 years after the procedure had a very low probability of developing VA recurrence thereafter. In conclusion, Endo-epi CA is more effective than Endo CA alone in reducing the risk of VA recurrence in patients with SHD, especially those with arrhythmogenic right ventricular cardiomyopathy and ICM. </p> <h2>Other Information</h2> <p>Published in: The American Journal of Cardiology<br> License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br> See article on publisher's website: <a href="https://doi.org/10.1016/j.amjcard.2023.05.068" target="_blank">https://doi.org/10.1016/j.amjcard.2023.05.068</a> </p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_fb218c53be942e04d4300e6ca6f0cd08 |
| identifier_str_mv | 10.1016/j.amjcard.2023.05.068 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/23633736 |
| publishDate | 2023 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Endocardial-Epicardial Catheter Ablation Versus Endocardial Catheter Ablation Alone for Ventricular Arrhythmia in Patients With Structural Heart Disease (Meta-Analysis of Reconstructed Time-to-Event Data)Nour Shaheen (14034758)Ahmed Shaheen (15205087)Mohamed Elmasry (14254660)Abdulqadir J. Nashwan (16328993)Biomedical and clinical sciencesCardiovascular medicine and haematologyMathematical sciencesStatisticsVentricular ArrhythmiaEndocardial-EpicardialHeart DiseaseEndocardial Catheter Ablation<p>Endocardial-epicardial (Endo-epi) catheter ablation (CA) has been shown to reduce the rate of ventricular arrhythmia (VA) ablation in patients with structural heart disease (SHD). However, the effectiveness of this technique compared with endocardial (Endo) CA alone remains uncertain. This meta-analysis aims to compare the effectiveness of Endo-epi versus Endo alone in reducing the risk of VA recurrence in patients with SHD. We searched PubMed, Embase, and Cochrane Central Register with a comprehensive strategy. We used reconstructed time-to-event data to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for VA recurrence accompanied by at least one Kaplan–Meier curve for ventricular tachycardia recurrence. Our meta-analysis included 11 studies with a total of 977 patients. Endo-epi had a significantly lower risk of VA recurrence compared with those treated with Endo alone (HR 0.43, 95% CI 0.32 to 0.57, p <0.001). Subgroup analysis based on the type of cardiomyopathy revealed that patients with arrhythmogenic right ventricular cardiomyopathy and ischemic cardiomyopathy (ICM) benefited significantly from Endo-epi in reducing the risk of VA recurrence (HR 0.835, 0.55 to 0.87, p <0.021). However, there was no significant difference with non-ICM (HR 0.440, 0.55 to 0.87, p <0.33). The analysis of conditional survival showed that patients who remained free of VA recurrence for 5 years after the procedure had a very low probability of developing VA recurrence thereafter. In conclusion, Endo-epi CA is more effective than Endo CA alone in reducing the risk of VA recurrence in patients with SHD, especially those with arrhythmogenic right ventricular cardiomyopathy and ICM. </p> <h2>Other Information</h2> <p>Published in: The American Journal of Cardiology<br> License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br> See article on publisher's website: <a href="https://doi.org/10.1016/j.amjcard.2023.05.068" target="_blank">https://doi.org/10.1016/j.amjcard.2023.05.068</a> </p>2023-06-28T00:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.amjcard.2023.05.068https://figshare.com/articles/journal_contribution/Endocardial-Epicardial_Catheter_Ablation_Versus_Endocardial_Catheter_Ablation_Alone_for_Ventricular_Arrhythmia_in_Patients_With_Structural_Heart_Disease_Meta-Analysis_of_Reconstructed_Time-to-Event_Data_/23633736CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/236337362023-06-28T00:00:00Z |
| spellingShingle | Endocardial-Epicardial Catheter Ablation Versus Endocardial Catheter Ablation Alone for Ventricular Arrhythmia in Patients With Structural Heart Disease (Meta-Analysis of Reconstructed Time-to-Event Data) Nour Shaheen (14034758) Biomedical and clinical sciences Cardiovascular medicine and haematology Mathematical sciences Statistics Ventricular Arrhythmia Endocardial-Epicardial Heart Disease Endocardial Catheter Ablation |
| status_str | publishedVersion |
| title | Endocardial-Epicardial Catheter Ablation Versus Endocardial Catheter Ablation Alone for Ventricular Arrhythmia in Patients With Structural Heart Disease (Meta-Analysis of Reconstructed Time-to-Event Data) |
| title_full | Endocardial-Epicardial Catheter Ablation Versus Endocardial Catheter Ablation Alone for Ventricular Arrhythmia in Patients With Structural Heart Disease (Meta-Analysis of Reconstructed Time-to-Event Data) |
| title_fullStr | Endocardial-Epicardial Catheter Ablation Versus Endocardial Catheter Ablation Alone for Ventricular Arrhythmia in Patients With Structural Heart Disease (Meta-Analysis of Reconstructed Time-to-Event Data) |
| title_full_unstemmed | Endocardial-Epicardial Catheter Ablation Versus Endocardial Catheter Ablation Alone for Ventricular Arrhythmia in Patients With Structural Heart Disease (Meta-Analysis of Reconstructed Time-to-Event Data) |
| title_short | Endocardial-Epicardial Catheter Ablation Versus Endocardial Catheter Ablation Alone for Ventricular Arrhythmia in Patients With Structural Heart Disease (Meta-Analysis of Reconstructed Time-to-Event Data) |
| title_sort | Endocardial-Epicardial Catheter Ablation Versus Endocardial Catheter Ablation Alone for Ventricular Arrhythmia in Patients With Structural Heart Disease (Meta-Analysis of Reconstructed Time-to-Event Data) |
| topic | Biomedical and clinical sciences Cardiovascular medicine and haematology Mathematical sciences Statistics Ventricular Arrhythmia Endocardial-Epicardial Heart Disease Endocardial Catheter Ablation |