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The long-term efficacy and safety of combining ablation and left atrial appendage closure: A systematic review and meta-analysis
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  • Feng Li,
  • Jin-Yu Sun,
  • Li-Da Wu,
  • Jian-feng Hao,
  • Ru-Xing Wang
Feng Li
Wuxi People's Hospital
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Jin-Yu Sun
Wuxi People’s Hospital Affiliated to Nanjing Medical University
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Li-Da Wu
Wuxi People's Hospital Affiliated to Nanjing Medical University
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Jian-feng Hao
Wuxi Tongren Rehabilitation Hospital
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Ru-Xing Wang
Wuxi People's Hospital Affiliated to Nanjing Medical University
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Abstract

Backgroud The long-term outcomes of this combined procedure remain elusive. This meta-analysis aimed to assess the long-term efficacy and safety of combined procedure. Methods PubMed, Embase, Cochrane Library, and Web of Science were systematically searched from the establishment of databases to 1 January 2021. Studies on the long-term (defined as a mean follow-up of approximately 12 months or longer) efficacy and safety outcomes of combined ablation and LAAC were included for meta-analysis. Results A total of 16 studies comprising 1,428 patients were included in the meta-analysis. The pooled long term freedom rate from atrial arrhythmia was 0.66 (95% confidence interval [CI], 0.59-0.71), long-term successful rate sealing of LAAC was 1.00 (95% CI, 1.00-1.00), and ischemic stroke/transient ischemic attack/systemic embolism during follow-up was 0.01 (95% CI, 0.00-0.02). Meanwhile, the rates of peri-procedural adverse events included phrenic nerve palsy, intracoronary air embolus, device embolization, peri-procedural death of 0.00 (95% CI, 0.00-0.00), procedure-related bleeding events of 0.03 (95% CI, 0.02-0.04), and pericardial effusion requiring or not requiring intervention of 0.00 (95% CI, 0.00-0.01). Moreover, the rates of long-term adverse events rate included device dislocation, intracranial bleeding, and pericardial effusion requiring or not requiring intervention, and all-cause mortality of 0.00 (95% CI, 0.00-0.00), device embolization of 0.01 (95% CI, 0.00-0.01), and other bleeding events of 0.01 (95% CI, 0.00-0.03). Conclusion This meta-analysis suggests that the strategy of combined atrial ablation and LAAC is effective and safe during long-term follow-up

Peer review status:IN REVISION

25 Apr 2021Submitted to Journal of Cardiovascular Electrophysiology
06 May 2021Assigned to Editor
06 May 2021Submission Checks Completed
09 May 2021Reviewer(s) Assigned
13 Jun 2021Review(s) Completed, Editorial Evaluation Pending
18 Jun 2021Editorial Decision: Revise Minor