心房颤动导管消融相关无症状脑梗塞发生率Meta分析

Meta-analysis for the Incidence Rate of Asymptomatic Cerebral Embolism in Patients With Atrial Fibrillation After Catheter Ablation

目的：应用Meta分析综合评价心房颤动（房颤）导管消融相关无症状脑梗塞发生率，为房颤导管消融术相关无症状脑梗塞预防提供基础资料。方法：系统检索PubMed、Springer、Elsevier-SDOL、EMbase、SSCI、VIP、中国生物医学文献数据库（CBM）、中国期刊全文数据库（CNKI）、万方数据资源系统、中国优秀硕士学位论文全文数据库和中国重要会议论文全文数据库中2006年-2014年发表有关房颤导管消融相关无症状脑梗塞研究文献。利用疾病患病率或发病率质量准则评价文献质量，应用R软件进行Meta分析，合并房颤导管消融相关无症状脑梗塞发生率，采用敏感性分析评价研究对象类型和研究质量对结果的影响。结果：共纳入合格文献16篇，总样本量1258人，房颤导管消融相关无症状脑梗塞发生率为17.46％（95％可信区间：13.13-22.8）。通过敏感性分析，删除文献质量评价得分最低和研究对象为部分年龄段人群的文献后，Meta分析的结果无明显变化。结论：房颤导管消融相关无症状脑梗塞发生率处在一个较高水平，是房颤导管消融以降低栓塞事件过程中必须面对的一个严峻问题，应得到更多关注，并采取相应的干预措施。

Objective： To generally assess the incidence rate of asymptomatic cerebral embolism in patients with atrial ifbrillation （AF） after catheter ablation by Meta-analysis in order to provide the basic information for cerebral embolism prevention. Methods： We systemically searched the publications of PubMed, Springer, Elsevier-SDOL, EMbase, SSCI, VIP, Chinese biomedical literature database （CBM）, Chinese journal full-text database （CNKI）, Wanfang data resource, Chinese outstanding master’s degree thesis database and Chinese important articles published in full-text database from 2006 to 2014 for the literatures regarding the asymptomatic cerebral embolism in AF patients after catheter ablation. The literature quality was evaluated by Loney criteria, Meta-analysis was conducted by R software to assess the incidence rate of asymptomatic cerebral embolism after ablation, the impact of type and quality for research were estimated by sensitivity analysis. Results： A total of 16 qualiifed literatures were enrolled in our research with 1258 patients. The incidence rate of asymptomatic cerebral embolism in AF patients after ablation was 17.46% （95% CI 13.13% - 22.84%）. The sensitivity analysis indicated that excluding the literature at the lowest quality and the literature only with the part of age group, the Meta-analysis result had no obvious changes. Conclusion： The asymptomatic cerebral embolism in AF patients after ablation is at a relatively high prevalence condition, it should be seriously emphasized and with the active intervention in clinical practice.